Image-guided radiofrequency ablation of hepatocellular carcinoma (HCC): Is MR guidance more effective than CT guidance?
Image-guided radiofrequency ablation of hepatocellular carcinoma (HCC): Is MR guidance more effective than CT guidance?
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DOI：
10.1016/j.ejrad.2013.09.018
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发表时间：
2014-01-01
影响因子：
3.3
通讯作者：
Claussen, Claus D.
中科院分区：
文献类型：
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作者：
Clasen, Stephan;Rempp, Hansjoerg;Claussen, Claus D.
目的：本研究的目的是回顾性比较计算机断层扫描（CT）引导和磁共振（MR）引导下射频消融治疗肝细胞癌（HCC）的技术效果。材料和方法：在连续35例患者中，53例CT引导（n=29）或MR引导（n=24）行消融手术治疗56例（CT: 29; MR: 27） HCC。整个消融过程在多层ct扫描仪或介入性0.2特斯拉核磁共振扫描仪上进行。治疗效果评估基于1.5特斯拉的动态磁共振成像。平均随访22.9个月。在消融治疗后4个月评估主要技术的有效性。在兼性第二次消融手术后4个月评估二次技术的有效性。采用卡方（Chi-Square）检验比较ct引导下和mr引导下射频消融的主要和次要技术有效性。结果：26127例（96.3%）mr引导下射频消融后的HCC和23129例（79.3%）ct引导下射频消融后的HCC在单次治疗后达到了主要技术有效性（χ - square: p=0.04）。26127例（96.3%）HCC在mr引导下射频消融后获得二次技术有效性，26129例（89.7%）HCC在ct引导下射频消融后获得二次技术有效性（χ - square: p = 0.32）。8152例（15.4%）肿瘤在初步技术效果后发现局部肿瘤进展。3153例（5.7%）消融后发现主要并发症。结论：ct引导和mr引导下射频消融是治疗HCC的局部有效方法。由于核磁共振引导的射频消融具有较高的主要技术有效性，可以减少肿瘤完全治疗所需的疗程数。2013爱思唯尔爱尔兰有限公司版权所有。
Objectives: The purpose of the study was to retrospectively compare technique effectiveness of computed tomography (CT)-guided versus magnetic resonance (MR)-guided radiofrequency (RF) ablation of hepatocellular carcinoma (HCC).Materials and methods: In 35 consecutive patients 53 CT-guided (n=29) or MR-guided (n=24) ablation procedures were performed in the treatment of 56 (CT: 29; MR: 27) HCC. The entire ablation procedure was performed at a multislice CT-scanner or an interventional 0.2-Tesla MR-scanner. Assessment of treatment response was based on dynamic MR imaging at 1.5 Tesla. The mean follow-up was 22.9 months. Primary technique effectiveness was assessed 4 months after ablation therapy. Secondary technique effectiveness was assessed 4 months after a facultative second ablation procedure. Primary and secondary technique effectiveness of CT-guided and MR-guided RF ablation was compared by using Chi-Square (likelihood ratio) test.Results: Primary technique effectiveness after a single session was achieved in 26127(96.3%) HCC after MR-guided RF ablation and 23129 (79.3%) HCC after CT-guided RF ablation (Chi-Square: p=0.04). Secondary technique effectiveness was achieved in 26127 (96.3%) HCC after MR-guided RF ablation and in 26129 (89.7%) HCC after CT-guided RF ablation (Chi-Square: p = 0.32). A local tumor progression was detected in 8152 (15.4%) tumors after initial technique effectiveness. Major complications were detected after 3153 (5.7%) ablation procedures.Conclusions: CT-guided and MR-guided RF ablations are locally effective therapies in the treatment of HCC. Due to a higher rate of primary technique effectiveness MR-guided RF ablation may reduce the number of required sessions for complete tumor treatment. (C) 2013 Elsevier Ireland Ltd. All rights reserved.