Magnetic resonance-guided laparoscopic interstitial laser therapy of the liver.
BACKGROUND
There is a necessity for an imaging method during laparoscopy to get a three-dimensional access to the target. In this study we evaluated laparoscopic interstitial laser therapy of the liver under magnetic resonance imaging guidance.


METHODS
Five domestic pigs underwent laparoscopy in an open-configuration magnetic resonance system. Under simultaneous real-time magnetic resonance imaging interstitial laser therapy was applied to the liver. Magnetic resonance images, macroscopic aspects of the lesions, and light microscopic findings were compared.


RESULTS
The interventions could be safely performed. There was no image artifact caused by instruments or by the carbon dioxide. Dynamic gadolinium-enhanced imaging proved to significantly predict the macroscopic volume of the laser lesions.


CONCLUSIONS
Magnetic resonance-guided laparoscopic interstitial laser therapy of the liver combines the advantages of minimal invasive surgery and magnetic resonance imaging. Further development should focus on laparoscopic instruments and temperature sensitive sequences.
Klotz
H P
HP
Department of Surgery, University of Zurich Hospital, Switzerland.
Flury
R
R
Erhart
P
P
Steiner
P
P
Debatin
J F
JF
Uhlschmid
G
G
Largiadèr
F
F
D000818:Animals; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D010535:Laparoscopy / Q000379:methods*; D017075:Laser Coagulation / Q000379:methods*; D008099:Liver / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation; D008536:Meglumine; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009942:Organometallic Compounds; D013552:Swine
D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; D005682:Gadolinium; C072417:gadoterate meglumine