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Computed tomography-guided radiofrequency ablation of the retained iodized oil after simultaneous combination with transarterial embolization in small recurrent or residual hepatocellular carcinoma. J Interv Med 2020; 3:49-54. [PMID: 34805907 PMCID: PMC8562296 DOI: 10.1016/j.jimed.2020.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objective To assess the clinical efficacy and safety of transarterial embolization (TAE) in simultaneous combination with computed tomography (CT)-guided radiofrequency ablation (RFA) for recurrent or residual hepatocellular carcinoma (HCC), and to determine the risk factors influencing local tumor progression following this procedure. Methods One hundred eighteen patients with recurrent or residual HCC (tumor size, 10-30 mm) underwent RFA. During the 19-month follow-up, 59 patients received RFA only (RFA group), and the remaining 59 received RFA immediately after TAE (TAE + RFA group). All patients were followed up to observe the short-term therapeutic effects and complications. The cumulative local tumor progression rates in both groups were calculated using unpaired Student's t tests and the Kaplan-Meier method. Results The rate of major complications was 5.08% in the TAE + RFA group and 3.39% in the RFA group. The overall response rate was 96.61% in the TAE + RFA group and 79.66% in the RFA group (P = 0.008). The disease control rate was significantly higher in the TAE + RFA group than in the RFA group (94.92% vs. 79.66%, P = 0.024). The median time to local tumor progression was 4.8 months in the RFA group and 9.6 months in the TAE + RFA group. The cumulative local tumor progression rate at 1 year was 10.60% in the RFA group and 23.60% in the TAE + RFA group (P = 0.016). Conclusion TAE in simultaneous combination with CT-guided RFA was effective and safe against recurrent or residual HCC. Local tumor progression can be minimized by the complete ablation of targeted iodized oil deposits after simultaneous TAE.
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Gao H, Wang X, Wu S, Zhou Z, Bai Y, Wu W. Conformal coverage of liver tumors by the thermal coagulation zone in 2450-MHz microwave ablation. Int J Hyperthermia 2020; 36:591-605. [PMID: 31172824 DOI: 10.1080/02656736.2019.1617437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose: To optimize treatment schemes using 2450-MHz microwave ablation (MWA), a novel conformal coverage method based on bipolar-angle mapping is proposed that determines whether a liver tumor is completely encompassed by thermal coagulation zones. Materials and methods: Firstly, three-dimensional (3-D) triangular mesh data of liver tumors were reconstructed from clinical computed tomography (CT) slices using the Marching cubes (MC) algorithm. Secondly, characterization models of thermal coagulation zones were established based on finite element simulation results of 40, 45, 50, 55, and 60 W ablations. Finally, coagulation zone models and tumor surface data were mapped and fused on a two-dimensional (2-D) plane to achieve conformal coverage of liver tumors by comparing the corresponding polar radii. Results: Optimal parameters for ablation treatment of liver tumors were efficiently obtained with the proposed conformal coverage method. Fifteen liver tumors were obtained with maximal diameters of 12.329-78.612 mm (mean ± standard deviation, 39.094 ± 19.447 mm). The insertion positions and orientations of the MWA antenna were determined based on 3-D reconstruction results of these tumors. The ablation patterns and durations of tumors were planned according to the minimum mean standard deviations between the ablative margin and tumor surface. Conclusion: The proposed method can be applied to computer-assisted MWA treatment planning of liver tumors, and is expected to guide clinical procedures in future.
