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  • Title: Adrenal metastases: CT-guided and MR-thermometry-controlled laser-induced interstitial thermotherapy.
    Author: Vogl TJ, Lehnert T, Eichler K, Proschek D, Flöter J, Mack MG.
    Journal: Eur Radiol; 2007 Aug; 17(8):2020-7. PubMed ID: 17180325.
    Abstract:
    The aim of the study was to evaluate the feasibility, safety and effectiveness of CT-guided and MR-thermometry-controlled laser-induced interstitial thermotherapy (LITT) in adrenal metastases. Nine patients (seven male, two female; average age 65.0 years; range 58.7-75.0 years) with nine unilateral adrenal metastases (mean diameter 4.3 cm) from primaries comprising colorectal carcinoma (n = 5), renal cell carcinoma (n = 1), oesophageal carcinoma (n = 1), carcinoid (n = 1), and hepatocellular carcinoma (n = 1) underwent CT-guided, MR-thermometry-controlled LITT using a 0.5 T MR unit. LITT was performed with an internally irrigated power laser application system with an Nd:YAG laser. A thermosensitive, fast low-angle shot 2D sequence was used for real-time monitoring. Follow-up studies were performed at 24 h and 3 months and, thereafter, at 6-month intervals (median 14 months). All patients tolerated the procedure well under local anaesthesia. No complications occurred. Average number of laser applicators per tumour: 1.9 (range 1-4); mean applied laser energy 33 kJ (range 15.3-94.6 kJ), mean diameter of the laser-induced coagulation necrosis 4.5 cm (range 2.5-7.5 cm). Complete ablation was achieved in seven lesions, verified by MR imaging; progression was detected in two lesions in the follow-up. The preliminary results suggest that CT-guided, MR-thermometry-controlled LITT is a safe, minimally invasive and promising procedure for treating adrenal metastases.
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