MRI-Guided Cryoablation of Hepatic Dome Hepatocellular Carcinomas Using 1-T Open High-Field-Strength Scanner.

Wang, Ligang; Liu, Chao; Liu, Jiantao; Li, Peipei; Xiang, Jianfeng; Liu, Ming; Li, Chengli · AJR Am J Roentgenol · 2019

prospective_cohort · Level II

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Abstract

<b>OBJECTIVE.</b> The objective of our study was to prospectively evaluate the feasibility, safety, and effectiveness of 1-T open MRI-guided percutaneous cryoablation of hepatic dome hepatocellular carcinomas (HCCs). <b>SUBJECTS AND METHODS.</b> Thirty-seven patients with 37 hepatic dome HCCs underwent MRI-guided percutaneous cryoablations. MR fluoroscopy with a freehand technique was applied in the procedure. All lesions ranged in size from 8 to 38 mm. Patients were followed for at least 12 months after cryoablation or until death. Survival period, local tumor control, and complications were recorded. <b>RESULTS.</b> MRI-guided percutaneous cryoablation procedures were successfully performed on all 37 lesions. The technical success rate was 100%. The median follow-up time was 21.0 months (range, 10-26 months). Two patients with local tumor progression at the 4th and 11th month after the procedure were treated with a supplementary cryoablation. One patient died of upper gastrointestinal hemorrhage at the 10th month after cryoablation. Local tumor progression and overall survival rates were 2.7% (1/37) and 100% (37/37) at 6 months and 5.4% (2/37) and 97.3% (36/37) at 1 year, respectively. Postoperative hydrothorax that required chest tube drainage occurred in two patients; no other severe complications occurred. <b>CONCLUSION.</b> Cryoablation of hepatic dome HCCs with 1-T open MRI guidance is a feasible, safe, and effective therapy method.