Real time monitoring of radiofrequency ablation based on MR thermometry and thermal dose in the pig liver in vivo

To evaluate the feasibility and accuracy of MR thermometry based on the thermal dose (TD) concept for monitoring radiofrequency (RF) ablations, 13 RF ablations in pig livers were performed under continuous MR thermometry at 1.5 T with a filtered clinical RF device. Respiratory gated fast gradient echo images were acquired simultaneously to RF deposition for providing MR temperature maps with the proton resonant frequency technique. Residual motion, signal to noise ratio (SNR) and standard deviation (SD) of MR temperature images were quantitatively analyzed to detect and reject artifacted images in the time series. SD of temperature measurement remained under 2 degrees C. Macroscopic analysis of liver ablations showed a white zone (Wz) surrounded by a red zone (Rz). A detailed histological analysis confirmed the ongoing nature of the coagulation necrosis in both Wz and Rz. Average differences (+/- SD) between macroscopic size measurements of Wz and Rz and TD predictions of ablation zones were 4.1 (+/- 1.93) mm and -0.71 (+/- 2.47) mm, respectively. Correlation values between TD and Wz and TD and Rz were 0.97 and 0.99, respectively. MR thermometry monitoring based on TD is an accurate method to delineate the size of the ablation zone during the RF procedure and provides a clinical endpoint.