Skip to main content

Advertisement

Log in

MR-guided radiofrequency ablation using a wide-bore 1.5-T MR system: clinical results of 213 treated liver lesions

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Lencioni R, Cioni D, Crocetti L et al (2005) Early-stage hepatocellular carcinoma in patients with cirrhosis: long-term results of percutaneous image-guided radiofrequency ablation. Radiology 234:961–967

    Article  PubMed  Google Scholar 

  2. Gillams AR, Lees WR (2009) Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation. Eur Radiol 19:1206–1213

    Article  PubMed  CAS  Google Scholar 

  3. Goldberg SN, Ahmed M (2002) Minimally invasive image-guided therapies for hepatocellular carcinoma. J Clin Gastroenterol 35:S115–S129

    Article  PubMed  CAS  Google Scholar 

  4. Solbiati L, Livraghi T, Goldberg SN et al (2001) Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology 221:159–166

    Article  PubMed  CAS  Google Scholar 

  5. Bonastre J, De Baere T, Elias D et al (2007) Cost of radiofrequency ablation in the treatment of hepatic malignancies. Gastroenterol Clin Biol 31:828–835

    Article  PubMed  Google Scholar 

  6. Llovet JM (2005) Updated treatment approach to hepatocellular carcinoma. J Gastroenterol 40:225–235

    Article  PubMed  Google Scholar 

  7. Bruix J, Sherman M (2005) Management of hepatocellular carcinoma. Hepatology 42:1208–1236

    Article  PubMed  Google Scholar 

  8. Kudo M (2010) Radiofrequency ablation for hepatocellular carcinoma: updated review in 2010. Oncology 78(Suppl 1):113–124

    Article  PubMed  Google Scholar 

  9. Lee WS, Yun SH, Chun HK et al (2008) Clinical outcomes of hepatic resection and radiofrequency ablation in patients with solitary colorectal liver metastasis. J Clin Gastroenterol 42:945–949

    Article  PubMed  Google Scholar 

  10. Aloia TA, Vauthey JN, Loyer EM et al (2006) Solitary colorectal liver metastasis: resection determines outcome. Arch Surg 141:460–466, discussion 466–467

    Article  PubMed  Google Scholar 

  11. de Baere T, Elias D, Dromain C et al (2000) Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than 1 year. AJR Am J Roentgenol 175:1619–1625

    PubMed  Google Scholar 

  12. Mulier S, Ni Y, Jamart J, Michel L, Marchal G, Ruers T (2008) Radiofrequency ablation versus resection for resectable colorectal liver metastases: time for a randomized trial? Ann Surg Oncol 15:144–157

    Article  PubMed  Google Scholar 

  13. Lin SM, Lin CJ, Lin CC, Hsu CW, Chen YC (2005) Randomised controlled trial comparing percutaneous radiofrequency thermal ablation, percutaneous ethanol injection, and percutaneous acetic acid injection to treat hepatocellular carcinoma of 3 cm or less. Gut 54:1151–1156

    Article  PubMed  CAS  Google Scholar 

  14. Machi J, Bueno RS, Wong LL (2005) Long-term follow-up outcome of patients undergoing radiofrequency ablation for unresectable hepatocellular carcinoma. World J Surg 29:1364–1373

    Article  PubMed  Google Scholar 

  15. Mulier S, Ni Y, Jamart J, Ruers T, Marchal G, Michel L (2005) Local recurrence after hepatic radiofrequency coagulation: multivariate meta-analysis and review of contributing factors. Ann Surg 242:158–171

    Article  PubMed  Google Scholar 

  16. Leyendecker JR, Dodd GD 3rd, Halff GA et al (2002) Sonographically observed echogenic response during intraoperative radiofrequency ablation of cirrhotic livers: pathologic correlation. AJR Am J Roentgenol 178:1147–1151

    PubMed  Google Scholar 

  17. Pacella CM, Bizzarri G, Anelli V et al (1998) Evaluation of the vascular pattern of hepatocellular carcinoma with dynamic computed tomography and its use in identifying optimal temporal windows for helical computed tomography. Eur Radiol 8:30–35

