Radiology, Vol 187, 333-337, Copyright © 1993 by Radiological Society of North America

ARTICLES

Interstitial hyperthermia of colorectal liver metastases with a US- guided Nd-YAG laser with a diffuser tip: a pilot clinical study

CP Nolsoe, S Torp-Pedersen, F Burcharth, T Horn, S Pedersen, NE Christensen, ES Olldag, PH Andersen, S Karstrup and T Lorentzen
Department of Ultrasound, Herlev Hospital, University of Copenhagen, Denmark.

Ultrasound (US)-guided interstitial hyperthermia performed with the neodymium yttrium aluminum garnet laser with a diffuser tip involves placement of a laser fiber in solid tissue followed by irradiation from within the center of the tumor to be treated. The authors previously described the development of a US-guided technique that permits simultaneous interstitial laser irradiation and temperature measurements, with real-time US monitoring. With the use of a dedicated diffuser tip modification of the bare laser fiber, it has proved possible to produce spherical coagulations with a diameter comparable to that of liver metastases of clinical relevance. This technique was used in 11 patients with 16 colorectal liver metastases, 12 of which were radically ablated. Real-time US and interstitial temperature monitoring during treatment had a positive predictive value of 86% and negative predictive value of 100% in judging the final result. The technique is feasible, effective, and safe, but the effect on patient survival must be tested in future randomized clinical studies.

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