MR-guided Radiofrequency Ablation of Hapatocellular Carcinoma: Long-term Effectiveness

作者:Clasen Stephan*; Rempp Hansjoerg; Boss Andreas; Schmidt Diethard; Fritz Jan; Schraml Christina; Schick Fritz; Claussen Claus D; Pereira Philippe L
来源:Journal of Vascular and Interventional Radiology, 2011, 22(6): 762-770.
DOI:10.1016/j.jvir.2011.03.006

摘要

Purpose: To evaluate long-term effectiveness of magnetic resonance (MR)-guided radiofrequency (RF) ablation of hepatocellular carcinoma (HCC).
Materials and Methods: This prospective study was approved by the institutional review board. In 20 patients, 28 HCCs (mean diameter, 28.0 mm; range, 6-58 mm) were treated with 25 sessions of MR-guided RF ablation. Previous chemoembolization had been performed in nine HCCs with diameters greater than 3 cm. The entire RF ablation procedures were carried out on a 0.2-T open MR system. Placement of MR-compatible internally cooled electrodes was performed under MR fluoroscopic imaging with fast gradient-echo sequences. Therapeutic assessment was based on dynamic MR-imaging (1.5 T) at a mean follow-up of 24.2 months (range, 6-52 mo).
Results: MR-guided RF ablation was technically successful in all 25 sessions (100%), as assessed at the end of each session. T2-weighted sequences were accurate to monitor the ablation zone and supported guidance of overlapping ablations if necessary. Technique effectiveness, defined as complete ablation confirmed at MR imaging 4 months after RF ablation, was achieved in 27 of 28 HCCs (96.4%). To achieve complete ablation, 25 of 27 tumors (92.6%) were treated in a single session and two tumors were treated twice. In one tumor initially defined as having been treated with technically effective RF ablation, local tumor progression was detected more than 4 months after ablation. Consequently, the available follow-up indicated complete ablation in 26 of 28 HCCs (92.9%). There was one major complication (4.0%) and one minor complication (4.0%).
Conclusions: On a long-term basis, MR-guided RF ablation is an effective therapy option in the treatment of HCC.

  • 出版日期2011-6