Real-time MRI-guided interstitial laser therapy for inoperable renal lesions: A novel therapeutic approach?

Introduction: In patients with renal lesions which may be amenable to resection but in whom surgery is contraindicated, interstitial laser therapy may provide a novel therapeutic approach in the future. The advent of an open-coil MRI scanner in our unit allows interventional procedures to be performed under the guidance of real-time images. This technique was used to examine the effect of interstitial laser therapy on cadaveric liver and kidney tissue. Materials and methods: Cadaveric livers and kidneys were procured; the organs were imaged at 0.5 Tesla using an opencoil MRI unit. Using real-time images, an interstitial laser was introduced and used to achieve a suitable volume of coagulation necrosis, which was recorded on MRI. These images were then correlated with a macroscopic examination of the coagulated area in the open specimen. Results: Good necrosis is achieved in the cadaveric specimens using the laser. Correlation with open specimens showed that real-time MRI is accurate in locating a particular area of an organ, and also in determining the volume of tissue necrosed. Conclusions: Interstitial laser coagulation is a novel therapeutic approach for treating renal lesions which is still in its infancy. However, our early results have been promising and this technique is currently undergoing further research.