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MR Imaging-guided Radio-frequency Thermal Ablation in the Pancreas in a Porcine Model with a Modified Clinical C-Arm System¹

¹ From the Departments of Radiology, Division of MRI (E.M.M., J.R.H., J.L.D., J.S.L.), Biomedical Engineering (J.L.D.), Pathology (G.H.J.), and Oncology (J.S.L.), University Hospitals of Cleveland, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106, and the Department of Diagnostic Radiology, University of Ulm, Germany (E.M.M., H.J.B.). From the 1998 RSNA scientific assembly. Received September 9, 1998; revision requested November 3; final revision received February 12, 1999; accepted June 8. Supported in part by grants from the Whitaker Foundation, Siemens Medical Systems, Minrad, Radionics, American Cancer Society, Mary Ann S. Swetland Fund, and the M. E. and F. J. Callahan Foundation and by Deutsche Forschungsgemeinschaft grant Me 1593/1-1. Address reprint requests to J.S.L. (e-mail: lewin@uhrad.com)

PURPOSE: To test the hypotheses that (a) magnetic resonance (MR) imaging-guided radio-frequency (RF) thermal ablation in the pancreas is safe and feasible in a porcine model and (b) induced thermal lesion size can be predicted with MR imaging monitoring.

MATERIALS AND METHODS: MR imaging-guided RF ablation was performed in the pancreas of six pigs. A 17-gauge monopolar RF probe was inserted into the pancreas with MR imaging guidance, and RF was applied for 10 minutes. After postprocedural imaging (T2-weighted, short inversion time inversion-recovery [STIR], and T1-weighted imaging before and after intravenous administration of gadodiamide), the pigs were observed for 7 days and follow-up MR images were acquired. The pigs were sacrificed, and pathologic examination was performed.

RESULTS: Successful RF probe placement was accomplished in all pigs; the interventional procedure took 46–80 minutes. Thermal lesions were 12–15 mm perpendicular to the probe track and were best seen on STIR and contrast material–enhanced T1-weighted images with a radiologic and/or pathologic mean difference in RF lesion diameter of 1.7 mm ± 1.0 (SD) and 0.8 mm ± 1.2, respectively. Diarrhea was the only side effect during the 1-week follow-up; no clinical signs of pancreatitis occurred.

CONCLUSION: MR imaging–guided RF thermal ablation in the pancreas is feasible and safe. Induced thermal lesion size can best be monitored with STIR and contrast-enhanced T1-weighted images. In the future, RF ablation may offer an alternative treatment option for pancreatic cancer.

Index terms: Interventional procedures, experimental studies, 77.12, 77.12149, 77.1269 • Magnetic resonance (MR), guidance, 77.121411, 77.121412, 77.12143 • Pancreas, interventional procedures, 77.1269 • Pancreatitis, 77.291 • Radiofrequency (RF) ablation, 77.1293, 77.1269

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