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Affiliation(s)
- Hongjian Gao
- a College of Life Science and Bioengineering , Beijing University of Technology , Beijing , China
| | - Xiaoru Wang
- a College of Life Science and Bioengineering , Beijing University of Technology , Beijing , China
| | - Shuicai Wu
- a College of Life Science and Bioengineering , Beijing University of Technology , Beijing , China
| | - Zhuhuang Zhou
- a College of Life Science and Bioengineering , Beijing University of Technology , Beijing , China
| | - Yanping Bai
- a College of Life Science and Bioengineering , Beijing University of Technology , Beijing , China
| | - Weiwei Wu
- b College of Biomedical Engineering , Capital Medical University , Beijing , China
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Darweesh SK, Gad AA. Percutaneous microwave ablation for HCV-related hepatocellular carcinoma: Efficacy, safety, and survival. TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 30:445-453. [PMID: 31060999 DOI: 10.5152/tjg.2019.17191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIMS Hepatocellular carcinoma (HCC) has a poor prognosis if managed late. Percutaneous microwave ablation (MWA) emerged as one of the top therapeutic decisions for non-surgical patients. The aim of the present study aim was to evaluate the efficacy, side effects, and survival after MWA of hepatitis C virus (HCV)-related HCC tumors with spectrum sizes up to 5 cm. MATERIALS AND METHODS Fifty-nine patients with early HCC were treated in the Hepatology Department using percutaneous MWA. Patients were assessed for side effects and efficacy that includes the rate of complete ablation, primary or de novo recurrence, and survival. RESULTS Complete ablation was achieved in 57 (96.6%) patients treated by MWA, with a minor complication rate of 3.3% (n=2) including liver abscess formation and abdominal skin burn. The ablation rates in lesions <3 versus 3-5 cm were not different. Of the patients, 3 (5%) had primary recurrence in the treated HCC tumors, de novo lesions (secondary recurrence) developed in 8 (13.5%, 5 of them >3 cm), and 2 (3.3%) had malignant portal vein thrombosis. The survival rates were 95.4% and 69% at 1 and 2 years, respectively. CONCLUSION Percutaneous MWA had achieved a safe and effective treatment with good overall survival in patients with HCV-related HCC.
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Affiliation(s)
- Samar K Darweesh
- Department of Hepato-gastroenterology and Tropical Medicine, Cairo University School of Medicine, Egypt
| | - Amal A Gad
- Department of Internal Medicine, Suez Canal University School of Medicine, Ismailia, Egypt
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Gunn AJ, Parikh NS, Bhatia S. Society of Interventional Radiology Quality Improvement Standards on Percutaneous Ablation in Renal Cell Carcinoma. J Vasc Interv Radiol 2020; 31:195-201.e3. [PMID: 31917026 DOI: 10.1016/j.jvir.2019.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Andrew J Gunn
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Nainesh S Parikh
- Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida
| | - Shivank Bhatia
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
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Emerging Prospects for Nanoparticle-Enabled Cancer Immunotherapy. J Immunol Res 2020; 2020:9624532. [PMID: 32377541 PMCID: PMC7199570 DOI: 10.1155/2020/9624532] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 10/30/2019] [Accepted: 11/02/2019] [Indexed: 12/18/2022] Open
Abstract
One of the standards for cancer treatment is cancer immunotherapy which treats both primary and metastasized tumors. Although cancer immunotherapeutics show better outcomes as compared with conventional approaches of cancer treatment, the currently used cancer immunotherapeutics have limited application in delivering cancer antigens to immune cells. Conversely, in solid tumors, tumor microenvironment suppresses the immune system leading to the evasion of anticancer immunity. Some promising attempts have been made to overcome these drawbacks by using different approaches, for instance, the use of biomaterial-based nanoparticles. Accordingly, various studies involving the application of nanoparticles in cancer immunotherapy have been discussed in this review article. This review not only describes the modes of cancer immunotherapy to reveal the importance of nanoparticles in this modality but also narrates nanoparticle-mediated delivery of cancer antigens and therapeutic supplements. Moreover, the impact of nanoparticles on the immunosuppressive behavior of tumor environment has been discussed. The last part of this review deals with cancer immunotherapy using a combination of traditional interventional oncology approach and image-guided local immunotherapy against cancer. According to recent studies, cancer therapy can potentially be improved through nanoparticle-based immunotherapy. In addition, drawbacks associated with the currently used cancer immunotherapeutics can be fixed by using nanoparticles.
