Open-configuration MR-guided microwave thermocoagulation therapy for metastatic liver tumors from breast cancer.
BACKGROUND
Liver metastases from breast cancer are associated with a poor prognosis, however, local control with microwave thermocoagulation therapy has been used in certain subgroups of these patients in the past decade. In this study, open-configuration magnetic resonance (MR) -guided microwave thermocoagulation therapy was used for metastatic liver tumors from breast cancer, and the efficacy of this treatment was assessed.


METHODS
Between June 2000 and April 2004, we used MR-guided microwave thermocoagulation therapy on 11 nodules in 8 patients with metastatic liver tumors from breast cancer. The procedure was carried out under general anesthesia. A 0.5 T open-configuration MR system and a microwave coagulator were used. Near-real-time MR images and real-time temperature images were collected and displayed on the monitor. The MR-compatible thoracoscope was used and combined with MR imaging guidance. Navigation software, a 3D Slicer, was installed and customized.


RESULTS
The customized navigation software displayed near-real-time MR images. The percutaneous puncture into the tumors was successful in all cases. No mortality or major complications occurred as a result of the procedures. Five of the 8 patients are alive with new metastatic foci with a mean observation period of 25.9 months.


CONCLUSIONS
We developed several devices to allow safe, easy, and accurate MR-guided microwave thermocoagulation therapy of liver tumors. Open-configuration MR-guided microwave thermocoagulation therapy appears to be a feasible method for tumor ablation of metastatic liver tumors from breast cancer.
Abe
Hajime
H
Division of General Surgery, Department of Surgery, Shiga University of Medical Science, Seta-Tsukinowa, Otsu, Shiga, 520-2192, Japan. abe@belle.shiga-med.ac.jp
Kurumi
Yoshimasa
Y
Naka
Shigeyuki
S
Shiomi
Hisanori
H
Umeda
Tomoko
T
Naitoh
Hiroyuki
H
Endo
Yoshihiro
Y
Hanasawa
Kazuyoshi
K
Morikawa
Shigehiro
S
Tani
Tohru
T
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001224:Aspartic Acid / Q000097:blood; D001943:Breast Neoplasms / Q000473:pathology*; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged
D001224:Aspartic Acid; D000410:Alanine Transaminase