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J Cancer Res Ther. 2019;15(4):825-830. doi: 10.4103/jcrt.JCRT_38_19.

Navigated magnetic resonance imaging-guided celiac plexus neurolysis using an open magnetic resonance system for pancreatic cancer patients with upper abdominal pain.

Author information

1
Department of Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.
2
Department of Oncology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.

Abstract

Aims:

The study aimed to evaluate the safety and efficacy of navigated magnetic resonance imaging (MRI)-guided celiac plexus neurolysis (CPN) using a 0.4 T open magnetic resonance system.

Materials and Methods:

A retrospective analysis was performed on 23 patients with unresectable pancreatic cancer who underwent MRI-guided CPN between January 2013 and October 2017. Clinical outcomes were evaluated by recording the complications, the opioid intake, and questionnaire before the intervention and at the time point of 1 day, 1 month, and 3 months postprocedure using a numerical visual analog scale (VAS).

Results:

Navigated MRI guidance allowed the precise placement of needle in the targeted area and the visualization of the injected neurolysis agents for all cases. The VAS scores decreased from 8.8 ± 1.0 to 2.9 ± 0.9, 4.2 ± 1.7, and 4.7 ± 1.8 at 1 day, 1 month, and 3 months postprocedure (P < 0.05). This intervention reduced the dosage of opioid consumption 1 month after the procedure (52.3 ± 10.4 mg before the treatment vs. 28.2 ± 4.9 mg after the treatment; P < 0.001). Treatment-related side effects included hematoma in one patient, short episodes of diarrhea in three patients, and hypotension in four patients.

Conclusions:

With the assistance of the navigation system, MRI-guided CPN is a safe and effective treatment approach for managing the upper abdominal pain in patients with unresectable pancreatic cancer.

KEYWORDS:

Celiac plexus neurolysis; interventional magnetic resonance imaging; navigated open magnetic resonance imaging system; optical tracking

PMID:
31436238
DOI:
10.4103/jcrt.JCRT_38_19
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