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Alexander ES, Xiong L, Baird GL, Fernando H, Dupuy DE. CT Densitometry and Morphology of Radiofrequency-Ablated Stage IA Non-Small Cell Lung Cancer: Results from the American College of Surgeons Oncology Group Z4033 (Alliance) Trial. J Vasc Interv Radiol 2020; 31:286-293. [PMID: 31902554 DOI: 10.1016/j.jvir.2019.09.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 08/26/2019] [Accepted: 09/02/2019] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To evaluate tumor and ablation zone morphology and densitometry related to tumor recurrence in participants with Stage IA non-small cell lung cancer undergoing radiofrequency ablation in a prospective, multicenter trial. MATERIALS AND METHODS Forty-five participants (median 76 years old; 25 women; 20 men) from 16 sites were followed for 2 years (December 2006 to November 2010) with computed tomography (CT) densitometry. Imaging findings before and after ablation were recorded, including maximum CT attenuation (in Hounsfield units) at precontrast and 45-, 90-, 180-, and 300-s postcontrast. RESULTS Every 1-cm increase in the largest axial diameter of the ablation zone at 3-months' follow-up compared to the index tumor reduced the odds of 2-year recurrence by 52% (P = .02). A 1-cm difference performed the best (sensitivity, 0.56; specificity, 0.93; positive likelihood ratio of 8). CT densitometry precontrast and at 45 seconds showed significantly different enhancement patterns in a comparison among pretreated lung cancer (delta = +61.2 HU), tumor recurrence (delta = +57 HU), and treated tumor/ablation zone (delta [change in attenuation] = +16.9 HU), (P < .0001). Densitometry from 45 to 300 s was also different among pretreated tumor (delta = -6.8 HU), recurrence (delta = -11.2 HU), and treated tumor (delta = +12.1 HU; P = .01). Untreated and residual tumor demonstrated washout, whereas treated tumor demonstrated increased attenuation. CONCLUSIONS An ablation zone ≥1 cm larger than the initial tumor, based on 3-month follow-up imaging, is recommended to decrease odds of recurrence. CT densitometry can delineate tumor versus treatment zones.
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Affiliation(s)
- Erica S Alexander
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Lillian Xiong
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Grayson L Baird
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Hiran Fernando
- Department of Surgery, Inova Schar Cancer Institute, Fairfax, Virginia
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Fujimori M, Yamanaka T, Sugino Y, Matsushita N, Sakuma H. Percutaneous Image-guided Thermal Ablation for Renal Cell Carcinoma. INTERVENTIONAL RADIOLOGY 2020; 5:32-42. [PMID: 36284654 PMCID: PMC9550385 DOI: 10.22575/interventionalradiology.2020-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/17/2020] [Indexed: 11/05/2022]
Abstract
Nephrectomy is the gold standard for the treatment of renal cell carcinoma (RCC). However, some patients are not suitable candidates for nephrectomy because of high surgical risk, reduced renal function, or the presence of multiple renal tumors. Percutaneous image-guided thermal ablation, including cryoablation and radiofrequency ablation, is a minimally invasive and highly effective treatment and can be used to treat RCC in patients who are not good candidates for surgery. This article will review percutaneous image-guided thermal ablation for RCC, covering treatment indications, ablation modalities and techniques, oncologic outcomes, and possible complications. In addition, the characteristics of each ablation modality and its comparison with nephrectomy are also presented.
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Affiliation(s)
| | | | - Yuichi Sugino
- Department of Radiology, Mie University School of Medicine
| | | | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine
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Ravikanth R. Management of metastatic vertebral lesions by interventional techniques: Systematic review of outcomes. J Craniovertebr Junction Spine 2020; 11:61-70. [PMID: 32905009 PMCID: PMC7462143 DOI: 10.4103/jcvjs.jcvjs_56_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/02/2020] [Indexed: 11/26/2022] Open
Abstract
Vertebral metastases represent an important cause of cancer-related morbidity and mortality. Among all available treatments, interventional percutaneous techniques have recently emerged as potential strategies for the management of oncologic patients with vertebral lesions. Minimally invasive image-guided therapies include “ablative” and “consolidative” ones. According to the number of metastases and the patient's performance status, ablative techniques can be performed with a curative or a palliative purpose since necrosis induced by critic changes of intralesional temperature determines both tumor debulking and destruction of pain receptors. On the other hand, consolidative treatments are based on the injection of polymethylmethacrylate cement to improve structural vertebral integrity and obtain pain alleviation and prevention of skeletal-related events. This article reviews the current recommendations supporting the role of interventional radiology in the management of vertebral metastases, focusing on the last updates in literature.
