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MR-guided microwave ablation in hepatic malignancies: clinical experiences from 50 procedures.
International Journal of Hyperthermia ( IF 3.1 ) Pub Date : 2020-04-14 , DOI: 10.1080/02656736.2020.1750713
Jakob Weiss 1 , Moritz T Winkelmann 1 , Georg Gohla 1 , Jens Kübler 1 , Stephan Clasen 1 , Konstantin Nikolaou 1 , Rüdiger Hoffmann 1
Affiliation  

Abstract

Purpose: To investigate technical success, technique efficacy, safety and outcome of MR-guided microwave ablation (MWA) in hepatic malignancies.

Material and methods: In this prospective IRB-approved study, patients scheduled for percutaneous treatment of hepatic malignancies underwent MR-guided MWA in a closed-bore 1.5 T MR system. Technical success was assessed on post-procedural MR control imaging. Technique efficacy was evaluated 4 weeks after the procedure on multi-parametric MRI. Assessment of safety followed the Society of Interventional Radiology grading system. Kaplan–Meier survival estimates were calculated to evaluate overall survival (OS), time to local tumor progression (TLTP), and time to non-target progression (TNTP).

Results: Between 2015 and 2019, 47 patients (60.5 ± 12.2 years; 39 male) underwent 50 procedures for 58 hepatic tumors (21 hepatocellular carcinomas; 37 metastases). Mean target tumor size was 16 ± 7mm (range: 6–39 mm). Technical success and technique efficacy were 100% and 98%, respectively. Lesions were treated using 2.6 applicator positions (range: 1–6). Mean energy, ablation duration per tumor, and procedure duration were 43.2 ± 23.5 kJ, 26.7 ± 13.1 min and 211.2 ± 68.7 min, respectively. 10 minor (20%) and 3 major (6%) complications were observed. Median post-interventional hospital admission was 1 day (range: 1–19 days). Median OS was 41.6 (IQR: 26.4–) months. Local recurrence occurred after 4 procedures (8%) with TLTP ranging between 3.1 and 41.9 months. Non-target recurrence was observed in 64% of patients after a median TNTP of 13.8 (IQR 2.3–) months.

Conclusion: MR-guided MWA allows for safe and successful treatment of hepatic malignancies with a high technique efficacy however with relatively long procedure durations.



中文翻译:

MR引导的微波消融在肝恶性肿瘤中的应用:50例手术的临床经验。

摘要

目的:研究在肝恶性肿瘤中MR引导微波消融(MWA)的技术成功率,技术有效性,安全性和结果。

材料和方法:在这项经过IRB批准的前瞻性研究中,计划进行经皮肝癌治疗的患者在封闭口径1.5 T MR系统中接受了MR引导的MWA。在手术后的MR控制成像中评估了技术的成功。在多参数MRI手术后4周评估技术疗效。安全性评估遵循介入放射学学会分级系统。计算Kaplan–Meier生存估计以评估总体生存(OS),到局部肿瘤进展的时间(TLTP)和到非靶标进展的时间(TNTP)。

结果:在2015年至2019年之间,对47例患者(60.5±12.2岁;男39例)进行了50次手术,治疗58例肝肿瘤(21例肝细胞癌; 37例转移)。平均目标肿瘤大小为16±7mm(范围:6-39 mm)。技术成功率和技术效率分别为100%和98%。使用2.6个涂抹器位置治疗病变(范围:1-6)。平均能量,每个肿瘤的消融持续时间和手术持续时间分别为43.2±23.5 kJ,26.7±13.1分钟和211.2±68.7分钟。观察到10例轻微(20%)和3例严重(6%)并发症。干预后住院的中位数为1天(范围:1-19天)。OS中位数为41.6(IQR:26.4–)个月。4例手术(8%)后发生局部复发,TLTP在3.1到41.9个月之间。在TNTP中位数为13.8(IQR 2)之后,在64%的患者中观察到非靶标复发。

结论: MR引导的MWA可安全,成功地治疗肝恶性肿瘤,具有较高的技术效力,但手术时间相对较长。

更新日期:2020-04-14
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