title: MR-guided microwave ablation in hepatic tumours: initial results in clinical routine.
abstract: OBJECTIVE
  Evaluation of the technical success, patient safety and technical effectiveness of magnetic resonance (MR)-guided microwave ablation of hepatic malignancies.
  
  
  METHODS
  Institutional review board approval and informed patient consent were obtained. Fifteen patients (59.8 years ± 9.5) with 18 hepatic malignancies (7 hepatocellular carcinomas, 11 metastases) underwent MR-guided microwave ablation using a 1.5-T MR system. Mean tumour size was 15.4 mm ± 7.7 (7-37 mm). Technical success and ablation zone diameters were assessed by post-ablative MR imaging. Technique effectiveness was assessed after 1 month. Complications were classified according to the Common Terminology Criteria for Adverse Events (CTCAE). Mean follow-up was 5.8 months ± 2.6 (1-10 months).
  
  
  RESULTS
  Technical success and technique effectiveness were achieved in all lesions. Lesions were treated using 2.5 ± 1.2 applicator positions. Mean energy and ablation duration per tumour were 37.6 kJ ± 21.7 (9-87 kJ) and 24.7 min ± 11.1 (7-49 min), respectively. Coagulation zone short- and long-axis diameters were 31.5 mm ± 10.5 (16-65 mm) and 52.7 mm ± 15.4 (27-94 mm), respectively. Two CTCAE-2-complications occurred (pneumothorax, pleural effusion). Seven patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed.
  
  
  CONCLUSIONS
  Microwave ablation is feasible under near real-time MR guidance and provides effective treatment of hepatic malignancies in one session.
  
  
  CONCLUSIONS
  • Planning, applicator placement and therapy monitoring are possible without using contrast enhancement • Energy transmission from the generator to the scanner room is safely possible • MR-guided microwave ablation provides effective treatment of hepatic malignancies in one session • Therapy monitoring is possible without applicator retraction from the ablation site.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany. Ruediger.Hoffmann@med.uni-tuebingen.de.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Hoffmann
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Rempp
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
authors.forename: David-Emanuel
authors.initials: DE
authors.lastname: Keßler
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
authors.forename: Jakob
authors.initials: J
authors.lastname: Weiß
authors.affiliation: Department of Radiology, Minimally Invasive Therapies and Nuclear Medicine, SLK-Kliniken Heilbronn GmbH, Am Gesundbrunnen 20-26, 74078, Heilbronn, Germany.
authors.forename: Philippe L
authors.initials: PL
authors.lastname: Pereira
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Clasen
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000601:surgery; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Hepatocellular carcinoma; Liver metastases; MR guidance; Magnetic resonance fluoroscopy; Microwave ablation