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Abstract
Background: Although clinical studies indicate that thermal ablation is effective in treating low-risk papillary thyroid microcarcinomas (PTMCs), the effectiveness of this treatment in patients with low-risk PTMC has not yet been systematically evaluated. Methods: Ovid-MEDLINE and EMBASE databases were searched for studies published through May 1, 2019, which report the efficacy of thermal ablation in patients with low-risk PTMCs. Data were extracted and methodological quality was assessed independently by two radiologists according to PRISMA guidelines. Results: This systematic review identified 503 low-risk PTMCs in 470 patients treated by thermal ablation from 9 studies. During follow-up, no patient experienced local tumor recurrence or distant metastasis, whereas two patients (0.4%) experienced lymph node (LN) metastasis. One patient (0.2%) developed a new PTMC, which was successfully treated by additional ablation. Five patients (1.1%) underwent delayed surgery after ablation, including the two patients with LN metastasis and three additional patients with unknown etiology. Conclusions: Thermal ablation is an excellent local tumor control method in patients with low-risk PTMCs. Strict inclusion criteria and technical expertise are required to obtain favorable results.
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Affiliation(s)
- Se Jin Cho
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sae Rom Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Han X, Wang R, Xu J, Chen Q, Liang C, Chen J, Zhao J, Chu J, Fan Q, Archibong E, Jiang L, Wang C, Liu Z. In situ thermal ablation of tumors in combination with nano-adjuvant and immune checkpoint blockade to inhibit cancer metastasis and recurrence. Biomaterials 2019; 224:119490. [DOI: 10.1016/j.biomaterials.2019.119490] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 08/11/2019] [Accepted: 09/11/2019] [Indexed: 12/27/2022]
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Han X, Yang X, Huang G, Li C, Zhang L, Qiao Y, Wang C, Dong Y, Chen X, Feng Q, Wang C, Rong Z, Ding K, Wei Z, Ni Y, Wang J, Li W, Meng M, Ye X. Safety and clinical outcomes of computed tomography-guided percutaneous microwave ablation in patients aged 80 years and older with early-stage non-small cell lung cancer: A multicenter retrospective study. Thorac Cancer 2019; 10:2236-2242. [PMID: 31679181 PMCID: PMC6885429 DOI: 10.1111/1759-7714.13209] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 01/28/2023] Open
Abstract
Background Previous studies have documented the therapeutic value of computed tomography (CT)‐guided percutaneous microwave ablation (MWA) for early‐stage non‐small cell lung cancer (NSCLC). However, few studies have focused on patients aged 80 years and older. This retrospective study aimed to evaluate the safety and clinical outcomes of CT‐guided percutaneous MWA in patients aged 80 years and older with early‐stage peripheral NSCLC. Methods A retrospective analysis of 63 patients aged 80 years and older with cT1a‐2bN0M0 peripheral NSCLC who underwent CT‐guided percutaneous MWA was performed between January 2008 and January 2018 at 11 hospitals in Shandong Province, China. Results The median follow‐up time was 21.0 months. The overall median survival time was 50 months. The cancer‐specific median survival time was not reached in five years. The one‐, two‐, three‐, four‐, and five‐year overall survival rates were 97.1%, 92.6%, 63.4%, 54.4%, and 32.6%, respectively. The one‐, two‐, and three‐year cancer‐specific survival (CSS) rates were 97.9%, 97.9%, and 69.4%, respectively. The four‐ and five‐year CSS rates were not achieved. A total of 14 patients (22.2%) had local progression. The one‐, two‐, three‐, four‐, and five‐year local control rates were 88.8%, 78.8%, 70.3%, 63.9%, and 63.9%, respectively. The mortality rate was 0% within 30 days after the procedure. Major complications included pneumothorax requiring drainage (21.1%), pulmonary infection (4.2%), and pleural effusions requiring drainage (2.8%). Conclusions CT‐guided percutaneous MWA is a safe and effective modality for treating patients aged 80 years and older with early‐stage peripheral NSCLC.
