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MR-Guided High-Power Microwave Ablation in Hepatic Malignancies: Initial Results in Clinical Routine

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Title: MR-Guided High-Power Microwave Ablation in Hepatic Malignancies: Initial Results in Clinical Routine
Authors: Moritz T. Winkelmann, Georg Gohla, Jens Kübler, Jakob Weiß, Stephan Clasen, Konstantin Nikolaou, Rüdiger Hoffmann
Source: Cardiovasc Intervent Radiol
Publisher Information: Springer Science and Business Media LLC, 2020.
Publication Year: 2020
Subject Terms: Ablation Techniques, Adult, Male, Carcinoma, Hepatocellular, Liver Neoplasms, Middle Aged, Magnetic Resonance Imaging, 3. Good health, Treatment Outcome, Therapy, Computer-Assisted, Female [MeSH], Clinical Investigation, Therapy, Computer-Assisted/methods [MeSH], Aged [MeSH], Liver Neoplasms/diagnosis [MeSH], Adult [MeSH], Humans [MeSH], Liver Neoplasms/therapy [MeSH], Liver neoplasms, Treatment Outcome [MeSH], Carcinoma, Hepatocellular/diagnosis [MeSH], Duration of therapy, Middle Aged [MeSH], Carcinoma, Hepatocellular/therapy [MeSH], Neoplasm Staging [MeSH], Ablation Techniques/methods [MeSH], Male [MeSH], Patient Safety [MeSH], Microwaves/therapeutic use [MeSH], Ablation techniques, Magnetic Resonance Imaging/methods [MeSH], Microwave ablation, Interventional magnetic resonance imaging, Non-Vascular Interventions, Humans, Female, Patient Safety, Microwaves, Aged, Neoplasm Staging
Description: Purpose Evaluation of technique effectiveness, patient safety and ablation parameters of MR-guided microwave ablation in hepatic malignancies using an MR-conditional high-power microwave ablation system. Materials and Methods Institutional review board approval and informed patient consent were obtained. Patients who underwent MR-guided microwave ablation of hepatic malignancies in a 1.5T wide-bore scanner using a perfusion-cooled high-power microwave ablation system with a maximum generator power of 150 W were included. Ablation parameters comprising procedure durations, net ablation duration, applicator positions and ablation zone dimensions were recorded. Adverse events were classified according to the CIRSE classification system. Technique effectiveness was assessed after 1 month. Follow-up was conducted with contrast-enhanced MRI and ranged from 1 to 20 months (mean: 6.1 ± 5.4 months). Results Twenty-one consecutive patients (age: 63.4 ± 10.5 years; 5 female) underwent 22 procedures for 28 tumours (9 hepatocellular carcinomas, 19 metastases) with a mean tumour diameter of 14.6 ± 5.4 mm (range: 6–24 mm). Technique effectiveness was achieved in all lesions. Tumours were treated using 1.7 ± 0.7 applicator positions (range: 1–3). Mean energy and ablation duration per tumour were 75.3 ± 35.4 kJ and 13.3 ± 6.2 min, respectively. Coagulation zone short- and long-axis diameters were 29.1 ± 6.4 mm and 39.9 ± 7.4 mm, respectively. Average procedure duration was 146.4 ± 26.2 min (range: 98–187 min). One minor complication was reported. Five patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed during initial follow-up. Conclusion MR-guided high-power microwave ablation provides safe and effective treatment of hepatic malignancies with short ablation times and within acceptable procedure durations.
Document Type: Article
Other literature type
Language: English
ISSN: 1432-086X
0174-1551
DOI: 10.1007/s00270-020-02584-5
Access URL: https://link.springer.com/content/pdf/10.1007/s00270-020-02584-5.pdf
https://pubmed.ncbi.nlm.nih.gov/32699978
https://pubmed.ncbi.nlm.nih.gov/32699978/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591402
https://link.springer.com/content/pdf/10.1007/s00270-020-02584-5.pdf
https://link.springer.com/article/10.1007/s00270-020-02584-5
https://repository.publisso.de/resource/frl:6470136
Rights: CC BY
Accession Number: edsair.doi.dedup.....e40199126a2cf503e20403098bc3a7fb
Database: OpenAIRE
Description
Abstract:Purpose Evaluation of technique effectiveness, patient safety and ablation parameters of MR-guided microwave ablation in hepatic malignancies using an MR-conditional high-power microwave ablation system. Materials and Methods Institutional review board approval and informed patient consent were obtained. Patients who underwent MR-guided microwave ablation of hepatic malignancies in a 1.5T wide-bore scanner using a perfusion-cooled high-power microwave ablation system with a maximum generator power of 150 W were included. Ablation parameters comprising procedure durations, net ablation duration, applicator positions and ablation zone dimensions were recorded. Adverse events were classified according to the CIRSE classification system. Technique effectiveness was assessed after 1 month. Follow-up was conducted with contrast-enhanced MRI and ranged from 1 to 20 months (mean: 6.1 ± 5.4 months). Results Twenty-one consecutive patients (age: 63.4 ± 10.5 years; 5 female) underwent 22 procedures for 28 tumours (9 hepatocellular carcinomas, 19 metastases) with a mean tumour diameter of 14.6 ± 5.4 mm (range: 6–24 mm). Technique effectiveness was achieved in all lesions. Tumours were treated using 1.7 ± 0.7 applicator positions (range: 1–3). Mean energy and ablation duration per tumour were 75.3 ± 35.4 kJ and 13.3 ± 6.2 min, respectively. Coagulation zone short- and long-axis diameters were 29.1 ± 6.4 mm and 39.9 ± 7.4 mm, respectively. Average procedure duration was 146.4 ± 26.2 min (range: 98–187 min). One minor complication was reported. Five patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed during initial follow-up. Conclusion MR-guided high-power microwave ablation provides safe and effective treatment of hepatic malignancies with short ablation times and within acceptable procedure durations.
ISSN:1432086X
01741551
DOI:10.1007/s00270-020-02584-5