Treatment of hepatocellular carcinoma adjacent to large blood vessels using 1.5T MRI-guided percutaneous radiofrequency ablation combined with iodine-125 radioactive seed implantation

Eur J Radiol. 2012 Nov;81(11):3079-83. doi: 10.1016/j.ejrad.2012.05.007. Epub 2012 Jun 4.

Abstract

Objective: The objective is to study the technology associated with and feasibility of the treatment of hepatocellular carcinoma (HCC) adjacent to large blood vessels using 1.5 T MRI-guided radiofrequency ablation combined with iodine-125 (I-125) radioactive seed implantation.

Methods: Sixteen patients with a total of 24 HCC lesions (average maximum diameter: 2.35±1.03 cm) were pathologically confirmed by biopsy or clinically diagnosed received 1.5 T MRI-guided percutaneous radiofrequency ablation (RFA) treatment. Each patient had one lesion adjacent to large blood vessels (≥3 mm); after the ablation, I-125 radioactive seeds were implanted in the portions of the lesions that were adjacent to the blood vessels.

Results: All the ablations and I-125 radioactive seed implantations were successful; a total of 118 seeds were implanted. The ablated lesions exhibited hypointense signals on the T2WI sequence with a thin rim of hyperintense signals; they also exhibited significant hyperintense signals on the T1WI sequence with clear boundaries. The average follow-up period was 11.1±6.2 months. There were 23 complete responses and one partial response in the 24 lesions. The alpha-fetoprotein (AFP) levels of the patients significantly decreased.

Conclusion: The 1.5 T MRI-guided RFA combined with I-125 radioactive seed implantation for the treatment of HCC adjacent to large blood vessels is an effective technology.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brachytherapy / methods*
  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / therapy*
  • Catheter Ablation / methods*
  • Combined Modality Therapy
  • Female
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / therapy*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Radiopharmaceuticals / therapeutic use
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Surgery, Computer-Assisted / methods
  • Treatment Outcome

Substances

  • Iodine Radioisotopes
  • Radiopharmaceuticals