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MRI guidance of infra-red laser liver tumour ablations, utilising an open MRI configuration system: technique and early progress.

Abstract：

BACKGROUND/AIMS:Primary and secondary liver tumours are a common clinical problem, with a poor prognosis in most cases. Surgical resection offers the best outcome, but is only appropriate for the minority. Thermal ablation techniques have been described, but the lack of an optimal means of monitoring has limited their use. We undertook a pilot study to assess the feasibility and safety of an integrated MR-guided laser thermoablation technique under local anaesthesia using a real-time colourisation thermal monitoring technique in a newly developed open MR scanner. METHODS:Liver tumours were punctured after the administration of intravenous Mangafodipir trisodium (MnDPDP) using real-time MR image guidance under local or general anaesthesia, and treated using a water-cooled interstitial fibre and a Nd-YAG laser source. Twenty-seven procedures were performed in 12 patients. Therapy was monitored using a real-time MR colourisation sequence. Thermoablation was followed by a colour change in a region of interest. RESULTS:Thermal lesions of mean size 3 cm in diameter were produced with a maximum size of 5 cm. Eight out of 12 patients were discharged the next day with few significant complications. Repeat procedures have been performed in seven of 12 patients. Two patients with lesions of 3 cm diameter have had complete tumour ablation with only one procedure. CONCLUSION:Percutaneous laser thermoablation for liver tumours performed as an integrated one-step technique in an open configuration MR scanner is described. It can be safely performed under local anaesthesia in the majority of patients, with few side effects. MR control shows the site and size of the evolving thermal lesions, allowing appropriate action to be taken in terms of further burns, time of application and power applied.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

de Jode MG,Lamb GM,Thomas HC,Taylor-Robinson SD,Gedroyc WM

doi

10.1016/s0168-8278(99)80234-7

subject

Has Abstract

pub_date

1999-08-01 00:00:00

pages

347-53

issue

eissn

0168-8278

issn

1600-0641

pii

S0168827899802347

journal_volume

pub_type

临床试验,杂志文章

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MRI guidance of infra-red laser liver tumour ablations, utilising an open MRI configuration system: technique and early progress.