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Abstract #4308

Utility of Intra-Procedural Gadoxetate Disodium Administration During MRI-Guided Laser Ablation of Hepatic Metastases: Experience with 47 Treated Lesions

Sherif G. Nour1, 2, David A. Kooby3, 4, Shishir K. Maithel3, 4, Charles A. Staley3, 4, Hiroumi D. Kitajims1, 2, William C. Small1, 4, William E. Torres1, 4

1Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States; 2Interventional MRI Program, Emory University, Atlanta, GA, United States; 3Surgical Oncology, Emory University, Atlanta, GA, United States; 4School of Medicine, Emory University, Atlanta, GA, United States

Adequate quantification of liver metastases and reliable targeting of subtle lesions for percutaneous ablation are current challenges leading to hepatic resections/open ablations that maybe avoidable particularly in poor surgical candidates. This investigation reports the utilization of intra-procedural gadoxetate disodium with controlled breath suspension under anesthesia for a)detecting subtle metastases not seen on pre-procedure scans in a manner analogous to using intra-operative ultrasound for metastatic mapping prior to metastatectomy; b)facilitating precise percutaneous targeting of subtle previously unapproachable lesions; c)allowing proper tailoring of ablations and inclusion of adequate safety margins around infiltrative lesions and d) enhancing ablation safety near central bile ducts.

Keywords

ablation ablations abutting accounted accurate achieve achieved additional adequate administered administration agent allow allowed allowing analogous anesthesia applicator applied assess avoidable bile biliary bore breathing burden care cell central challenging choice complete complications confirmed contrast control controlled cooling currently definitive delineation detecting detection diagnostic diode direct disease dose ducts encased endpoint energy evaluated exact exposed exquisite facilitating fact fiber final focal gastric general growing guide guided hepatic identification immediate included inclusion infiltrative interactive intervention intra invasive investigation laser lesion lesions liver lobe location management mapping margins medicine metastases metastatic minimally modes modified multidisciplinary needed occult open operative option outline pancreatic part particular particularly patients percutaneous placements planned planning precise prior procedural procedure proceeding program proper providing quantification real referred repositioning requires room safety scanner school segments subtle surgical suspended suspension system tailoring target targeted targeting temperature toxicity treated treating treatment tumor typically ultrasound unequivocal utility utilizing vibe vicinity whole wide zone