title: Image-guided radiofrequency ablation of hepatocellular carcinoma (HCC): is MR guidance more effective than CT guidance?
abstract: OBJECTIVE
  The purpose of the study was to retrospectively compare technique effectiveness of computed tomography (CT)-guided versus magnetic resonance (MR)-guided radiofrequency (RF) ablation of hepatocellular carcinoma (HCC).
  
  
  METHODS
  In 35 consecutive patients 53 CT-guided (n=29) or MR-guided (n=24) ablation procedures were performed in the treatment of 56 (CT: 29; MR: 27) HCC. The entire ablation procedure was performed at a multislice CT-scanner or an interventional 0.2-Tesla MR-scanner. Assessment of treatment response was based on dynamic MR imaging at 1.5Tesla. The mean follow-up was 22.9 months. Primary technique effectiveness was assessed 4 months after ablation therapy. Secondary technique effectiveness was assessed 4 months after a facultative second ablation procedure. Primary and secondary technique effectiveness of CT-guided and MR-guided RF ablation was compared by using Chi-Square (likelihood ratio) test.
  
  
  RESULTS
  Primary technique effectiveness after a single session was achieved in 26/27 (96.3%) HCC after MR-guided RF ablation and 23/29 (79.3%) HCC after CT-guided RF ablation (Chi-Square: p=0.04). Secondary technique effectiveness was achieved in 26/27 (96.3%) HCC after MR-guided RF ablation and in 26/29 (89.7%) HCC after CT-guided RF ablation (Chi-Square: p=0.32). A local tumor progression was detected in 8/52 (15.4%) tumors after initial technique effectiveness. Major complications were detected after 3/53 (5.7%) ablation procedures.
  
  
  CONCLUSIONS
  CT-guided and MR-guided RF ablations are locally effective therapies in the treatment of HCC. Due to a higher rate of primary technique effectiveness MR-guided RF ablation may reduce the number of required sessions for complete tumor treatment.
authors.affiliation: University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany(1). Electronic address: stephan.clasen@med.uni-tuebingen.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: Clasen
authors.affiliation: University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany(1). Electronic address: hansjoerg.rempp@med.uni-tuebingen.de.
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Rempp
authors.affiliation: University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany(1). Electronic address: ruediger.hoffmann@med.uni-tuebingen.de.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Hoffmann
authors.affiliation: University Hospital, Department of Diagnostic and Interventional Radiology, Section of Experimental Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany(2). Electronic address: hansjoerg.graf@med.uni-tuebingen.de.
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Graf
authors.affiliation: SLK Clinic Heilbronn, Clinic for Radiology, Minimal-invasive Therapies, and Nuclear Medicine, Am Gesundbrunnen 20-26, 74078 Heilbronn, Germany(3). Electronic address: Philippe.Pereira@slk-kliniken.de.
authors.forename: Philippe L
authors.initials: PL
authors.lastname: Pereira
authors.affiliation: University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany(1). Electronic address: claus.claussen@med.uni-tuebingen.de.
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D012086:Reoperation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: Computed tomography; Hepatocellular carcinoma; Interventional MRI; Liver; Radiofrequency ablation