MR-guided percutaneous ethanol ablation of hepatocellular carcinomas before liver transplantation.

Abstract

It was the objective of this study to evaluate MR-guided, percutaneous ethanol injection of hepatocellular carcinoma in ten patients scheduled for liver transplantation. Using a 0.2 T open MR scanner (Magnetom Open, Siemens Medical Systems, Erlangen, Germany) and percutaneous instillation of ethanol, 12 liver tumors (median tumor volume, 6.3; range, 0.6-43.2 ccm) were treated. Coagulation necrosis, morbidity, and post-transplant histology were assessed. No major complications were observed. A mean of 16.4+/-11.4 ml ethanol was injected for each tumor. The median volume of the ablation necrosis was 12.3 (range, 0.3-48.3) ccm. Three tumors were retreated and complete radiological necrosis before liver transplantation was found in eight of 12 tumors (67%). One patient developed multifocal disease and was excluded from transplantation; thus nine of ten patients underwent liver transplantation within 3.9+/-3.1 months. In the explants, satellite nodules (n = 2), new liver tumors (n = 2) and a complete necrosis were found in five of 12 treated tumors (42%). During follow-up (median 41.3; range, 0.4-86.1 months), three patients died, but no tumor-seeding or post-transplantation recurrence occurred. MR-guided ethanol injection is feasible, and may delay tumor progression. However, the local recurrence rate is high, and the spatial resolution of a low-field MR scanner limits the detection of small tumors.

• Authors: Melanie Blum, Christian Mueller, Markus Peck-Radosavljevic, Friedrich Wrba, Gabriela Berlakovich, Ferdinand Mühlbacher, Rudolf Steiniger, Maria Speiser, Mario Pones, Michael Hüpfl, Johannes Lammer, Joachim Kettenbach
• Journal: Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy (Minim Invasive Ther Allied Technol) Vol. 16 Issue 4 Pg. 230-40 ( 2007) ISSN: 1364-5706 [Print] England
• PMID: 17763097 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Ethanol

Topics

• Administration, Cutaneous
• Adult
• Carcinoma, Hepatocellular (complications, mortality, therapy)
• Combined Modality Therapy
• Ethanol (administration & dosage, therapeutic use)
• Female
• Humans
• Liver Cirrhosis (complications, therapy)
• Liver Neoplasms (complications, mortality, therapy)
• Liver Transplantation
• Magnetic Resonance Imaging, Interventional
• Male
• Middle Aged
• Neoplasm Recurrence, Local