Predicting liver ablation volumes with real-time MRI thermometry

Area of Science:

• Medical Imaging
• Interventional Radiology
• Oncology

Background:

• Microwave ablation is used for liver tumors but lacks real-time visualization, leading to incomplete treatment.
• MRI guidance offers superior soft-tissue contrast and real-time thermometry for precise lesion targeting.

Purpose of the Study:

• To evaluate the correlation between real-time MR thermometry-predicted lesion volume and the actual ablation zone volume.
• To assess the accuracy of MR thermometry in guiding microwave ablation for liver lesions.

Main Methods:

• A single-center retrospective analysis of patients undergoing MRI-guided microwave ablation with real-time thermometry.
• Thermal dose maps (CEM43 threshold) were created, and predicted volumes were compared to postprocedural MRI ablation zones using Pearson correlation.
• Radiologists performed visual assessment for shape and volume similarity.

Main Results:

• A strong correlation (R=0.89, p<0.001) was found between thermal dose-predicted lesion volume and postprocedural ablation zone volume.
• Twenty-seven lesions in 24 patients were analyzed after excluding those with artifacts.
• Visual assessment showed perfect similarity in shape for 85.1% of lesions.

Conclusions:

• Real-time MR thermometry-predicted volumes strongly correlate with ablation zone volumes one day post-procedure.
• This technique enhances visualization and accuracy in MRI-guided microwave ablation for liver tumors.
• Improved accuracy may lead to reduced local recurrence rates and enable re-ablation within the same procedure.