1.5 T conventional MR-guided iodine-125 interstitial implants for hepatocellular carcinoma: Feasibility and preliminary clinical experience

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• 作者：Zheng-Yu Lin^a ; ^{linsinlan@yahoo.com.cn} ; Jun Lin^b ; ¹ ; ^{linjun@163.com} ; Cong Lin^c ; ² ; ^{aostcong@163.com} ; Yin-Guan Li^a ; ³ ; ^{lygyax@163.com} ; Shao-Ming Chen^b ; ⁴ ; ^{csming1981@yahoo.com.cn} ; Jian-Ping Hu^a ; ⁵ ; ^{hujianping08@sohu.com} ; Rui Hu^b ; ⁶ ; ^{hrydh2004@126.com} ; Jin Chen^a ; ⁷ ; ^{snow8968851@163.com}
• 关键词：Brachytherapy ; Magnetic resonance imaging ; Hepatocellular carcinoma ; Intervention ; Iodine 125
• 刊名：European Journal of Radiology
• 出版年：2012
• 期刊代码：93_0720048x
• 类别：med
• 出版时间：July, 2012
• 卷：81
• 期：7
• 页码：1420-1425
• 文件大小：1073 K

摘要

Purpose

To evaluate the feasibility and therapeutic efficacy of 1.5 T conventional MR-guided percutaneous interstitial implantation of I-125 radioactive seeds in patients with hepatocellular carcinoma (HCC).

Materials and methods

The institutional ethics committee approved this study. After imformed consent was obtained, twenty-three patients suffering from a total of 65 HCC lesions were treated with I-125 seed permanent interstitial implantation under the guidance of a 1.5 T conventional magnetic resonance imaging (MRI) system. The FSE T2WI, T1 FSPGR, FIESTA 2D, 3D Dyn T1WI sequences were used to guide an 18G MR-compatible needle inserted into the lesions to introduce the I-125 seeds. The response evaluation criteria in solid tumors (RECIST) were used to evaluate the curative effect.

Results

The needle and I-125 seed were seen clearly on MRI images. The final dose delivered to total decay was 173.46 卤 32.44 Gy (range, 110-270 Gy) as calculated by postoperative TPS. The complete response (CR) was seen in 22 lesions (33.8%), partial response (PR) in 24 lesions (36.9%), stable disease (SD) in 9 lesions (13.8%), and progressive disease (PD) in 10 lesions (15.4%). The post-operative alpha-fetoprotein (AFP) was decreased (t = 3.117, P = 0.005 < 0.05). Two patients were observed a small area of subcapsular bleeding that did not lead to any symptoms or clinical sequelae.

Conclusion

MR-guided I-125 implantation for HCC is technically feasible and effective.