    Article  PubMed  CAS  Google Scholar 

  18. Lewin JS, Connell CF, Duerk JL et al (1998) Interactive MRI-guided radiofrequency interstitial thermal ablation of abdominal tumors: clinical trial for evaluation of safety and feasibility. J Magn Reson Imaging 8:40–47

    Article  PubMed  CAS  Google Scholar 

  19. McDannold N, Jolesz F (2000) Magnetic resonance image-guided thermal ablations. Top Magn Reson Imaging 11:191–202

    Article  PubMed  CAS  Google Scholar 

  20. Clasen S, Pereira PL (2008) Magnetic resonance guidance for radiofrequency ablation of liver tumors. J Magn Reson Imaging 27:421–433

    Article  PubMed  Google Scholar 

  21. Hindmann JC (1966) Proton resonance shift of water in the gas and liquid state. J Chem Phys 44:4582–4592

    Article  Google Scholar 

  22. Rempp H, Hoffmann R, Roland J et al (2011) Threshold-based prediction of the coagulation zone in sequential temperature mapping in MR-guided radiofrequency ablation of liver tumours. Eur Radiol. doi:10.1007/s00330-011-2335-8

  23. Rofsky NM, Lee VS, Laub G et al (1999) Abdominal MR imaging with a volumetric interpolated breath-hold examination. Radiology 212:876–884

    PubMed  CAS  Google Scholar 

  24. Lee VS, Lavelle MT, Rofsky NM et al (2000) Hepatic MR imaging with a dynamic contrast-enhanced isotropic volumetric interpolated breath-hold examination: feasibility, reproducibility, and technical quality. Radiology 215:365–372

    PubMed  CAS  Google Scholar 

  25. Schraml C, Schwenzer NF, Clasen S et al (2009) Navigator respiratory-triggered diffusion-weighted imaging in the follow-up after hepatic radiofrequency ablation-initial results. J Magn Reson Imaging 29:1308–1316

    Article  PubMed  Google Scholar 

  26. Kierans AS, Elazzazi M, Braga L et al (2010) Thermoablative treatments for malignant liver lesions: 10-year experience of MRI appearances of treatment response. AJR Am J Roentgenol 194:523–529

    Article  PubMed  Google Scholar 

  27. Goldberg SN, Grassi CJ, Cardella JF et al (2009) Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol 20:S377–S390

    Article  PubMed  Google Scholar 

  28. Kelekis AD, Terraz S, Roggan A et al (2003) Percutaneous treatment of liver tumors with an adapted probe for cooled-tip, impedance-controlled radio-frequency ablation under open-magnet MR guidance: initial results. Eur Radiol 13:1100–1105

    PubMed  Google Scholar 

  29. Huppert PE, Trubenbach J, Schick F, Pereira P, Konig C, Claussen CD (2000) MRI-guided percutaneous radiofrequency ablation of hepatic neoplasms—first technical and clinical experiences. Rofo 172:692–700

    Article  PubMed  CAS  Google Scholar 

  30. Kettenbach J, Köstler W, Rücklinger E et al (2003) Percutaneous saline-enhanced radiofrequency ablation of unresectable hepatic tumors: initial experience in 26 patients. AJR Am J Roentgenol 180:1537–1545

    PubMed  Google Scholar 

  31. Mahnken AH, Buecker A, Spuentrup E et al (2004) MR-guided radiofrequency ablation of hepatic malignancies at 1.5T: initial results. J Magn Reson Imaging 19:342–348

    Article  PubMed  Google Scholar 

  32. Gaffke G, Gebauer B, Knollmann FD (2006) Use of semiflexible applicators for radiofrequency ablation of liver tumors. Cardiovasc Intervent Radiol 29:270–275

    Article  PubMed  CAS  Google Scholar 

  33. Boss A, Rempp H, Martirosian P et al (2008) Wide-bore 1.5 Tesla MR imagers for guidance and monitoring of radiofrequency ablation of renal cell carcinoma: initial experience on feasibility. Eur Radiol 18:1449–1455

    Article  PubMed  Google Scholar 

  34. Chen MH, Wei Y, Yan K et al (2006) Treatment strategy to optimize radiofrequency ablation for liver malignancies. J Vasc Interv Radiol 17:671–683

