Gd-EOB-DTPA-enhanced MR guidance in thermal ablation of liver malignancies
Autor: | Andrea Jahn, Christian Rosenberg, Tilman Pickartz, Ulrich Wahnschaffe, M. Patrzyk, Norbert Hosten |
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Rok vydání: | 2014 |
Předmět: |
Gadolinium DTPA
Male Percutaneous Time Factors Cost effectiveness medicine.medical_treatment lcsh:Medicine Contrast Media Diagnostic Radiology Functional Magnetic Resonance Imaging Gastrointestinal Cancers Image Processing Computer-Assisted Medicine and Health Sciences lcsh:Science Aged 80 and over Brain Mapping Multidisciplinary medicine.diagnostic_test Pharmaceutics Liver Diseases Radiology and Imaging Liver Neoplasms Middle Aged Ablation Magnetic Resonance Imaging Surgical Oncology Liver Oncology Female Laser Therapy medicine.drug Research Article Adult medicine.medical_specialty Gadoxetic acid Thermal ablation Surgical and Invasive Medical Procedures Gastroenterology and Hepatology Text mining Malignant Tumors Diagnostic Medicine Parenchyma Gastrointestinal Tumors medicine Humans Aged Retrospective Studies Colorectal Cancer business.industry lcsh:R Biology and Life Sciences Cancers and Neoplasms Second Malignancies Magnetic resonance imaging Hepatocellular Carcinoma Surgery Metastatic Tumors Gastrointestinal Imaging lcsh:Q Clinical Medicine business Nuclear medicine Liver and Spleen Scan Neuroscience |
Zdroj: | PLoS ONE PLoS ONE, Vol 9, Iss 12, p e109217 (2014) |
ISSN: | 1932-6203 |
Popis: | Objective To evaluate the potency of Gd-EOB-DTPA to support hepatic catheter placement in laser ablation procedures by quantifying time-dependent delineation effects for instrumentation and target tumor within liver parenchyma. Monitoring potential influence on online MR thermometry during the ablation procedure is a secondary aim. Materials and Methods 30 cases of MR-guided laser ablation were performed after i.v. bolus injection of gadoxetic acid (0.025 mmol/Kg Gd-EOB-DTPA; Bayer Healthcare, Berlin, Germany). T1-weighted GRE sequences were used for applicator guidance (FLASH 3D) in the catheter placement phase and for therapy monitoring (FLASH 2D) in the therapy phase. SNR and consecutive CNR values were measured for elements of interest plotted over time both for catheter placement and therapy phase and compared with a non-contrast control group of 19 earlier cases. Statistical analysis was realized using the paired Wilcoxon test. Results Sustainable signal elevation of liver parenchyma in the contrast-enhanced group was sufficient to silhouette both target tumor and applicator against the liver. Differences in time dependent CNR alteration were highly significant between contrast-enhanced and non-contrast interventions for parenchyma and target on the one hand (p = 0.020) and parenchyma and instrument on the other hand (p = 0.002). Effects lasted for the whole procedure (monitoring up to 60 min) and were specific for the contrast-enhanced group. Contrasting maxima were seen after median 30 (applicator) and 38 (tumor) minutes, in the potential core time of a multineedle procedure. Contrast influence on T1 thermometry for real-time monitoring of thermal impact was not significant (p = 0.068–0.715). Conclusion Results strongly support anticipated promotive effects of Gd-EOB-DTPA for MR-guided percutaneous liver interventions by proving and quantifying the delineating effects for therapy-relevant elements in the procedure. Time benefit, cost effectiveness and oncologic outcome of the described beneficiary effects will have to be part of further investigations. |
Databáze: | OpenAIRE |
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