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Thomas C, Wojtczyk H, Rempp H, Clasen S, Horger M, von Lassberg C, Fritz J, Claussen CD, Pereira PL. Carbon fibre and nitinol needles for MRI-guided interventions: First in vitro and in vivo application. Eur J Radiol 2011; 79:353-8. [DOI: 10.1016/j.ejrad.2010.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 07/02/2010] [Accepted: 07/07/2010] [Indexed: 10/19/2022]
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Kickhefel A, Rosenberg C, Weiss CR, Rempp H, Roland J, Schick F, Hosten N. Clinical evaluation of MR temperature monitoring of laser-induced thermotherapy in human liver using the proton-resonance-frequency method and predictive models of cell death. J Magn Reson Imaging 2011; 33:704-12. [PMID: 21563256 DOI: 10.1002/jmri.22499] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To assess the feasibility, precision, and accuracy of real-time temperature mapping (TMap) during laser-induced thermotherapy (LITT) for clinical practice in patients liver with a gradient echo (GRE) sequence using the proton resonance frequency (PRF) method. MATERIALS AND METHODS LITT was performed on 34 lesions in 18 patients with simultaneous real-time visualization of relative temperature changes. Correlative contrast-enhanced T1-weighted magnetic resonance (MR) images of the liver were acquired after treatment using the same slice positions and angulations as TMap images acquired during LITT. For each slice, TMap and follow-up images were registered for comparison. Afterwards, segmentation based on temperature (T) >52°C on TMap and based on necrosis seen on follow-up images was performed. These segmented structures were overlaid and divided into zones where the TMap was found to either over- or underestimate necrosis on the postcontrast images. Regions with T>52°C after 20 minutes were defined as necrotic tissue based on data received from two different thermal dose models. RESULTS The average intersecting region of TMap and necrotic zone was 87% ± 5%, the overestimated 13% ± 4%, and the underestimated 13% ± 5%. CONCLUSION This study demonstrates that MR temperature mapping appears reasonably capable of predicting tissue necrosis on the basis of indicating regions having greater temperatures than 52°C and could be used to monitor and adjust the thermal therapy appropriately during treatment.
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Rempp H, Clasen S, Pereira PL. Image-based monitoring of magnetic resonance-guided thermoablative therapies for liver tumors. Cardiovasc Intervent Radiol 2011; 35:1281-94. [PMID: 21785888 DOI: 10.1007/s00270-011-0227-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 06/23/2011] [Indexed: 12/27/2022]
Abstract
Minimally invasive treatment options for liver tumor therapy have been increasingly used during the last decade because their benefit has been proven for primary and inoperable secondary liver tumors. Among these, radiofrequency ablation has gained widespread consideration. Optimal image-guidance offers precise anatomical information, helps to position interventional devices, and allows for differentiation between already-treated and remaining tumor tissue. Patient safety and complete ablation of the entire tumor are the overriding objectives of tumor ablation. These may be achieved most elegantly with magnetic resonance (MR)-guided therapy, where monitoring can be performed based on precise soft-tissue imaging and additional components, such as diffusion-weighted imaging and temperature mapping. New MR scanner types and newly developed sequence techniques have enabled MR-guided intervention to move beyond the experimental phase. This article reviews the current role of MR imaging in guiding radiofrequency ablation. Signal characteristics of primary and secondary liver tumors are identified, and signal alteration during therapy is described. Diffusion-weighted imaging (DWI) and temperature mapping as special components of MR therapy monitoring are introduced. Practical information concerning coils, sequence selection, and parameters, as well as sequence gating, is given. In addition, sources of artifacts are identified and techniques to decrease them are introduced, and the characteristic signs of residual tumor in T1-, T2-, and DWI are described. We hope to enable the reader to choose MR sequences that allow optimal therapy monitoring depending on the initial signal characteristics of the tumor as well as its size and location in the liver.
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Clasen S, Rempp H, Boss A, Schmidt D, Fritz J, Schraml C, Schick F, Claussen CD, Pereira PL. MR-guided radiofrequency ablation of hepatocellular carcinoma: long-term effectiveness. J Vasc Interv Radiol 2011; 22:762-70. [PMID: 21530311 DOI: 10.1016/j.jvir.2011.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Revised: 03/01/2011] [Accepted: 03/04/2011] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To evaluate long-term effectiveness of magnetic resonance (MR)-guided radiofrequency (RF) ablation of hepatocellular carcinoma (HCC). MATERIALS AND METHODS This prospective study was approved by the institutional review board. In 20 patients, 28 HCCs (mean diameter, 28.0 mm; range, 6-58 mm) were treated with 25 sessions of MR-guided RF ablation. Previous chemoembolization had been performed in nine HCCs with diameters greater than 3 cm. The entire RF ablation procedures were carried out on a 0.2-T open MR system. Placement of MR-compatible internally cooled electrodes was performed under MR fluoroscopic imaging with fast gradient-echo sequences. Therapeutic assessment was based on dynamic MR-imaging (1.5 T) at a mean follow-up of 24.2 months (range, 6-52 mo). RESULTS MR-guided RF ablation was technically successful in all 25 sessions (100%), as assessed at the end of each session. T2-weighted sequences were accurate to monitor the ablation zone and supported guidance of overlapping ablations if necessary. Technique effectiveness, defined as complete ablation confirmed at MR imaging 4 months after RF ablation, was achieved in 27 of 28 HCCs (96.4%). To achieve complete ablation, 25 of 27 tumors (92.6%) were treated in a single session and two tumors were treated twice. In one tumor initially defined as having been treated with technically effective RF ablation, local tumor progression was detected more than 4 months after ablation. Consequently, the available follow-up indicated complete ablation in 26 of 28 HCCs (92.9%). There was one major complication (4.0%) and one minor complication (4.0%). CONCLUSIONS On a long-term basis, MR-guided RF ablation is an effective therapy option in the treatment of HCC.
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Rempp H, Mezger D, Voigtländer M, Enderle M, Hoffmann R, Pereira PL, Claussen CD, Clasen S. Ex-vivo Vergleichsstudie von mono- und bipolaren intern gas- und wassergekühlten Radiofrequenzapplikatoren. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rempp H, Waibel L, Hoffmann R, Pereira PL, Claussen CD, Clasen S. MR-gesteuerte Radiofrequenzablation in einem weitgebohrten 1,5 T-System: Klinische Ergebnisse von 202 behandelten Lebertumoren. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Clasen S, Rempp H, Hoffmann R, Waibel L, Schmidt D, Schick F, Claussen CD, Pereira PL. MRT-gesteuerte Radiofrequenz-Ablation: Effektivitäts-Beurteilung in der Behandlung von 50 Patienten mit Hepatozellulärem Karzinom (HCC). ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schmidt D, Clasen S, Schäfer J, Rempp H, Erdtmann B, König CW, Duda S, Trübenbach J, Kluba T, Claussen CD, Pereira PL. Manuelle versus maschinelle Bohrung in der CT gesteuerten RFA von Osteoid-osteomen - 11-jährige klinische Erfahrung. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hoffmann R, Rempp H, Schmidt D, Claussen CD, Pereira PL, Clasen S. Antibiotikaprophylaxe zur Prävention chologener Abszesse nach Radiofrequenz-Ablation bei Risikopatienten mit biliodigestiver Anastomose. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schmidt D, Clasen S, Schaefer J, Rempp H, Duda S, Trübenbach J, König C, Erdtmann B, Claussen C, Pereira P. CT-gesteuerte Radiofrequenz(RF)-Ablation von Osteoidosteomen: klinische Langzeitergebnisse. ROFO-FORTSCHR RONTG 2011; 183:381-7. [DOI: 10.1055/s-0029-1245998] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Clasen S, Rempp H, Schmidt D, Schraml C, Hoffmann R, Claussen CD, Pereira PL. Multipolar radiofrequency ablation using internally cooled electrodes in ex vivo bovine liver: correlation between volume of coagulation and amount of applied energy. Eur J Radiol 2010; 81:111-3. [PMID: 21112714 DOI: 10.1016/j.ejrad.2010.10.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 10/20/2010] [Accepted: 10/20/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the relationship between applied energy and volume of coagulation induced by multipolar radiofrequency (RF) ablation. METHODS AND MATERIALS Multipolar RF ablations (n=80) were performed in ex vivo bovine liver. Three bipolar applicators with two electrodes located on each applicator shaft were placed in a triangular array. The power-output (75-225 W) and the distance between the different applicators (2, 3, 4, 5 cm) were systematically varied. The volume of confluent white coagulation and the amount of applied energy were assessed. Based on our experimental data the relationship between the volume of coagulation and applied energy was assessed by nonlinear regression analysis. The variability explained by the model was determined by the parameter r(2). RESULTS The volume of coagulation increases with higher amounts of applied energy. The maximum amount of energy was applied at a power-output of 75 W and an applicator distance of 5 cm. The corresponding maximum volume of coagulation was 324 cm(3) and required an application of 453 kJ. The relationship between amount of applied energy (E) and volume (V) of coagulation can be described by the function, V=4.39E(0.7) (r(2)=0.88). By approximation the volume of coagulation can be calculated by the linear function V=0.61E+40.7 (r(2)=0.87). CONCLUSION Ex vivo the relationship between volume of coagulation and amount of applied energy can be described by mathematical modeling. The amount of applied energy correlates to the volume of coagulation and may be a useful parameter to monitor multipolar RF ablation.
