title: MR-guided laser thermal ablation of primary and secondary liver tumours.
abstract: 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.
authors.affiliation: Department of Interventional MRI, St Mary's Hospital Campus, Faculty of Medicine, Imperial College, Praed St, London, UK.
authors.forename: E A
authors.initials: EA
authors.lastname: Dick
authors.forename: R
authors.initials: R
authors.lastname: Joarder
authors.forename: M
authors.initials: M
authors.lastname: de Jode
authors.forename: S D
authors.initials: SD
authors.lastname: Taylor-Robinson
authors.forename: H C
authors.initials: HC
authors.lastname: Thomas
authors.forename: G R
authors.initials: GR
authors.lastname: Foster
authors.forename: W M W
authors.initials: WM
authors.lastname: Gedroyc
mesh_terms: 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