nach oben

European Radiology

Erschienen in:

01.09.2012 | Interventional

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

verfasst von: Hansjörg Rempp, Lorenz Waibel, Rüdiger Hoffmann, Claus D. Claussen, Philippe L. Pereira, Stephan Clasen

Erschienen in: European Radiology | Ausgabe 9/2012

Einloggen, um Zugang zu erhalten

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.

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 234:961–967PubMedCrossRef

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

Goldberg SN, Ahmed M (2002) Minimally invasive image-guided therapies for hepatocellular carcinoma. J Clin Gastroenterol 35:S115–S129PubMedCrossRef

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 221:159–166PubMedCrossRef

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

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

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

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

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 42:945–949PubMedCrossRef

10.

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

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 175:1619–1625PubMed

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 15:144–157PubMedCrossRef

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 54:1151–1156PubMedCrossRef

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 29:1364–1373PubMedCrossRef

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 242:158–171PubMedCrossRef

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 178:1147–1151PubMed

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 8:30–35PubMedCrossRef

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 8:40–47PubMedCrossRef

19.

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

20.

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

21.

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

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 212:876–884PubMed

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 215:365–372PubMed

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 29:1308–1316PubMedCrossRef

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 194:523–529PubMedCrossRef

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–S390PubMedCrossRef

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 13:1100–1105PubMed

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 172:692–700PubMedCrossRef

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 180:1537–1545PubMed

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 19:342–348PubMedCrossRef

32.

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

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 18:1449–1455PubMedCrossRef

34.

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

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 15:385–392PubMedCrossRef

36.

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

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 34:188–192PubMedCrossRef

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–S23PubMedCrossRef

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 49:43–54PubMed

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):98–103PubMedCrossRef

41.

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

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 26:1043–1052PubMedCrossRef

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 18:323–328PubMed

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 11:914–921PubMedCrossRef

45.

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

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 129:122–130PubMedCrossRef

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 42:535–540PubMedCrossRef

48.

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

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 12:183–191PubMedCrossRef

Titel: MR-guided radiofrequency ablation using a wide-bore 1.5-T MR system: clinical results of 213 treated liver lesions
verfasst von: Hansjörg Rempp
Lorenz Waibel
Rüdiger Hoffmann
Claus D. Claussen
Philippe L. Pereira
Stephan Clasen
Publikationsdatum: 01.09.2012
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 9/2012
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2438-x

Neu im Fachgebiet Radiologie

18.04.2024 | Pädiatrische Notfallmedizin | Nachrichten

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

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

Abstract

Objective

Methods

Results

Conclusion

Key Points

Neu im Fachgebiet Radiologie

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Studie bestätigt Potenzial von KI in der Radiologie

Quantitative Angiografie könnte IVUS-Alternative darstellen

Update Radiologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Objective

Methods

Results

Conclusion

Key Points

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2012

Prediction of early response to uterine arterial embolisation of adenomyosis: value of T2 signal intensity ratio of adenomyosis

18F-FDG uptake by spleen helps rapidly predict the dose level after total body irradiation in a Tibetan minipig model

Diagnostic performance of whole-body MRI for the detection of persistent or relapsing disease in multiple myeloma after stem cell transplantation

Axial T2* mapping in intervertebral discs: a new technique for assessment of intervertebral disc degeneration

Magnetic resonance imaging of the knee at 3 and 7 Tesla: a comparison using dedicated multi-channel coils and optimised 2D and 3D protocols

Diagnostic performance of stress myocardial perfusion imaging for coronary artery disease: a systematic review and meta-analysis

Neu im Fachgebiet Radiologie

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Studie bestätigt Potenzial von KI in der Radiologie

Quantitative Angiografie könnte IVUS-Alternative darstellen

Update Radiologie