Abstract
Objective
To evaluate the technical effectiveness, technical success and patient safety of MR-guided radiofrequency (RF) ablation of liver malignancies using a wide-bore 1.5-T MR system.
Methods
In 110 patients, 56 primary liver lesions and 157 liver metastases were treated in 157 sessions using percutaneous RF ablation. Mean lesion diameter was 20 mm (range 4–54 mm). All planning, procedural and post-interventional control MR investigations were carried out using a wide-bore 1.5-T MR system. Technical success was assessed by a contrast-enhanced MR liver examination immediately after the intervention. Technique effectiveness was assessed by dynamic hepatic MR study 1 month post ablation; mean follow-up period was 24.2 months (range 5–44).
Results
Technical success and technique effectiveness were achieved in 210/213 lesions (98.6 %). In 18/210 lesions (8.6 %), local tumour progression occurred 4–28 months after therapy. Seven of these 18 lesions were treated in a second session achieving complete ablation, 6 other lesions were referred to surgery. Overall RF effectiveness rate was 199/213 (93.4 %); overall therapy success (including surgery) was 205/213 (96.2 %). Two major complications (1.3 %) (bleeding and infected biloma) and 14 (8.9 %) minor complications occurred subsequent to 157 interventions.
Conclusion
Wide-bore MR-guided RF ablation is a safe and effective treatment option for liver lesions.
Key Points
• Magnetic resonance-guided radiofrequency ablation offers various options for monitoring therapy.
• All steps of RF ablation carried out in 1.5-T wide-bore system.
• Therapeutic decisions were based on T1-weighted imaging.
• Technical success and technical effectiveness were high.
• Local tumour progression rate was 8.6 % over a 24-month mean follow-up.
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Acknowledgement
Thanks to Li Pan from Siemens Research for the development and provision of real-time MR sequences for applicator placement.
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Rempp, H., Waibel, L., Hoffmann, R. et al. MR-guided radiofrequency ablation using a wide-bore 1.5-T MR system: clinical results of 213 treated liver lesions. Eur Radiol 22, 1972–1982 (2012). https://doi.org/10.1007/s00330-012-2438-x
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DOI: https://doi.org/10.1007/s00330-012-2438-x