Radiofrequency Ablation of the Liver: Determination of Ablative Margin at MR Imaging with Impaired Clearance of Ferucarbotran—Feasibility Study

Institutional review board approval and informed consent were obtained. The feasibility of magnetic resonance (MR) imaging with impaired clearance of ferucarbotran to visualize ablated liver parenchyma surrounding a tumor (ablative margin [AM]) was evaluated after radiofrequency (RF) ablation of the liver. Twenty-one patients with hepatocellular carcinomas underwent RF ablation 2–7 hours after ferucarbotran-enhanced MR imaging. On unenhanced T2*-weighted images acquired after 3–5 days, AMs appeared as hypointense rims. The AM status was related to incidence of residual or recurrent tumors. This technique is feasible for visualization of AM and prediction of residual or recurrent tumors after RF ablation of the liver.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2512081161/DC1

© RSNA, 2009

References

  • 1 Kim Y, Rhim H, Cho OK, Koh BH, Kim Y. Intrahepatic recurrence after percutaneous radiofrequency ablation of hepatocellular carcinoma: analysis of the pattern and risk factors. Eur J Radiol 2006; 59: 432–441.
  • 2 Zytoon AA, Ishii H, Murakami K, et al. Recurrence-free survival after radiofrequency ablation of hepatocellular carcinoma: a registry report of the impact of risk factors on outcome. Jpn J Clin Oncol 2007; 37: 658–672.
  • 3 Nakazawa T, Kokubu S, Shibuya A, et al. Radiofrequency ablation of hepatocellular carcinoma: correlation between local tumor progression after ablation and ablative margin. AJR Am J Roentgenol 2007; 188: 480–488.
  • 4 Limanond P, Zimmerman P, Raman SS, Kadell BM, Lu DS. Interpretation of CT and MRI after radiofrequency ablation of hepatic malignancies. AJR Am J Roentgenol 2003; 181: 1635–1640.
  • 5 Hamm B, Staks T, Taupitz M, et al. Contrast-enhanced MR imaging of liver and spleen: first experience in humans with a new superparamagnetic iron oxide. J Magn Reson Imaging 1994; 4: 659–668.
  • 6 Mehta CR, Patel NR. A network algorithm for performing Fisher's exact test in r × c contingency tables. J Am Stat Assoc 1983; 78: 427–434.
  • 7 Wray CJ, Lowy AM, Mathews JB, et al. The significance and clinical factors associated with a subcentimeter resection of colorectal liver metastases. Ann Surg Oncol 2005; 12: 374–380.
  • 8 Are C, Gonen M, Zazzali K, et al. The impact of margins on outcome after hepatic resection for colorectal metastasis. Ann Surg 2007; 246: 295–300.
  • 9 Lei HJ, Chau GY, Lui WY, et al. Prognostic value and clinical relevance of the 6th Edition 2002 American Joint Committee on Cancer staging system in patients with resectable hepatocellular carcinoma. J Am Coll Surg 2006; 203: 426–435.
  • 10 Tralhão JG, Kayal S, Dagher I, Sanhueza M, Vons C, Franco D. Resection of hepatocellular carcinoma: the effect of surgical margin and blood transfusion on long-term survival—analysis of 209 consecutive patients. Hepatogastroenterology 2007; 54: 1200–1206.
  • 11 Kawasaki S, Makuuchi M, Miyagawa S, et al. Results of hepatic resection for hepatocellular carcinoma. World J Surg 1995; 19: 31–34.
  • 12 Poon RT, Fan ST, Ng IO, Wong J. Significance of resection margin in hepatectomy for hepatocellular carcinoma: a critical reappraisal. Ann Surg 2000; 231: 544–551.
  • 13 Matsui Y, Terakawa N, Satoi S, et al. Postoperative outcomes in patients with hepatocellular carcinomas resected with exposure of the tumor surface: clinical role of the no-margin resection. Arch Surg 2007; 142: 596–602.
  • 14 Pawlik TM, Scoggins CR, Zorzi D, et al. Effect of surgical margin status on survival and site of recurrence after hepatic resection for colorectal metastases. Ann Surg 2005; 241: 715–722.
  • 15 Hamady ZZ, Cameron IC, Wyatt J, Prasad RK, Toogood GJ, Lodge JP. Resection margin in patients undergoing hepatectomy for colorectal liver metastasis: a critical appraisal of the 1 cm rule. Eur J Surg Oncol 2006; 32: 557–563.
  • 16 Montorsi M, Santambrogio R, Bianchi P, et al. Survival and recurrences after hepatic resection or radiofrequency for hepatocellular carcinoma in cirrhotic patients: a multivariate analysis. J Gastrointest Surg 2005; 9: 62–67.
  • 17 Hong SN, Lee SY, Choi MS, et al. Comparing the outcomes of radiofrequency ablation and surgery in patients with a single small hepatocellular carcinoma and well-preserved hepatic function. J Clin Gastroenterol 2005; 39: 247–252.
  • 18 Guglielmi A, Ruzzenente A, Valdegamberi A, et al. Radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma in cirrhosis. J Gastrointest Surg 2008; 12: 192–198.
  • 19 Aloia TA, Vauthey JN, Loyer EM, et al. Solitary colorectal liver metastasis: resection determines outcome. Arch Surg 2006; 141: 460–466.
  • 20 Oswald P, Clement O, Chambon C, Schouman-Claeys E, Frija G. Liver positive enhancement after injection of superparamagnetic nanoparticles: respective role of circulating and uptaken particles. Magn Reson Imaging 1997; 15: 1025–1031.
  • 21 Tanimoto A, Oshio K, Suematsu M, Pouliquen D, Stark DD. Relaxation effects of clustered particles. J Magn Reson Imaging 2001; 14: 72–77.
  • 22 Imai Y, Murakami T, Yoshida S, et al. Superparamagnetic iron oxide-enhanced magnetic resonance images of hepatocellular carcinoma: correlation with histological grading. Hepatology 2000; 32: 205–212.
  • 23 Saxton RE, Huang A, Anzai Y, Castro DJ, Lufkin RB. Laser photothermal effects on stability and toxicity of magnetic resonance contrast agent. J Clin Laser Med Surg 1995; 13: 363–366.
  • 24 Merkle EM, Goldberg SN, Boll DT, et al. Effects of superparamagnetic iron oxide on radiofrequency-induced temperature distribution: in vitro measurements in polyacrylamide phantoms and in vitro results in a rabbit liver model. Radiology 1999; 212: 459–466.
  • 25 Miyake T, Sato S, Okamoto E, et al. Ferucarbotran expands area treated by radiofrequency ablation in rabbit livers. J Gastroenterol Hepatol 2008; 23: e270–e274.
  • 26 Chang S, Kim SH, Lim HK, Lee WJ, Choi D, Lim JH. Needle tract implantation after sonographically guided percutaneous biopsy of hepatocellular carcinoma: evaluation of doubling time, frequency, and features on CT. AJR Am J Roentgenol 2005; 185: 400–405.
  • 27 Bruix J, Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology 2005; 42: 1208–1236.

Article History

Published in print: 2009