    Article  PubMed  Google Scholar 

  35. Aube C, Schmidt D, Brieger J et al (2004) Magnetic resonance imaging characteristics of six radiofrequency electrodes in a phantom study. J Vasc Interv Radiol 15:385–392

    Article  PubMed  Google Scholar 

  36. Bathe OF, Mahallati H (2007) MR-guided ablation of hepatocellular carcinoma aided by gadoxetic acid. J Surg Oncol 95:670–673

    Article  PubMed  Google Scholar 

  37. Fischbach F, Bunke J, Thormann M et al (2011) MR-guided freehand biopsy of liver lesions with fast continuous imaging using a 1.0-T open MRI scanner: experience in 50 patients. Cardiovasc Intervent Radiol 34:188–192

    Article  PubMed  Google Scholar 

  38. Solbiati L, Ierace T, Tonolini M, Cova L (2004) Guidance and monitoring of radiofrequency liver tumor ablation with contrast-enhanced ultrasound. Eur J Radiol 51(Suppl):S19–S23

    Article  PubMed  Google Scholar 

  39. Wiggermann P, Zuber-Jerger I, Zausig Y et al (2011) Contrast-enhanced ultrasound improves real-time imaging of ablation region during radiofrequency ablation: Preliminary results. Clin Hemorheol Microcirc 49:43–54

    PubMed  CAS  Google Scholar 

  40. Takahashi S, Kudo M, Chung H et al (2007) Initial treatment response is essential to improve survival in patients with hepatocellular carcinoma who underwent curative radiofrequency ablation therapy. Oncology 72(Suppl 1):98–103

    Article  PubMed  Google Scholar 

  41. Clasen S, Rempp H, Boss A et al (2011) MR-guided radiofrequency ablation of hepatocellular carcinoma: long-term effectiveness. J Vasc Interv Radiol 22:762–770

    Article  PubMed  Google Scholar 

  42. Clasen S, Boss A, Schmidt D et al (2007) MR-guided radiofrequency ablation in a 0.2-T open MR system: technical success and technique effectiveness in 100 liver tumors. J Magn Reson Imaging 26:1043–1052

    Article  PubMed  Google Scholar 

  43. Laspas F, Sotiropoulou E, Mylona S et al (2009) Computed tomography-guided radiofrequency ablation of hepatocellular carcinoma: treatment efficacy and complications. J Gastrointestin Liver Dis 18:323–328

    PubMed  Google Scholar 

  44. Buscarini L, Buscarini E, Di Stasi M, Vallisa D, Quaretti P, Rocca A (2001) Percutaneous radiofrequency ablation of small hepatocellular carcinoma: long-term results. Eur Radiol 11:914–921

    Article  PubMed  CAS  Google Scholar 

  45. Gillams AR, Lees WR (2008) Five-year survival following radiofrequency ablation of small, solitary, hepatic colorectal metastases. J Vasc Interv Radiol 19:712–717

    Article  PubMed  Google Scholar 

  46. Shiina S, Teratani T, Obi S et al (2005) A randomized controlled trial of radiofrequency ablation with ethanol injection for small hepatocellular carcinoma. Gastroenterology 129:122–130

    Article  PubMed  Google Scholar 

  47. Camma C, Di Marco V, Orlando A et al (2005) Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study. J Hepatol 42:535–540

    Article  PubMed  Google Scholar 

  48. Guglielmi A, Ruzzenente A, Battocchia A, Tonon A, Fracastoro G, Cordiano C (2003) Radiofrequency ablation of hepatocellular carcinoma in cirrhotic patients. Hepatogastroenterology 50:480–484

    PubMed  Google Scholar 

  49. Ng KK, Poon RT, Lo CM, Yuen J, Tso WK, Fan ST (2008) Analysis of recurrence pattern and its influence on survival outcome after radiofrequency ablation of hepatocellular carcinoma. J Gastrointest Surg 12:183–191

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

Thanks to Li Pan from Siemens Research for the development and provision of real-time MR sequences for applicator placement.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hansjörg Rempp.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-012-2438-x

Keywords

Navigation