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[Oligonodular hepatocellular carcinoma (HCC): MR-controlled laser-induced thermotherapy]
K Eichler1, M G Mack, R Straub
1Institut für Diagnostische und Interventionelle Radiologie, Klinikum der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, 60590 Frankfurt am Main. K.Eichler@em.uni-frankfurt.de
Purpose:
To prospectively evaluate the therapeutic potential of MR-guided laser-induced thermotherapy (LITT) in patients with oligonodular hepatocellular carcinoma.
Material And Methods:
39 patients with 61 intrahepatic lesions were treated with LITT. The Nd:YAG laser fiber was introduced with a percutaneously positioned irrigated laser application system. Qualitative and quantitative MR parameters and clinical data were evaluated.
Results:
All patients tolerated the procedure well under local anesthesia. All observed complications were minor and no further treatment was necessary. Online MR thermometry allowed exact visualization. Lesions up to 2 cm in diameter could be efficiently treated with a single laser application, larger lesions were treated simultaneous multiapplication. In 97.5% we achieved a complete necrosis of the tumor and a 5 mm safety margin, resulting in a complete destruction of the tumor without local recurrences. Mean survival was 4.4 years (95% CI: 3.6-5.2 years) after the time of diagnoses of the HCC (Kaplan-Meier-method).
Conclusion:
In intrahepatic oligonodular involvement of hepatocellular carcinoma LITT appears to be an effective therapeutic procedure with a high tumor control rate and better survival data.