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Liver Cancer pp 81-101 | Cite as

Intraoperative Magnetic Resonance Imaging for Radiofrequency Ablation of Hepatic Tumors

  • Oliver F. Bathe
  • Houman Mahallati
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Part of the Methods of Cancer Diagnosis, Therapy and Prognosis book series (HAYAT, volume 5)

Curative resection represents the best therapeutic alternative for colorectal liver metastases and primary liver tumors (Abdalla et al., 2004; Llovet, 2005). For functioning metastatic neuroendocrine tumors, resection for the purpose of debulking is also a therapeutic consideration (Veenendaal et al., 2006). However, in some patients, resection is not feasible because of anatomic constraints, insufficient hepatic functional reserve, or other safety limitations. Radiofrequency ablation (RFA) represents an alternative therapy, but there are limitations to this treatment modality. It is best for small lesions that can be fully ablated by a single placement of the probe (Berber et al., 2005; Komorizono et al., 2003). Larger lesions require multiple probe placements to fully encompass the volume of the target lesion (Figure 7.1). Unfortunately, ultrasound does not clearly delineate the full extent of the burn and it cannot distinguish necrotic from viable tissue (Solbiati et al., 2004). In fact, bubbles occupy the general region of the heated liver and, if multiple heat applications are required, the bubbles produced by the first burns have often dissipated by the time the last burns have been completed. This further impairs the surgeon's ability to estimate the extent of tissue necrosis. Thus, RFA, while a suitable adjunct in some instances, has technical limitations that limit its use in the setting of more extensive lesions.

Intraoperative magnetic resonance imaging (iMRI) represents a potential solution to the limitations of RFA. Magnetic resonance imaging provides excellent soft tissue contrast and resolution, and it provides clear visualization of vascular structures. It detects hepatic tumors with high sensitivity, and is known to be useful for following lesions after RFA (Aliberti et al., 2004; Limanond et al., 2003). In view of this, iMRI may be a useful tool for optimizing the application of RFA or other similar ablative adjuncts.

Keywords

Radiofrequency Ablation Local Recurrence Rate Colorectal Liver Metastasis Hepatic Tumor Thermal Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science + Business Media B.V. 2009

Authors and Affiliations

  • Oliver F. Bathe
    • 1
  • Houman Mahallati
    • 1
  1. 1.Department of Surgery and OncologyUniversity of Calgary, Tom Baker Cancer CenterCalgaryCanada

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