title: Intraoperative contrast-enhanced MR-imaging as predictor of tissue damage during cryoablation of porcine liver.
abstract: This study evaluate intraoperative Magnetic Resonance Imaging (MRI) as predictor of tissue damage following cryoablation of porcine liver with and without concomitant hepatic vascular inflow occlusion. Inflow occlusion was used during freezing in 6 of 12 pigs included. The volumes of the procedural ice-balls were estimated from MR images. Immediately after thawing contrast (MnDPDP) enhanced MRI was performed to estimate the volume of the cryolesion. Four days after ablation MRI was repeated of the in-vivo and the ex-vivo liver. Photography was performed of the sliced liver specimens to estimate the volumes of the lesions. The intraoperative volume of the cryolesion as shown by contrast enhanced MRI corresponded well to the ice-ball volume for lesions made without vascular occlusion (difference 0.3 +/- 0.9 cm(3), p = 0.239). For lesions made during occlusion the volume of the intraoperative cryolesion was larger than the corresponding ice-ball (difference 7.5 +/- 3.3 cm(3), p = 0.003). The volume of the cryolesions as estimated from histopathology four days after freezing and contrast enhanced MRI immediately after freezing corresponded well for lesions made with (difference -2.6 +/- 4.5 cm(3), p = 0.110) and without vascular occlusion (difference -0.5 +/- 2.3 cm(3), p = 0.695). Intraoperative MnDPDP-enhanced MRI of the cryolesion is predictive of the tissue damage induced during cryoablation of porcine liver. The procedural ice-ball is not, if induced during inflow occlusion.
authors.affiliation: Interventional Centre and Surgical Department, Rikshospitalet, 0027 Oslo, Norway. tom.mala@rikshospitalet.no
authors.forename: Tom
authors.initials: T
authors.lastname: Mala
authors.forename: Lars
authors.initials: L
authors.lastname: Frich
authors.forename: Lars
authors.initials: L
authors.lastname: Aurdal
authors.forename: Ole Petter
authors.initials: OP
authors.lastname: Clausen
authors.forename: Bjorn
authors.initials: B
authors.lastname: Edwin
authors.forename: Odd
authors.initials: O
authors.lastname: Soreide
authors.forename: Ivar
authors.initials: I
authors.lastname: Gladhaug
mesh_terms: D000818:Animals; D003287:Contrast Media; D003452:Cryosurgery; D004492:Edetic Acid / Q000031:analogs & derivatives*; D007430:Intraoperative Care; D008099:Liver / Q000473:pathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008345:Manganese; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives*; D013552:Swine
chemical_list: D003287:Contrast Media; D008345:Manganese; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid