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- Title
MR-guided microwave ablation in hepatic tumours: initial results in clinical routine.
- Authors
Hoffmann, Rüdiger; Rempp, Hansjörg; Keßler, David-Emanuel; Weiß, Jakob; Pereira, Philippe; Nikolaou, Konstantin; Clasen, Stephan; Pereira, Philippe L
- Abstract
<bold>Objectives: </bold>Evaluation of the technical success, patient safety and technical effectiveness of magnetic resonance (MR)-guided microwave ablation of hepatic malignancies.<bold>Methods: </bold>Institutional review board approval and informed patient consent were obtained. Fifteen patients (59.8 years ± 9.5) with 18 hepatic malignancies (7 hepatocellular carcinomas, 11 metastases) underwent MR-guided microwave ablation using a 1.5-T MR system. Mean tumour size was 15.4 mm ± 7.7 (7-37 mm). Technical success and ablation zone diameters were assessed by post-ablative MR imaging. Technique effectiveness was assessed after 1 month. Complications were classified according to the Common Terminology Criteria for Adverse Events (CTCAE). Mean follow-up was 5.8 months ± 2.6 (1-10 months).<bold>Results: </bold>Technical success and technique effectiveness were achieved in all lesions. Lesions were treated using 2.5 ± 1.2 applicator positions. Mean energy and ablation duration per tumour were 37.6 kJ ± 21.7 (9-87 kJ) and 24.7 min ± 11.1 (7-49 min), respectively. Coagulation zone short- and long-axis diameters were 31.5 mm ± 10.5 (16-65 mm) and 52.7 mm ± 15.4 (27-94 mm), respectively. Two CTCAE-2-complications occurred (pneumothorax, pleural effusion). Seven patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed.<bold>Conclusions: </bold>Microwave ablation is feasible under near real-time MR guidance and provides effective treatment of hepatic malignancies in one session.<bold>Key Points: </bold>• Planning, applicator placement and therapy monitoring are possible without using contrast enhancement • Energy transmission from the generator to the scanner room is safely possible • MR-guided microwave ablation provides effective treatment of hepatic malignancies in one session • Therapy monitoring is possible without applicator retraction from the ablation site.
- Subjects
TUMORS; PATIENT safety; LIVER cancer; METASTASIS; ABLATION techniques; MAGNETIC resonance imaging
- Publication
European Radiology, 2017, Vol 27, Issue 4, p1467
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-016-4517-x