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Eur J Radiol. 2014 Jan;83(1):111-6. doi: 10.1016/j.ejrad.2013.09.018. Epub 2013 Oct 8.

Image-guided radiofrequency ablation of hepatocellular carcinoma (HCC): is MR guidance more effective than CT guidance?

Author information

  • 1University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany(1). Electronic address: stephan.clasen@med.uni-tuebingen.de.
  • 2University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany(1). Electronic address: hansjoerg.rempp@med.uni-tuebingen.de.
  • 3University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany(1). Electronic address: ruediger.hoffmann@med.uni-tuebingen.de.
  • 4University Hospital, Department of Diagnostic and Interventional Radiology, Section of Experimental Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany(2). Electronic address: hansjoerg.graf@med.uni-tuebingen.de.
  • 5SLK Clinic Heilbronn, Clinic for Radiology, Minimal-invasive Therapies, and Nuclear Medicine, Am Gesundbrunnen 20-26, 74078 Heilbronn, Germany(3). Electronic address: Philippe.Pereira@slk-kliniken.de.
  • 6University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany(1). Electronic address: claus.claussen@med.uni-tuebingen.de.

Abstract

OBJECTIVES:

The purpose of the study was to retrospectively compare technique effectiveness of computed tomography (CT)-guided versus magnetic resonance (MR)-guided radiofrequency (RF) ablation of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS:

In 35 consecutive patients 53 CT-guided (n=29) or MR-guided (n=24) ablation procedures were performed in the treatment of 56 (CT: 29; MR: 27) HCC. The entire ablation procedure was performed at a multislice CT-scanner or an interventional 0.2-Tesla MR-scanner. Assessment of treatment response was based on dynamic MR imaging at 1.5Tesla. The mean follow-up was 22.9 months. Primary technique effectiveness was assessed 4 months after ablation therapy. Secondary technique effectiveness was assessed 4 months after a facultative second ablation procedure. Primary and secondary technique effectiveness of CT-guided and MR-guided RF ablation was compared by using Chi-Square (likelihood ratio) test.

RESULTS:

Primary technique effectiveness after a single session was achieved in 26/27 (96.3%) HCC after MR-guided RF ablation and 23/29 (79.3%) HCC after CT-guided RF ablation (Chi-Square: p=0.04). Secondary technique effectiveness was achieved in 26/27 (96.3%) HCC after MR-guided RF ablation and in 26/29 (89.7%) HCC after CT-guided RF ablation (Chi-Square: p=0.32). A local tumor progression was detected in 8/52 (15.4%) tumors after initial technique effectiveness. Major complications were detected after 3/53 (5.7%) ablation procedures.

CONCLUSIONS:

CT-guided and MR-guided RF ablations are locally effective therapies in the treatment of HCC. Due to a higher rate of primary technique effectiveness MR-guided RF ablation may reduce the number of required sessions for complete tumor treatment.

Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

KEYWORDS:

Computed tomography; Hepatocellular carcinoma; Interventional MRI; Liver; Radiofrequency ablation

PMID:
24161781
[PubMed - indexed for MEDLINE]
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