Real-time monitoring of radiofrequency ablation of liver tumors using thermal-dose calculation by MR temperature imaging: initial results in nine patients, including follow-up

To assess the practical feasibility and effectiveness of real-time magnetic resonance (MR) temperature monitoring for the radiofrequency (RF) ablation of liver tumours in a clinical setting, nine patients (aged 49–87 years, five men and four women) with one malignant tumour (14–50 mm, eight hepatoce...

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Bibliographic Details
Published in:European radiology 2010-01, Vol.20 (1), p.193-201
Main Authors: Lepetit-Coiffé, Matthieu, Laumonier, Hervé, Seror, Olivier, Quesson, Bruno, Sesay, Musa-Bahazid, Moonen, Chrit T. W., Grenier, Nicolas, Trillaud, Hervé
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Catheter Ablation - methods
Computer Systems
Diagnostic Radiology
Female
Humans
Imaging
Internal Medicine
Interventional
Interventional Radiology
Liver Neoplasms - diagnosis
Liver Neoplasms - surgery
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Radiology
Surgery, Computer-Assisted - methods
Thermography - methods
Treatment Outcome
Ultrasound
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Summary:To assess the practical feasibility and effectiveness of real-time magnetic resonance (MR) temperature monitoring for the radiofrequency (RF) ablation of liver tumours in a clinical setting, nine patients (aged 49–87 years, five men and four women) with one malignant tumour (14–50 mm, eight hepatocellular carcinomas and one colorectal metastasis), were treated by 12-min RF ablation using a 1.5-T closed magnet for real-time temperature monitoring. The clinical monopolar RF device was filtered at 64 MHz to avoid electromagnetic interference. Real-time computation of thermal-dose (TD) maps, based on Sapareto and Dewey’s equation, was studied to determine its ability to provide a clear end-point of the RF procedure. Absence of local recurrence on follow-up MR images obtained 45 days after the RF ablation was used to assess the apoptotic and necrotic prediction obtained by real-time TD maps. Seven out of nine tumours were completely ablated according to the real-time TD maps. Compared with 45-day follow-up MR images, TD maps accurately predicted two primary treatment failures, but were not relevant in the later progression of one case of secondary local tumour. The real-time TD concept is a feasible and promising monitoring method for the RF ablation of liver tumours.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-009-1532-1