MR-guided radiofrequency ablation of hepatic neoplasms

Purpose: To evaluate the safety and efficacy of MR-guided radiofrequency ab lation (RFA) of hepatic neoplasms. Material and Methods: 16 hepatic neoplas ms (1.3 - 3.0 cm in diameter) in 11 patients were treated by 22 percutaneou s RFA sessions during a prospective study. 16 G, MR-compatible cooled-tip e lectrodes with active lengths of 2 cm and 3 cm, respectively, were placed u nder MR-guidance in an open 0.2 Tesla MR system (Magnetom Open, Siemens. Er langen) using fast T-1-weighted sequences. Pretreatment studies, evaluation of tumor necrosis (one week after last RFA), and further follow-up studies every 3 months were performed using 1.5 Tesla MR systems. Results: The mea n procedure time was 2.8 (1.5-3.3) h. Complications related to percutaneous treatment were not encountered. 14 of 16 neoplasms (87%) showed no CM enha ncement during MRI after the last RFA and were judged to be completely necr otic. In 11 tumors one treatment session was necessary, in 4 tumors two and in one tumor three. Followup studies revealed persistent complete necrosis in 13 of 14 (93%) tumors during a period of 3-18 (median: 11.8) months. In 5 patients new intrahepatic tumors developed that were not suitable for fu rther RFA treatment because of their number, size and location. Conclusion: MR-guided RFA using single cooled tip electrodes is safe and technically e ffective for treatment of hepatic neoplasms up to 3 cm in size, however fur ther improvements are necessary.