Combined Use of MR-HIFU and Intra-Arterial Embolization to Reduce Heat Sink: Quantification in a Porcine Liver Model

Joost W. Wijlemans¹, Mario Ries², Martijn de Greef², Gerald Schubert³, Max Khler³, Mika Ylihautala³, Lambertus W. Bartels², Chrit T.W. Moonen², Maurice A.A.J. van den Bosch¹

The heat sink effect, a major challenge in MR-HIFU ablation of liver tumors, can be reduced by performing intra-arterial embolization prior to MR-HIFU ablation. In this study, we investigated the synergistic effect of embolization and MR-HIFU. Six treatment cells were sonicated in a porcine liver model using PRFS thermometry. Subsequently, the liver was embolized and the treatment cells were re-sonicated. Mean temperature increase after embolization was 1.7 times higher than in perfused liver tissue. These results indicate that combination treatment with intra-arterial embolization and MR-HIFU could be an attractive treatment option for liver cancer patients in the palliative phase.