Chengli Li MD, PhD, Presenter: Nothing to Disclose

Evaluate the feasibility and effective of our initial experience with MRI-guided cryoablation of metastatic brain tumors.

With approval from the local ethics committee and patient consent. Between Sept.2008 – Jan. 2012, 7 brain mets in 6 consecutive patients (5 women, 1 men, mean age 53 years) were treated using cryoablation under conscious sedation. A 0.23T open MRI device mounted with optical tracking system was used for procedural imaging and instrument guidance. Once planning the intervention route, a 2-3mm burr-hole was drilled under sterile conditions and local anesthesia out of the 5 gauss line. Cryoablation was performed by using an MR-compatible, argon-based cryoablation system with 1.47mm probs according to the size of tumor. Multi-sites or multi-angles were performed if necessary to make the ice ball engulf the tumor and arrive to conformal ablation. For cystic lesions, aspirating fluid was performed first, then advancing the biopsy needle to acquire pathology specimen prior to the cryoablation. Two freeze-thaw cycles (10-minute freeze, 5-minute thaw, 10-minute interval) were performed for each site.

In 7 sessions, seven tumors in six patients were treated with 11 cryoablations.The ice around the probe tip was continuously and clearly visible as an ellipsoid-like signal-free area in MR images.one patient was died of pneumonia and high fever at the 12 days after cryoablation. Two patients had symptoms possibly related to intracranial hypertension.The mean operative time was 120 minutes.

MRI-guidance and monitoring cryoablation is safe, feasible, and effective for certain brain metastases patients. MRI-guided cryoablation can be used to substitute more invasive procedures in selected patient groups.

Excellent MR Guidance and Visualization. Generally,technically feasible and effective treatment option of brain metastases. Decrease viable tumour.

Li, C, MR Imaging-guided Brain Metastases Cryoablation:  Initial Experience in 6 Patients  .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002644.html