Thermoablative treatments for malignant liver lesions: 10-year experience of MRI appearances of treatment response

AJR Am J Roentgenol. 2010 Feb;194(2):523-9. doi: 10.2214/AJR.09.2621.

Abstract

Objective: The objective of our study was to describe our 10-year experience using MRI to evaluate response to local thermoablative interventions in the treatment of malignant liver lesions.

Materials and methods: This retrospective study was conducted from 1998 to 2008. MRI studies were performed at 1.5 and 3 T and were acquired < 4, 4-9, and > 9 months after radiofrequency ablation (RFA), cryoablation, and microwave ablation. MR features were evaluated on the basis of signal intensity on unenhanced T1-weighted images and the presence of ill-defined perilesional enhancement, well-defined lesional enhancement, or washout on contrast-enhanced images. Imaging features were evaluated with all interventional modalities together and separately.

Results: The study population was composed of 135 men and 36 women (203 ablated lesions) with a mean age of 65 years (range, 39-78 years). When the data for all treatment methods were combined, well-defined lesional enhancement and washout were significant findings among the resolved and unresolved outcome groups regardless of follow-up time category. After RFA, ablated areas had a tendency to show high signal intensity on T1 images, whereas low signal was seen after cryoablation and a hyperintense rim was seen after microwave ablation. Washout was only depicted 9 months after cryoablation but was seen in 12% of lesions < 4 months after RFA. No difference was appreciated on ill-defined perilesional enhancement with all methods combined or separately.

Conclusion: MRI findings after ablation are dependent on the treatment modality and the length of time between the procedure and follow-up examination.

MeSH terms

  • Adult
  • Aged
  • Catheter Ablation / methods*
  • Contrast Media
  • Cryotherapy / methods
  • Female
  • Gadolinium DTPA
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Imaging, Three-Dimensional
  • Liver Neoplasms / surgery*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Microwaves / therapeutic use
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Contrast Media
  • gadodiamide
  • Gadolinium DTPA