MR-guided laser thermal ablation of primary and secondary liver tumours.
OBJECTIVE
To test the hypothesis that magnetic resonance (MR)-guided hepatic tumour ablation is (i) safe and feasible, (ii) is associated with favourable patient survival, and (iii) decreases viable tumour.


METHODS
One hundred and twenty-five MR-guided laser thermal ablations (LTA) were performed on 35 patients with hepatocellular carcinoma (HCC, n=19), hepatic metastases (n=11, mainly colorectal) and carcinoid liver tumours (n=5).


RESULTS
Mean overall survival was 14.8 months (HCCs 14.6 months, metastases 15.2 months). Near real-time T1-weighted colourized thermal maps correlated moderately with follow-up gadolinium-enhanced MR imaging in predicting ablated tumour area (Pearson correlation coefficient=0.5). There was a significant difference in percentage enhancing pre- and post-LTA (Wilcoxon signed ranks test=0.0001). An average of 50.7% of tumour was ablated by each treatment. In patients with multiple liver tumours ablated tumours grew significantly less than untreated tumours (108%compared with 196% growth, follow-up period 5.8 months, WSRTp=0.07).


CONCLUSIONS
MR- guided LTA of primary and secondary liver tumours is safe, feasible, and significantly decreased amount of enhancing or viable tumour. MR-guided LTA produces a better survival in patients with HCC than would be expected in untreated patients, and has a mean survival in patients with metastases at least equal to the longest median survival in untreated patients.
Dick
E A
EA
Department of Interventional MRI, St Mary's Hospital Campus, Faculty of Medicine, Imperial College, Praed St, London, UK.
Joarder
R
R
de Jode
M
M
Taylor-Robinson
S D
SD
Thomas
H C
HC
Foster
G R
GR
Gedroyc
W M W
WM
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome