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.