Laboratoire Imagerie Moléculaire et Fonctionnelle, de la Physiologie à la Thérapie CNRS UMR 5231, Université Victor Segalen Bordeaux 2, 146 rue Léo Saignat - Case 117, 33076, Bordeaux Cedex, France.
Eur Radiol. 2010 Jan;20(1):193-201. doi: 10.1007/s00330-009-1532-1. Epub 2009 Aug 6.
To assess the practical feasibility and effectiveness of real-time magnetic resonance (MR) temperature monitoring for the radiofrequency (RF) ablation of liver tumours in a clinical setting, nine patients (aged 49-87 years, five men and four women) with one malignant tumour (14-50 mm, eight hepatocellular carcinomas and one colorectal metastasis), were treated by 12-min RF ablation using a 1.5-T closed magnet for real-time temperature monitoring. The clinical monopolar RF device was filtered at 64 MHz to avoid electromagnetic interference. Real-time computation of thermal-dose (TD) maps, based on Sapareto and Dewey's equation, was studied to determine its ability to provide a clear end-point of the RF procedure. Absence of local recurrence on follow-up MR images obtained 45 days after the RF ablation was used to assess the apoptotic and necrotic prediction obtained by real-time TD maps. Seven out of nine tumours were completely ablated according to the real-time TD maps. Compared with 45-day follow-up MR images, TD maps accurately predicted two primary treatment failures, but were not relevant in the later progression of one case of secondary local tumour. The real-time TD concept is a feasible and promising monitoring method for the RF ablation of liver tumours.
为评估实时磁共振（MR）温度监测在临床环境下射频（RF）消融肝脏肿瘤的实际可行性和有效性，对 9 例（年龄 49-87 岁，男 5 例，女 4 例）肝脏肿瘤患者（单发肿瘤，直径 14-50mm，其中 8 例肝细胞癌，1 例结直肠转移癌）进行了 12 分钟的 RF 消融治疗，采用 1.5T 闭合磁体进行实时温度监测。为避免电磁干扰，对临床单极 RF 设备进行了 64MHz 滤波。研究了基于 Sapareto 和 Dewey 方程的实时热剂量（TD）图计算，以确定其提供 RF 程序明确终点的能力。在 RF 消融后 45 天获得的 MR 图像上无局部复发，用于评估实时 TD 图获得的细胞凋亡和坏死预测。根据实时 TD 图，9 个肿瘤中有 7 个完全消融。与 45 天的随访 MR 图像相比，TD 图准确预测了 2 例原发性治疗失败，但在随后的 1 例继发性局部肿瘤进展中不相关。实时 TD 概念是一种可行且有前途的监测肝脏肿瘤 RF 消融的方法。
