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Wolf Bäumler,1 Mareike Sebald,2 Ingo Einspieler,1 Andreas Schicho,1 Jan Schaible,1 Philipp Wiggermann,3 Marco Dollinger,1 Christian Stroszczynski,1 Lukas Philipp Beyer4 1Department of Radiology, University Hospital Regensburg, Regensburg, Germany; 2Department of Radiology, Municipal Hospital Landshut, Landshut, Germany; 3Department of Radiology and Nuclear Medicine, Hospital Braunschweig, Braunschweig, Germany; 4Department of Diagnostic and Interventional Radiology, Ernst von Bergmann Hospital, Potsdam, GermanyCorrespondence: Wolf BäumlerDepartment of Radiology, University Hospital Regensburg, Regensburg 93053, GermanyTel +49 941 944 7410Email wolf.baeumler@ukr.dePurpose: To assess the incidence and evolution of biliary alterations adjacent to the ablation area in patients with hepatic malignancies during the first 3 months after percutaneous irreversible electroporation (IRE) and to investigate associated changes in laboratory values.Material and Methods: Bile ducts located within a ≤ 1.0 cm radius of the ablation zone were analyzed in 45 patients by preinterventional and postinterventional MRI (1– 3 days, 6 weeks, and 3 months after IRE). Moreover, levels of alkaline phosphatase (AP) and serum bilirubin (SB) were examined for evidence of bile duct injury. Biliary alterations and the presence of postinterventional-elevated laboratory levels were correlated with features of the lesions, patients, ablation procedures, and laboratory values.Results: A total of 80 bile ducts were located within a 1.0 cm radius of the ablation zone: 59 were encased, 16 were abutting and 5 were located within a radius of 0.1– 1.0 cm of the ablation area. In total, 38 biliary injuries (narrowing, n=22; dilatation, n=14; biloma, n=2) were detected, 3 cases of narrowing occurred for the first time 6 weeks and 3 months after IRE, 21 alterations (dilatation: n=9; narrowing; n=10; biloma: n=2) had resolved during the first 6 weeks, 1 alteration (dilatation: n=1) had resolved by the last follow-up control. Three months after IRE, 19 patients showed elevated levels of AP, whereas SB levels were increased in 10 cases. No significant association between biliary alterations or postinterventional-elevated laboratory values and the investigated characteristics of lesions, patients, ablation procedures or laboratory values could be proven.Conclusion: Different alterations of bile ducts adjacent to an IRE ablation zone are common, of which dilatation and especially narrowing commonly represent a long-term complication after IRE. Moreover, a definite correlation between the frequently observed prolonged post-ablative elevation of AP- and SB-levels and the postinterventional biliary alterations could not be proven.Keywords: bile ducts, hepatic tumors, electroporation |
