Clinical

MRI-guided percutaneous cryotherapy effective for ablation of liver tumors

Last Updated: 2004-11-30 14:45:03 -0400 (Reuters Health)

By M. Mary Conroy

CHICAGO (Reuters Health) - Percutaneous cryotherapy under magnetic resonance imaging guidance achieved an overall 49% success rate in ablating liver tumors of 5 cm or less, according to research reported at the 90th scientific assembly and annual meeting of the Radiological Society of North America (RSNA).

Lead investigator Dr. Kemal Tuncali, an instructor in radiology at Brigham and Women's Hospital in Boston, said the success rate was 62% for smaller lesions (3.5 cm or less).

Dr. Tuncali said 34 patients with 47 liver tumors have been treated using MRI-guided cryotherapy, and he reported results from a series of 31 patients with 44 lesions. "Most of the lesions were metastases from aggressive cancers in the colon and other sites," he told Reuters Health. "Only two of the lesions were hepatocellular cancers."

Sixteen of the patients were women and the mean age was 62. The mean lesion size was 2.9 cm.

"We were able to treat 39 of 44 lesions and 17 of those required only one treatment," Dr. Tuncali said.

The procedure involves "initial rapid freezing, which takes about 15 minutes, a thawing for 10 minutes and then a second rapid freezing for 15 minutes. We know that cells die with rapid freezing, then additional death occurs with thawing, and finally the second freezing achieves additional cell death."

Among the complications associated with the treatment were "a transitory rise in bilirubin, a blood clot in the lung, liver bleeding, a clotting problem and a cancer nodule recurrence under the skin," Dr. Tuncali said. All complications responded to treatment and there were no fatalities associated with treatment.

He noted that recovery time "was quick and most patients were discharged after 24 hours."

The overall survival rate at 15 months is 77% in the current series.