MR-guided microwave ablation in hepatic tumours: initial results in clinical routine

Hoffmann, Rüdiger; Rempp, Hansjörg; Keßler, David-Emanuel; Weiß, Jakob; Pereira, Philippe L.; Nikolaou, Konstantin; Clasen, Stephan

doi:10.1007/s00330-016-4517-x

Cited by 61 publications

(39 citation statements)

References 31 publications

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“…This prospective study was approved by the local ethics committee and all patients gave written informed consent. A subset of 15 patients included in the investigated cohort was previously analyzed in a pilot study investigating initial experiences in a clinical setting [21].…”

Section: Methodsmentioning

confidence: 99%

“…All procedures were performed by an alternating team of two trained radiologists with 4-12 years of experience in MRguided ablation procedures following a recently published protocol [21]. In brief, a 1.5 T closed-bore MR system (Magnetom ESPREE, Siemens Healthineers, Germany) was used for planning, targeting, monitoring and assessment of immediate treatment response.…”

Section: Ablation Procedures Protocolmentioning

confidence: 99%

“…The first routine post-procedural control imaging was scheduled 4 weeks after the procedure with multiparametric MR imaging followed by subsequent followup visits every 3 months for one year, thereafter every 6 months. Detailed information on the examination protocol has been described in detail earlier [21].…”

Section: Ablation Procedures Protocolmentioning

confidence: 99%

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MR-guided microwave ablation in hepatic malignancies: clinical experiences from 50 procedures

Weiß

Winkelmann

Gohla

et al. 2020

International Journal of Hyperthermia

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Purpose: To investigate technical success, technique efficacy, safety and outcome of MR-guided microwave ablation (MWA) in hepatic malignancies. Material and methods: In this prospective IRB-approved study, patients scheduled for percutaneous treatment of hepatic malignancies underwent MR-guided MWA in a closed-bore 1.5 T MR system. Technical success was assessed on post-procedural MR control imaging. Technique efficacy was evaluated 4 weeks after the procedure on multi-parametric MRI. Assessment of safety followed the Society of Interventional Radiology grading system. Kaplan-Meier survival estimates were calculated to evaluate overall survival (OS), time to local tumor progression (TLTP), and time to non-target progression (TNTP). Results: Between 2015 and 2019, 47 patients (60.5 ± 12.2 years; 39 male) underwent 50 procedures for 58 hepatic tumors (21 hepatocellular carcinomas; 37 metastases). Mean target tumor size was 16 ± 7mm (range: 6-39 mm). Technical success and technique efficacy were 100% and 98%, respectively. Lesions were treated using 2.6 applicator positions (range: 1-6). Mean energy, ablation duration per tumor, and procedure duration were 43.2 ± 23.5 kJ, 26.7 ± 13.1 min and 211.2 ± 68.7 min, respectively. 10 minor (20%) and 3 major (6%) complications were observed. Median post-interventional hospital admission was 1 day (range: 1-19 days). Median OS was 41.6 (IQR: 26.4-) months. Local recurrence occurred after 4 procedures (8%) with TLTP ranging between 3.1 and 41.9 months. Non-target recurrence was observed in 64% of patients after a median TNTP of 13.8 (IQR 2.3-) months. Conclusion: MR-guided MWA allows for safe and successful treatment of hepatic malignancies with a high technique efficacy however with relatively long procedure durations.

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Section: Methodsmentioning

confidence: 99%

Section: Ablation Procedures Protocolmentioning

confidence: 99%

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MR-guided microwave ablation in hepatic malignancies: clinical experiences from 50 procedures

Weiß

Winkelmann

Gohla

et al. 2020

International Journal of Hyperthermia

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“…The phantom was first placed inside the scanner bore for 1 h to achieve thermal equilibrium at 21°C. Parameters for radial VFA were axial slices, FOV = 256 × 256 × 48 mm 3…”

Section: Phantom Experimentsmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) provides crucial information to plan, guide, monitor, and assess minimally invasive thermal therapy modalities, including HIFU, radiofrequency (RF), microwave, and laser interstitial ablations . Among these modalities, MRI‐guided HIFU is especially attractive since both MRI and HIFU are noninvasive and can access tissues deep in the body for treating various conditions such as breast and prostatic cancers .…”

Section: Introductionmentioning

confidence: 99%

A variable flip angle golden‐angle‐ordered 3D stack‐of‐radial MRI technique for simultaneous proton resonant frequency shift and T₁‐based thermometry

Zhang

Armstrong

et al. 2019

Magnetic Resonance in Med

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Purpose To develop and evaluate a variable‐flip‐angle golden‐angle‐ordered 3D stack‐of‐radial MRI technique for simultaneous proton resonance frequency shift (PRF) and T1‐based thermometry in aqueous and adipose tissues, respectively. Methods The proposed technique acquires multiecho radial k‐space data in segments with alternating flip angles to measure 3D temperature maps dynamically on the basis of PRF and T1. A sliding‐window k‐space weighted image contrast filter is used to increase temporal resolution. PRF is measured in aqueous tissues and T1 in adipose tissues using fat/water masks. The accuracy for T1 quantification was evaluated in a reference T1/T2 phantom. In vivo nonheating experiments were conducted in healthy subjects to evaluate the stability of PRF and T1 in the brain, prostate, and breast. The proposed technique was used to monitor high‐intensity focused ultrasound (HIFU) ablation in ex vivo porcine fat/muscle tissues and compared to temperature probe readings. Results The proposed technique achieved 3D coverage with 1.1‐mm to 1.3‐mm in‐plane resolution and 2‐s to 5‐s temporal resolution. During 20 to 30 min of nonheating in vivo scans, the temporal coefficient of variation for T1 was <5% in the brain, prostate, and breast fatty tissues, while the standard deviation of relative PRF temperature change was within 3°C in aqueous tissues. During ex vivo HIFU ablation, the temperatures measured by PRF and T1 were consistent with temperature probe readings, with an absolute mean difference within 2°C. Conclusion The proposed technique achieves simultaneous PRF and T1‐based dynamic 3D MR temperature mapping in aqueous and adipose tissues. It may be used to improve MRI‐guided thermal procedures.

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Guiding Thermal Therapy with MR

Tyc,

Torchia

2023

The Application of Heat in Oncology

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MR-guided microwave ablation in hepatic tumours: initial results in clinical routine

Cited by 61 publications

References 31 publications

MR-guided microwave ablation in hepatic malignancies: clinical experiences from 50 procedures

MR-guided microwave ablation in hepatic malignancies: clinical experiences from 50 procedures

A variable flip angle golden‐angle‐ordered 3D stack‐of‐radial MRI technique for simultaneous proton resonant frequency shift and T₁‐based thermometry

Guiding Thermal Therapy with MR

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MR-guided microwave ablation in hepatic tumours: initial results in clinical routine

Cited by 61 publications

References 31 publications

MR-guided microwave ablation in hepatic malignancies: clinical experiences from 50 procedures

MR-guided microwave ablation in hepatic malignancies: clinical experiences from 50 procedures

A variable flip angle golden‐angle‐ordered 3D stack‐of‐radial MRI technique for simultaneous proton resonant frequency shift and T1‐based thermometry

Guiding Thermal Therapy with MR

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Product

Resources

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A variable flip angle golden‐angle‐ordered 3D stack‐of‐radial MRI technique for simultaneous proton resonant frequency shift and T₁‐based thermometry