CT versus MR guidance for radiofrequency ablation in patients with colorectal liver metastases: a 10-year follow-up favors MR guidance

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Philippe Lucien Pereira - , SLK-Kliniken Heilbronn GmbH, Danube Private University (DPU) (Author)
  • Panagiota Siemou - , Alexandra Hospital (Author)
  • Hans Jörg Rempp - , University of Tübingen (Author)
  • Rüdiger Hoffmann - , University of Tübingen (Author)
  • Ralf Thorsten Hoffmann - , Institute and Polyclinic of Diagnostic and Interventional Radiology (Author)
  • Joachim Kettenbach - , Landesklinikum Wiener Neustadt (Author)
  • Stephan Clasen - , University of Tübingen (Author)
  • Thomas Helmberger - , Munich Municipal Hospital Bogenhausen (Author)

Abstract

Objectives: To compare the results of CT- vs MR-guided radiofrequency ablation (RFA) of liver metastases (LM) from colorectal cancer after 10 years of follow-up in an observational, retrospective, and multicentric study. Methods: A total of 238 patients with 496 LM were treated with RFA either with CT (CT group) or magnetic resonance (MR group) guidance. Every ablated LM was assessed and followed up with diagnostic MRI. Technical success, technique efficacy, predictive factors, recurrence rates, and overall survival were assessed. Results: The CT group comprised 143 patients and the MR group 77 patients. Eighteen patients underwent ablation with both modalities. Technical success per patient and per lesion was 88% and 93% for CT and 87% and 89.6% for MR, and technique efficacy was 97.1% and 98.6% for CT and 98.7% and 99.3% for MR respectively. Local recurrence following the first ablation (primary patency) occurred in 20.1% (CT) vs 4.6% (MR) (p < 0.001). Residual liver tumor, size of LM, and advanced N and M stage at initial diagnosis were independent predictors for overall survival in both groups. The median overall survival measured from first RFA treatment was 2.6 years. The 1-year, 5-year, and 10-year survival were 85.9%, 25.5%, and 19.1% respectively. Conclusions: The MR group had significantly better local control compared to the CT group. There was no significant difference in patient survival between the two groups. Clinical relevance statement: MR-guided radiofrequency ablation of colorectal liver metastases is safe and effective, and offers better local control than CT-guided ablation. Key Points: • Imaging modality for radiofrequency ablation guidance is an independent predictor of local recurrence in colorectal liver metastases. • MR-guided radiofrequency ablation achieved better local control of liver metastases from colorectal cancer than CT-guided. • The number and size of liver metastases are, among others, independent predictors of survival. Radiofrequency ablation with MR guidance improved clinical outcome but does not affect survival.

Details

Original languageEnglish
Pages (from-to)4663-4671
Number of pages9
JournalEuropean radiology
Volume34
Issue number7
Publication statusPublished - Jul 2024
Peer-reviewedYes

External IDs

PubMed 38041717

Keywords

Sustainable Development Goals

Keywords

  • Colorectal liver metastases, Magnetic resonance imaging, Multidetector computed tomography, Radiofrequency ablation