1.5T conventional MR-guided iodine-125 interstitial implants for hepatocellular carcinoma: feasibility and preliminary clinical experience.

PURPOSE

To evaluate the feasibility and therapeutic efficacy of 1.5 T conventional MR-guided percutaneous interstitial implantation of I-125 radioactive seeds in patients with hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

The institutional ethics committee approved this study. After imformed consent was obtained, twenty-three patients suffering from a total of 65 HCC lesions were treated with I-125 seed permanent interstitial implantation under the guidance of a 1.5T conventional magnetic resonance imaging (MRI) system. The FSE T2WI, T1 FSPGR, FIESTA 2D, 3D Dyn T1WI sequences were used to guide an 18 G MR-compatible needle inserted into the lesions to introduce the I-125 seeds. The response evaluation criteria in solid tumors (RECIST) were used to evaluate the curative effect.

RESULTS

The needle and I-125 seed were seen clearly on MRI images. The final dose delivered to total decay was 173.46 ± 32.44 Gy (range, 110-270 Gy) as calculated by postoperative TPS. The complete response (CR) was seen in 22 lesions (33.8%), partial response (PR) in 24 lesions (36.9%), stable disease (SD) in 9 lesions (13.8%), and progressive disease (PD) in 10 lesions (15.4%). The post-operative alpha-fetoprotein (AFP) was decreased (t = 3.117, P = 0.005<0.05). Two patients were observed a small area of subcapsular bleeding that did not lead to any symptoms or clinical sequelae.

CONCLUSION

MR-guided I-125 implantation for HCC is technically feasible and effective.