MR-guided radiofrequency ablation of hepatocellular carcinoma: Long-term effectiveness

Stephan Clasen, Hansjörg Rempp, Andreas Boss, Diethard Schmidt, Jan Fritz, Christina Schraml, Fritz Schick, Claus D. Claussen, Philippe L. Pereira

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)762-770
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume22
Issue number6
DOIs
StatePublished - Jun 2011

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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