Complex hepatic surgery aided by a 1.5-tesla moveable magnetic resonance imaging system

Area of Science:

• Hepatobiliary surgery
• Oncology
• Radiology

Background:

• Resection is optimal for curable liver tumors; radiofrequency ablation (RFA) is an alternative.
• Ultrasound limitations in estimating RFA burn extent hinder curative potential.
• Intraoperative MRI (iMRI) was investigated for improved ablation assessment.

Purpose of the Study:

• To evaluate the utility of iMRI in assessing ablation completeness during liver tumor treatment.
• To determine if iMRI impacts intraoperative decision-making for RFA.

Main Methods:

• Open hepatic surgery was performed with a retractable 1.5-T magnet.
• Patients undergoing RFA (with or without resection) were selected for iMRI guidance.
• Lesion assessment via ultrasound and iMRI, followed by resection/ablation and margin confirmation.

Main Results:

• Nine patients (carcinoid, HCC, colorectal metastases) underwent the procedure.
• iMRI influenced decision-making in 4 patients.
• Five patients had nonlocal recurrences; one had a local recurrence.

Conclusions:

• iMRI may impact operative decisions for extensive liver disease ablation.
• The ability of iMRI to prevent local recurrences needs further investigation.
• The role of iMRI in liver tumor treatment requires definition.