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
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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