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Thomas C, Müller-Bierl BM, Rempp H, Siegmann K, Martirosian P, Claussen CD, Pereira PL. In vitro Assessment of Artifacts from Commercially Available Markers for Image-guided Preoperative Marking of Bone and Soft Tissue Lesions. J Vasc Interv Radiol 2010; 21:1100-4. [DOI: 10.1016/j.jvir.2010.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Revised: 02/28/2010] [Accepted: 04/03/2010] [Indexed: 10/19/2022] Open
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Würslin C, Machann J, Rempp H, Claussen C, Yang B, Schick F. Topography mapping of whole body adipose tissue using A fully automated and standardized procedure. J Magn Reson Imaging 2010; 31:430-9. [PMID: 20099357 DOI: 10.1002/jmri.22036] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE To obtain quantitative measures of human body fat compartments from whole body MR datasets for the risk estimation in subjects prone to metabolic diseases without the need of any user interaction or expert knowledge. MATERIALS AND METHODS Sets of axial T1-weighted spin-echo images of the whole body were acquired. The images were segmented using a modified fuzzy c-means algorithm. A separation of the body into anatomic regions along the body axis was performed to define regions with visceral adipose tissue present, and to standardize the results. In abdominal image slices, the adipose tissue compartments were divided into subcutaneous and visceral compartments using an extended snake algorithm. The slice-wise areas of different tissues were plotted along the slice position to obtain topographic fat tissue distributions. RESULTS Results from automatic segmentation were compared with manual segmentation. Relatively low mean deviations were obtained for the class of total tissue (4.48%) and visceral adipose tissue (3.26%). The deviation of total adipose tissue was slightly higher (8.71%). CONCLUSION The proposed algorithm enables the reliable and completely automatic creation of adipose tissue distribution profiles of the whole body from multislice MR datasets, reducing whole examination and analysis time to less than half an hour.
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Schmidt D, Clasen S, Schäfer J, Rempp H, König CW, Duda S, Erdtmann B, Claussen C, Pereira PL. 10-jährige klinische Erfahrung der CT gesteuerten Radiofrequenzablation von Osteoid-Osteomen. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schmidt D, Clasen S, Weihusen A, Rempp H, Schraml C, Boss A, Schick F, Claussen C, Pereira PL. Computerunterstützte Bildgebung zur Optimierung des Therapieerfolges der MR-gesteuerten Radiofrequenzablation von malignen Leberneoplasien. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Clasen S, Rempp H, Dorn J, Schmidt D, Claussen C, Pereira PL. Experimentelle ex-vivo Evaluation der hepatischen Mikrowellen-Ablation. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schmidt D, Clasen S, Rempp H, Weihusen A, Kern B, Claussen C, Pereira PL. Bestimmung der Wertigkeit der computerunterstützten präinterventionellen Planung und Ergebniskontrolle für die MR gesteuerte RFA von malignen Lebertumoren. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Thomas C, Springer F, Röthke M, Rempp H, Clasen S, Fritz J, Claussen CD, Pereira PL. In Vitro Assessment of Needle Artifacts with an Interactive Three-dimensional MR Fluoroscopy System. J Vasc Interv Radiol 2010; 21:375-80. [DOI: 10.1016/j.jvir.2009.11.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Revised: 11/08/2009] [Accepted: 11/11/2009] [Indexed: 01/20/2023] Open
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Rempp H, Clasen S, Schraml C, Schmidt D, Boss A, Roland J, Kickhefel A, Miller S, Schick F, Claussen C, Pereira PL. MR-Temperaturmapping bei der Radiofrequenzablation von hepatischen Tumoren: Wie genau kann das Koagulationsareal vorhergesagt werden? ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1253030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bartsch I, Bläser S, Röseler S, Sandrock K, Busse A, Huber M, Rempp H, Lieber M, Horn J, Brendle C, Zieger B. Human endothelial and platelet septin SEPT11: Cloning of novel variants and characterisation of interaction partners. Thromb Haemost 2010; 104:1201-10. [DOI: 10.1160/th10-07-0472] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 08/15/2010] [Indexed: 11/05/2022]
Abstract
