Magnetic Resonance-Guided Interstitial Laser Photocoagulation for the Treatment of Breast Cancer

摘要

This study explored the use of MRI directed laser ablation as a potential non-surgical treatment method for malignant breast neoplasms. RODEO MRI was used to determine lesion extent and interactively coordinate therapy. MR compatible needles were placed with stereotaxic guidance. Biopsy proven malignant breast lesions (30 patients) were treated with a bare tip fiber connected to a diode laser operating at 805 nm for a total of 600-seconds/ treatment zone. The effectiveness was established with H & E and PCNA stains. A total of 68 treatment zones were performed. Surgery (18 mastectomy, 12 lumpectomy) was performed between 2 hours and three days following laser treatment. Serial sectioning of the surgical specimens and stains of the ablation zones correlated in size with the hypointense zones seen on MRI. The average ablation zone size was 10 mm in diameter. Effective cell death was demonstrated in 60/68 zones on PCNA stains. Three patients had minor skin burns that were removed at surgery. Interactive MRI can be used to coordinate interstitial laser photocoagulation therapy. Laser thermal ablation can effectively destroy malignant breast neoplasms. MRI directed laser therapy offers the potential for treatment of small breast neoplasms without the disfigurement associated with breast conservation surgery.