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Malignant Liver Tumors Treated with MR Imaging–guided Laser-induced Thermotherapy: Experience with Complications in 899 Patients (2,520 lesions)¹

¹ From the Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. Received July 10, 2001; revision requested August 3; final revision received February 20, 2002; accepted March 14. Address correspondence to T.J.V. (e-mail: t.vogl@em.uni-frankfurt.de).

PURPOSE: To evaluate the complications from laser-induced thermotherapy (LITT) of malignant liver tumors and demonstrate that LITT is safe as an outpatient procedure.

MATERIALS AND METHODS: During 8 years, 899 patients with malignant liver tumors were treated with magnetic resonance (MR) imaging–guided LITT. A total of 2,132 LITT procedures were performed to treat 2,520 lesions. To account for the technical evolution of LITT during this time and the change from performing the procedure on an inpatient basis to performing it on an outpatient basis, patients were assigned to four groups. Overall complication rates and major and minor complications in the inpatient versus outpatient groups were evaluated. Multidimensional contingency table analysis with the ² test was performed.

RESULTS: On the basis of a total of 2,132 LITT procedures performed, complications were divided into major and minor categories and detected at clinical or imaging studies. Major complications included three deaths (0.1%) within 30 days after LITT, pleural effusion requiring thoracentesis in 16 (0.8%) cases, hepatic abscess requiring drainage in 15 (0.7%) cases, bile duct injury in four (0.2%) cases, segmental infarction in three (0.1%) cases, and hemorrhage requiring transfusion in one (0.05%) case. Minor complications included postprocedural fever in 710 (33.3%), pleural effusion not requiring thoracentesis in 155 (7.3%), subcapsular hematoma in 69 (3.2%), subcutaneous hematoma in 24 (1.1%), pneumothorax in seven (0.3%), and hemorrhage in two (0.1%) cases. Outpatient management did not significantly affect pleural effusion (P = .96) or subcapsular hematoma (P = .33) rate.

CONCLUSION: MR imaging–guided LITT with local anesthesia is safe and yields an acceptably low rate of major complications.

© RSNA, 2002

Index terms: Laser, interstitial therapy, 761.1269 • Liver, interventional procedures, 761.1269 • Liver neoplasms, 761.32, 761.33 • Liver neoplasms, MR, 761.121411, 761.121412, 761.12143 • Magnetic resonance (MR), thermometry, 761.1269

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