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Radiofrequency ablation of small liver malignancies under magnetic resonance guidance: progress in targeting and preliminary observations with temperature monitoring

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Abstract

Objectives

To evaluate the feasibility and effectiveness of magnetic resonance (MR)-guided radiofrequency (RF) ablation for small liver tumours with poor conspicuity on both contrast-enhanced ultrasonography (US) and computed tomography (CT), using fast navigation and temperature monitoring.

Methods

Sixteen malignant liver nodules (long-axis diameter, 0.6–2.4 cm) were treated with multipolar RF ablation on a 1.5-T wide-bore MR system in ten patients. Targeting was performed interactively, using a fast steady-state free precession sequence. Real-time MR-based temperature mapping was performed, using gradient echo–echo planar imaging (GRE-EPI) and hardware filtering. MR-specific treatment data were recorded. The mean follow-up time was 19 ± 7 months.

Results

Correct placement of RF electrodes was obtained in all procedures (image update, <500 ms; mean targeting time, 21 ± 11 min). MR thermometry was available for 14 of 16 nodules (88%) with an accuracy of 1.6°C in a non-heated region. No correlation was found between the size of the lethal thermal dose and the ablation zone at follow-up imaging. The primary and secondary effectiveness rates were 100% and 91%, respectively.

Conclusions

RF ablation of small liver tumours can be planned, targeted, monitored and controlled with MR imaging within acceptable procedure times. Temperature mapping is technically feasible, but the clinical benefit remains to be proven.

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Acknowledgments

The authors would like to thank André Roggan, PhD (Celon AG), Jörg Roland, PhD (Siemens Medical Solutions) and Erik Dumont, PhD (Image Guided Therapy) for valuable assistance and technical support.

This work was supported by the Swiss National Science Foundation–National Center for Competence in Research (NCCR), Computer-Aided Medical Interventions (CO-ME) Phase 2 Funding n° 51NF40–111383.

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Authors and Affiliations

  1. Department of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland

    Sylvain Terraz, Alexandru Cernicanu, Matthieu Lepetit-Coiffé, Magalie Viallon, Rares Salomir & Christoph D. Becker

  2. Department of Visceral Surgery and Transplantation, University Hospitals of Geneva, Geneva, Switzerland

    Gilles Mentha

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  1. Sylvain Terraz
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  2. Alexandru Cernicanu
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Correspondence to Sylvain Terraz.

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Terraz, S., Cernicanu, A., Lepetit-Coiffé, M. et al. Radiofrequency ablation of small liver malignancies under magnetic resonance guidance: progress in targeting and preliminary observations with temperature monitoring. Eur Radiol 20, 886–897 (2010). https://doi.org/10.1007/s00330-009-1611-3

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  • DOI: https://doi.org/10.1007/s00330-009-1611-3

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