MR-guided laser induced thermotherapy (LITT) of liver metastases

Purpose To demonstrate clinical findings and imaging criteria of side-effects and complications immediatly and delayed after the MR-guided LITT for the treatment of liver metastases. Material and methods In a time frame of 6 years 411 patients were prospectively treated with MR-guided LITT for liver metastases. Between June 1993 and March 1999 a total of 2440 laser applications were performed to treat 923 lesions in 322 consecutive patients. Concerning to the technical development of the LITT procedure the patients were subdivided for the evaluation of the local control rate and side effects in 3 groups (group 1: patient 1-100, group 2: patient 101-175, group 3: patient 176-322). The complications of the procedure were evaluated by clinical examination and unenhanced and contrast enhanced MR imaging performed once 24 to 48 hours after the intervention and then every 3 months. Results All patients tolerated the procedure under local anaesthesia well. The following complications or side-effects could be visualized on clinical examination or imaging studies: pleural effusion in 7.28%, subcapsular hematoma in 2.46%, intrahepatic abscess in 0.11%, intraabdominal bleeding in 0.11% and local infection on puncturing side in 0.2%. All complications except the following were clinical not relevant and only visible on imaging studies: In 0.36% of the cases the pleural effusion had to be treated by puncture due to clinical relevant dyspnoe. Two intrahepatic abscesses have treated by percutaneous drainage. The 30 day mortality was 1,2 % with septic shock in 1 patient after an ulcer bleeding.