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01-05-2012 | Interventional

Threshold-based prediction of the coagulation zone in sequential temperature mapping in MR-guided radiofrequency ablation of liver tumours

Authors: Hansjörg Rempp, Rüdiger Hoffmann, Jörg Roland, Alexandra Buck, Antje Kickhefel, Claus D. Claussen, Philippe L. Pereira, Fritz Schick, Stephan Clasen

Published in: European Radiology | Issue 5/2012

Abstract

Objective

To evaluate different cut-off temperature levels for a threshold-based prediction of the coagulation zone in magnetic resonance (MR)-guided radiofrequency (RF) ablation of liver tumours.

Methods

Temperature-sensitive measurements were acquired during RF ablation of 24 patients with primary (6) and secondary liver lesions (18) using a wide-bore 1.5 T MR sytem and compared with the post-interventional coagulation zone. Temperature measurements using the proton resonance frequency shift method were performed directly subsequent to energy application. The temperature maps were registered on the contrast-enhanced follow-up MR images acquired 4 weeks after treatment. Areas with temperatures above 50°, 55° and 60°C were segmented and compared with the coagulation zones. Sensitivity and positive predictive value were calculated.

Results

No major complications occurred and all tumours were completely treated. No tumour recurrence was observed at the follow-up examination after 4 weeks. Two patients with secondary liver lesions showed local tumour recurrence after 4 and 7 months. The 60°C threshold level achieved the highest positive predictive value (87.7 ± 9.9) and the best prediction of the coagulation zone.

Conclusions

For a threshold-based prediction of the coagulation zone, the 60°C cut-off level achieved the best prediction of the coagulation zone among the tested levels.

Key Points

• Temperature monitoring can be used to survey MR-guided radiofrequency ablation

• The developing ablation zone can be estimated based on post-interventional temperature measurements

• A 60°C threshold level can be used to predict the ablation zone

• The 50°C and 55°C temperature zones tend to overestimate the ablation zone

Kudo M (2010) Radiofrequency ablation for hepatocellular carcinoma: updated review in 2010. Oncology 78(Suppl 1):113–124PubMedCrossRef

Orlando A, Leandro G, Olivo M et al (2009) Radiofrequency thermal ablation vs. percutaneous ethanol injection for small hepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlled trials. Am J Gastroenterol 104:514–524PubMedCrossRef

Goldberg SN, Dupuy DE (2001) Image-guided radiofrequency tumor ablation: challenges and opportunities—part I. J Vasc Intervent Radiol 12:1021–1032CrossRef

Lencioni R, Crocetti L, Cioni D et al (2004) Percutaneous radiofrequency ablation of hepatic colorectal metastases: technique, indications, results, and new promises. Invest Radiol 39:689–697PubMedCrossRef

Livraghi T, Solbiati L, Meloni MF et al (2003) Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology 226:441–451PubMedCrossRef

Ayav A, Germain A, Marchal F et al (2010) Radiofrequency ablation of unresectable liver tumors: factors associated with incomplete ablation or local recurrence. Am J Surg 200:435–439PubMedCrossRef

Mulier S, Ruers T, Jamart J et al (2008) Radiofrequency ablation versus resection for resectable colorectal liver metastases: time for a randomized trial? An update. Dig Surg 25:445–460PubMedCrossRef

Mulier S, Ni Y, Jamart J et al (2005) Local recurrence after hepatic radiofrequency coagulation: multivariate meta-analysis and review of contributing factors. Ann Surg 242:158–171PubMedCrossRef

Pereira PL, Trubenbach J, Schenk M et al (2004) Radiofrequency ablation: in vivo comparison of four commercially available devices in pig livers. Radiology 232:482–490PubMedCrossRef

10.

Leyendecker JR, Dodd GD 3rd, Halff GA et al (2002) Sonographically observed echogenic response during intraoperative radiofrequency ablation of cirrhotic livers: pathologic correlation. AJR Am J Roentgenol 178:1147–1151PubMed

11.

De Senneville BD, Mougenot C, Quesson B et al (2007) MR thermometry for monitoring tumor ablation. Eur Radiol 17:2401–2410PubMedCrossRef

12.

Sapareto SA, Dewey WC (1984) Thermal dose determination in cancer therapy. Int J Radiat Oncol Biol Phys 10:787–800PubMedCrossRef

13.

Kickhefel A, Rosenberg C, Weiss CR et al (2011) Clinical evaluation of MR temperature monitoring of laser-induced thermotherapy in human liver using the proton-resonance-frequency method and predictive models of cell death. J Magn Reson Imaging 33:704–712PubMedCrossRef

14.

