Laser-induced thermotherapy for the treatment of liver metastasis. Correlation of gadolinium-DTPA-enhanced MRI with histomorphologic findings to determine criteria for follow-up monitoring

Surg Endosc. 1998 Nov;12(11):1317-25. doi: 10.1007/s004649900849.

Abstract

Purpose: To evaluate gadolinium (Gd)-diethylenetriamine-pentaacetic-acid (DTPA)-enhanced magnetic resonance imaging (MRI) for follow-up monitoring of laser-induced thermotherapy (LITT) and to determine a useful examination schedule.

Methods: LITT of the liver was performed in 55 rabbits using a neodymium: yttrium-aluminum-garnet (Nd:YAG) laser (4-W power output, 840-s exposure time). Gd-DTPA MRI and histologic examinations were performed at different times (0-168 days).

Results: Laser-induced lesions underwent regeneration and volume size reduction (69% after 168 days). The correlation coefficient (MR vs. macroscopic analysis) for the mean lesion diameter was r = 0.96. Histology of lesions comprised the four zones that correlated best with MRI findings. Coagulation necroses immediately after LITT was seen as an area of no enhancement on Gd-DTPA MRI. Circular enhancement was first seen 72-96 h after LITT, which was due to early mesenchymal proliferation.

Conclusions: Gd-DTPA MRI is a good monitoring procedure for LITT. MRI should be performed 24 and 96 h after LITT.

MeSH terms

  • Animals
  • Contrast Media
  • Female
  • Gadolinium DTPA
  • Hyperthermia, Induced / methods*
  • Image Enhancement
  • Lasers*
  • Liver / pathology
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy*
  • Magnetic Resonance Imaging
  • Monitoring, Physiologic
  • Rabbits

Substances

  • Contrast Media
  • Gadolinium DTPA