White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 2: Liver and Other Applications in Oncology

Jörg Barkhausen; Thomas Kahn; Gabriele A. Krombach; Christiane K. Kuhl; Joachim Lotz; David Maintz; Jens Ricke; Stefan O. Schönberg; Thomas J. Vogl; Frank K. Wacker; German Association of Chairmen in Academic Radiology (KLR)

doi:10.1055/s-0043-112336

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Table of Contents

Rofo 2017; 189(11): 1047-1054
DOI: 10.1055/s-0043-112336

Interventional Radiology

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 2: Liver and Other Applications in Oncology

Article in several languages: English | deutsch

Authors

Jörg Barkhausen

¹Department of Radiology and Nuclear Medicine, University Hospital Schleswig Holstein Luebeck Campus, Germany
Thomas Kahn

²Clinic and Policlinic for Diagnostic and Interventional Radiology, Leipzig, Germany
Gabriele A. Krombach

³Department of Radiology, University Hospital Giessen, Justus Liebig University, Giessen, Germany
Christiane K. Kuhl

⁴Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Germany
Joachim Lotz

⁵Institute for Diagnostic and Interventional Radiology, Georg-August-University Goettingen, Germany
David Maintz

⁶Department of Radiology, University Hospital of Cologne, Cologne, Germany
Jens Ricke

⁷Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Germany
Stefan O. Schönberg

⁸Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
Thomas J. Vogl

⁹Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Germany
Frank K. Wacker

¹⁰Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany

German Association of Chairmen in Academic Radiology (KLR)

Abstract

Background MRI is attractive for guiding and monitoring interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure flow and cardiac function.

Methods Technical solutions have been developed for all procedural steps including imaging guidance, MR-safe catheters and instruments and patient monitoring. This has led to widening of the clinical applications. Interventional MRI is becoming increasingly important for the treatment of patients suffering from malignant diseases. The detectability of masses and consequently their accessibility for biopsy is higher, compared to other modalities, due to the high intrinsic soft tissue contrast of MRI. Temperature-dependent sequences allow for minimally invasive and tissue-sparing ablation (A-0 ablation).

Conclusion Interventional MRI has become established in the clinical routine for a variety of indications, including biopsies and tumor ablation. Since the economic requirement of covering costs by reimbursement is met and interventional MRI decreases the mortality and morbidity of interventional procedures, broader application of interventional MRI can be expected in the clinical routine in the future.

Key points

Particularly for the treatment of oncological patients, interventional MRI is superior to other methods with respect to minimal invasiveness and tissue protection due to the ability to exactly determine tumor borders and to visualize and control the size of the ablation area on the basis of MR temperature measurement.
Due to the better visualization of targets and the effects of ablation in tissue, interventional MRI can lower the mortality and morbidity associated with these interventions for many indications.
The complex comparison of costs and reimbursement shows that this application can be performed in a cost-covering manner and broader application can be expected in the future.

Citation Format

Barkhausen J, Kahn T, Krombach GA et al. White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 2: Liver and Other Applications in Oncology. Fortschr Röntgenstr 2017; 189: 1047 – 1054

Key words

MR-guided interventions - MR-guided biopsy - MR-guided ablation - HIFU

Full Text

References

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