Rempp H, Clasen S, Boss A et al (2009) Prediction of cell necrosis with sequential temperature mapping after radiofrequency ablation. J Magn Reson Imaging 30:631–639PubMedCrossRef

15.

Hindmann JC (1966) Proton resonance shift of water in the gas and liquid state. J Chem Phys 44:4582–4592CrossRef

16.

Cernicanu A, Lepetit-Coiffe M, Roland J et al (2008) Validation of fast MR thermometry at 1.5 T with gradient-echo echo planar imaging sequences: phantom and clinical feasibility studies. NMR Biomed 21:849–858PubMedCrossRef

17.

Lepetit-Coiffe M, Laumonier H, Seror O et al (2010) Real-time monitoring of radiofrequency ablation of liver tumors using thermal-dose calculation by MR temperature imaging: initial results in nine patients, including follow-up. Eur Radiol 20:193–201PubMedCrossRef

18.

Schraml C, Schwenzer NF, Martirosian P et al (2009) Diffusion-weighted MRI of advanced hepatocellular carcinoma during sorafenib treatment: initial results. AJR Am J Roentgenol 193:W301–W307PubMedCrossRef

19.

Kierans AS, Elazzazi M, Braga L et al (2010) Thermoablative treatments for malignant liver lesions: 10-year experience of MRI appearances of treatment response. AJR Am J Roentgenol 194:523–529PubMedCrossRef

20.

Vigen KK, Daniel BL, Pauly JM et al (2003) Triggered, navigated, multi-baseline method for proton resonance frequency temperature mapping with respiratory motion. Magn Reson Med 50:1003–1010PubMedCrossRef

21.

De Senneville BD, Mougenot C, Moonen CT (2007) Real-time adaptive methods for treatment of mobile organs by MRI-controlled high-intensity focused ultrasound. Magn Reson Imaging 57:319–330

22.

Terraz S, Cernicanu A, Lepetit-Coiffe M et al (2010) Radiofrequency ablation of small liver malignancies under magnetic resonance guidance: progress in targeting and preliminary observations with temperature monitoring. Eur Radiol 20:886–897PubMedCrossRef

23.

Peters RD, Chan E, Trachtenberg J et al (2000) Magnetic resonance thermometry for predicting thermal damage: An application of interstitial laser coagulation in an in vivo canine prostate model. Magn Reson Med 44:873–883PubMedCrossRef

24.

McDannold N, Jolesz F (2000) Magnetic resonance image-guided thermal ablations. Top Magn Reson Imaging 11:191–202PubMedCrossRef

25.

Chen L, Wansapura JP, Heit G et al (2002) Study of laser ablation in the in vivo rabbit brain with MR thermometry. J Magn Reson Imaging 16:147–152PubMedCrossRef

26.

Roujol S, Ries M, Quesson B et al (2010) Real-time MR-thermometry and dosimetry for interventional guidance on abdominal organs. Magn Reson Med 63:1080–1087PubMedCrossRef

27.

Haen SP, Gouttefangeas C, Schmidt D, et al. (2011) Elevated serum levels of heat shock protein 70 can be detected after radiofrequency ablation. Cell Stress Chaperones

28.

Barnes JA, Dix DJ, Collins BW et al (2001) Expression of inducible Hsp70 enhances the proliferation of MCF-7 breast cancer cells and protects against the cytotoxic effects of hyperthermia. Cell Stress Chaperones 6:316–325PubMedCrossRef

29.

Lazebnik RS, Breen MS, Fitzmaurice M et al (2003) Radio-frequency-induced thermal lesions: subacute magnetic resonance appearance and histological correlation. J Magn Reson Imaging 18:487–495PubMedCrossRef

30.

Tsuda M, Rikimaru H, Majima K et al (2003) Time-related changes of radiofrequency ablation lesion in the normal rabbit liver: findings of magnetic resonance imaging and histopathology. Invest Radiol 38:525–531PubMed

31.

Sequeiros RB, Kariniemi J, Ojala R et al (2010) Liver tumor laser ablation—increase in the subacute ablation lesion volume detected with post procedural MRI. Acta Radiol 51:505–511PubMedCrossRef

Title: Threshold-based prediction of the coagulation zone in sequential temperature mapping in MR-guided radiofrequency ablation of liver tumours
Authors: Hansjörg Rempp
Rüdiger Hoffmann
Jörg Roland
Alexandra Buck
Antje Kickhefel
Claus D. Claussen
Philippe L. Pereira
Fritz Schick
Stephan Clasen
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: European Radiology / Issue 5/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-011-2335-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Threshold-based prediction of the coagulation zone in sequential temperature mapping in MR-guided radiofrequency ablation of liver tumours

Abstract

Objective

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Key Points

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