MR-guided liver tumor ablation employing open high-field 1.0T MRI for image-guided brachytherapy

作者：Ricke Jens^*; Thormann Markus; Ludewig Matthias; Jungnickel Kerstin; Grosser Oliver; Wybranski Christian; Peters Nils; Hass Peter; Bunke Juergen; Fischbach Frank

来源：European Radiology, 2010, 20(8): 1985-1993.

DOI：10.1007/s00330-010-1751-5

• MR intervention
• Liver malignancies
• Brachytherapy
• Minimally invasive oncology

To determine the feasibility and safety of image-guided brachytherapy employing a modified open high-field MR system.
This is a follow-up study of a development project enabling technologies for interventional use of 1.0T open MRI. Modifications included coils and in-bore visualization, fluoroscopic sequences and user interfaces. We recruited 104 patients with 224 liver malignancies to receive MR-guided brachytherapy. Interventions were performed > 20 min after Gd-EOB-DTPA. We recorded interventional parameters including the intervention time (from acquisition of the first scout until the final sequence for brachytherapy treatment planning). Two reviewers assessed MR-fluoroscopic images in comparison to plain CT as used in CT intervention, applying a rating scale of 1-10. Statistical analysis included Friedman and Kendall's W tests.
We employed freehand puncture with interactive dynamic imaging for navigation. Technical success rate was 218 complete ablations in 224 tumours (97%). The median intervention time was 61 min. We recorded no adverse events related to the use of MRI. No major complications occurred. The rate of minor complications was 4%. Local control at 3 months was 96%. Superiority of MR-fluoroscopic, Gd-EOB-DTPA-enhanced images over plain CT was highly significant (P < 0.001).
MR-guided brachytherapy employing open high-field MRI is feasible and safe.

• 出版日期2010-8