SummarySeptins are cytoskeletal GTPases forming heteropolymeric complexes involved in processes characterised by active membrane movement such as cytokinesis, vesicle trafficking, and exocytosis. Septins are expressed in non-mitotic cells such as neurons and platelets. SEPT11 belongs to the SEPT6 group and was identified as interaction partner of SEPT5. We cloned and characterised novel SEPT11 variants and investigated interaction partners of SEPT11 in platelets and human umbilical vein endothelial cells. An endothelial cell library was used for cloning novel SEPT11 variants. Using Northern analysis the different SEPT11 transcripts were illustrated. Interaction studies were performed using yeast two-hybrid system, precipitation, FRET, and immunofluorescence microscopy. We demonstrate that SEPT11 partners with SEPT2, SEPT4 and SEPT7 using yeast two-hybrid system and precipitation. The interaction of SEPT11 with SEPT7 is also demonstrated by FRET. In addition to the known SEPT11 transcript (SEPT11_v1) we identified a novel SEPT11 variant (SEPT11_v2) as interaction partner of SEPT4 and SEPT7. Library screening of an endothelial cell library also revealed the presence of this novel SEPT11_v2 transcript. In addition, a third SEPT11 variant (SEPT11_v3) was identified. Expression of SEPT11_v1 and of SEPT11_v2 and SEPT11_v3 in human brain regions was investigated by Northern analysis. Further interaction partners of SEPT11 are characterised using immunofluorescence. Co-localisation of SEPT2, SEPT4, SEPT7 and SEPT11 with tubulin and transferrin receptor (endocytotic marker) is demonstrated. In addition, co-localisation of SEPT4 and SEPT11 with the vesicle-associated protein synaptobrevin 1 (VAMP1), but not clearly with actin, was shown. Only SEPT2 and SEPT7 definitely co-localised with actin, but not clearly with VAMP1.
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Rempp H, Clasen S, Boss A, Roland J, Kickhefel A, Schraml C, Claussen CD, Schick F, Pereira PL. Prediction of cell necrosis with sequential temperature mapping after radiofrequency ablation. J Magn Reson Imaging 2009; 30:631-9. [DOI: 10.1002/jmri.21863] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Rempp H, Martirosian P, Boss A, Clasen S, Kickhefel A, Kraiger M, Schraml C, Claussen C, Pereira P, Schick F. MR temperature monitoring applying the proton resonance frequency method in liver and kidney at 0.2 and 1.5 T: segment-specific attainable precision and breathing influence. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2008; 21:333-43. [DOI: 10.1007/s10334-008-0139-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Revised: 07/18/2008] [Accepted: 08/07/2008] [Indexed: 12/13/2022]
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Boss A, Rempp H, Martirosian P, Clasen S, Schraml C, Stenzl A, Claussen CD, Schick F, Pereira PL. Wide-bore 1.5 Tesla MR imagers for guidance and monitoring of radiofrequency ablation of renal cell carcinoma: initial experience on feasibility. Eur Radiol 2008; 18:1449-55. [PMID: 18351355 DOI: 10.1007/s00330-008-0894-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Revised: 01/29/2008] [Accepted: 02/04/2008] [Indexed: 01/18/2023]
Abstract
This study was conducted to test and demonstrate the feasibility of magnetic resonance (MR)-guided radiofrequency (RF) ablation of renal cell carcinoma (RCC) using a 1.5 T whole-body scanner equipped with a wide-bore superconductive magnet. Two patients with contrast-enhancing renal masses were treated with multipolar RF ablation (Celon ProSurge). Applicator navigation and near real-time ablation monitoring were performed in a wide-bore 1.5 T scanner using adapted fluoroscopic and diagnostic sequences. In addition to T2-weighted imaging for ablation monitoring, perfusion-weighted images acquired with an arterial spin-labeling technique (FAIR-TrueFISP) were applied. Results were compared to a previous study on 12 patients performed at 0.2 T. Navigation and monitoring of RF ablation using the wide-bore system operating at 1.5 T were clearly improved compared to former experiences on a 0.2 T MR unit. Fluoroscopic and diagnostic images for MR guidance could be acquired with distinctly higher image quality and shorter acquisition time resulting in higher accuracy of applicator placement and shorter treatment time. Spin-labeling perfusion imaging exhibited good image quality, potentially providing additional clinically important information. MR-guided RF ablation of RCC can safely be performed in a 1.5 T wide-bore scanner offering higher image quality, shorter acquisition time, and new monitoring modalities not feasible at 0.2 T.
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Rempp H, Boss A, Martirosian P, Claussen CD, Schick F. Ganzkörper-Magnetisierungstransfer-MR-Bildgebung. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2006-956197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rempp H, Boss A, Kraiger M, Pereira P, Claussen CD, Schick F. MR-Thermographie an Leber und Nieren mittels Phasenkontrast-Methode – Einflüsse von Atmung und Bewegung auf die Messgenauigkeit. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2006-956196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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