Real-time monitoring of radiofrequency ablation of liver tumors using thermal-dose calculation by MR temperature imaging: initial results in nine patients, including follow-up.
To assess the practical feasibility and effectiveness of real-time magnetic resonance (MR) temperature monitoring for the radiofrequency (RF) ablation of liver tumours in a clinical setting, nine patients (aged 49-87 years, five men and four women) with one malignant tumour (14-50 mm, eight hepatocellular carcinomas and one colorectal metastasis), were treated by 12-min RF ablation using a 1.5-T closed magnet for real-time temperature monitoring. The clinical monopolar RF device was filtered at 64 MHz to avoid electromagnetic interference. Real-time computation of thermal-dose (TD) maps, based on Sapareto and Dewey's equation, was studied to determine its ability to provide a clear end-point of the RF procedure. Absence of local recurrence on follow-up MR images obtained 45 days after the RF ablation was used to assess the apoptotic and necrotic prediction obtained by real-time TD maps. Seven out of nine tumours were completely ablated according to the real-time TD maps. Compared with 45-day follow-up MR images, TD maps accurately predicted two primary treatment failures, but were not relevant in the later progression of one case of secondary local tumour. The real-time TD concept is a feasible and promising monitoring method for the RF ablation of liver tumours.
Lepetit-Coiffé
Matthieu
M
Laboratoire Imagerie Moléculaire et Fonctionnelle, de la Physiologie à la Thérapie CNRS UMR 5231, Université Victor Segalen Bordeaux 2, 146 rue Léo Saignat - Case 117, 33076, Bordeaux Cedex, France. matthieu.lepetit-coiffe@imf.u-bordeaux2.fr
Laumonier
Hervé
H
Seror
Olivier
O
Quesson
Bruno
B
Sesay
Musa-Bahazid
MB
Moonen
Chrit T W
CT
Grenier
Nicolas
N
Trillaud
Hervé
H
D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D003199:Computer Systems; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013817:Thermography / Q000379:methods*; D016896:Treatment Outcome