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Affiliation(s)
- Xiaoying Han
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan City, China
| | - Xia Yang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan City, China
| | - Guanghui Huang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan City, China
| | - Chunhai Li
- Shandong University Qilu Hospital, Jinan, China
| | | | - Yuanxun Qiao
- Taian Hospital of Traditional Chinese Medicine, Dezhou, China
| | - Chuntang Wang
- The Second People Hospital of Dezhou, Liaocheng, China
| | | | - Xiangming Chen
- Taishan Hospital affiliated to Taishan Medical College, Taian, China
| | | | - Chuandai Wang
- Feicheng Hospital of Traditional Chinese Medicine, Taian, China
| | - Zhenhua Rong
- The People's Hospital of Cao County, Heze, China
| | - Kun Ding
- Shouguang Hospital of Traditional Chinese Medicine, Weifang, China
| | - Zhigang Wei
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan City, China
| | - Yang Ni
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan City, China
| | - Jiao Wang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan City, China
| | - Wenhong Li
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan City, China
| | - Min Meng
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan City, China
| | - Xin Ye
- Liaocheng Tumor Hospital, Liaocheng, China
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Matsui Y, Hiraki T, Gobara H, Iguchi T, Tomita K, Uka M, Araki M, Nasu Y, Furuya M, Kanazawa S. Percutaneous thermal ablation for renal cell carcinoma in patients with Birt–Hogg–Dubé syndrome. Diagn Interv Imaging 2019; 100:671-677. [DOI: 10.1016/j.diii.2019.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/16/2019] [Accepted: 06/20/2019] [Indexed: 01/29/2023]
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Fang Z, Moser MAJ, Zhang EM, Zhang W, Zhang B. A Novel Method to Increase Tumor Ablation Zones With RFA by Injecting the Cationic Polymer Solution to Tissues: In Vivo and Computational Studies. IEEE Trans Biomed Eng 2019; 67:1787-1796. [PMID: 31634120 DOI: 10.1109/tbme.2019.2947292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study aims to examine, for the first time, the introduction of cationic polymer solutions to improve radiofrequency ablation (RFA) in terms of a potentially enlarged ablation zone. METHODS By using in vivo and computational RFA studies, two cationic polymers, Chitooligosaccharides (COS) and carboxymethyl chitosan (CMC), diluted in deionized water, were injected into tissues separately surrounding the RF bipolar electrode prior to power application. A total of 9 rabbits were used to 1) measure the increase in electrical conductivity of tissues injected with the cationic polymer solutions, and 2) explore the enhancement of the ablation performance in RFA trials. A computer model of RFA comprising a model of the solution diffusion with an RF thermal ablation model was also built, validated by the in vivo experiment, to quantitatively study the effect of cationic polymer solutions on ablation performances. RESULTS Compared to the control group, the electrical conductivity of rabbit liver tissues was increased by 42.20% (0.282 ± 0.006 vs. 0.401 ± 0.048 S/m, P = 0.001) and 43.97% (0.282 ± 0.006 vs. 0.406 ± 0.042 S/m, P = 0.001) by injecting the COS and CMC solution at the concentration of 100 mg/mL into the tissues, denoted COSDW100 and CMCDW100, respectively. Consequently, the in vivo experiments show that the ablation zone was enlarged by 95% (47.6 ± 6.3 vs. 92.6 ± 11.5 mm2, P < 0.001) and 87% (47.6± 6.3 vs. 88.8 ± 9.6 mm2, P < 0.001) by COSDW100 and CMCDW100, respectively. The computer simulation shows that the ablation zone was enlarged by 71% (51.9 vs. 88.7 mm2) and 63% (51.9 vs. 84.7 mm2) by COSDW100 and CMCDW100, respectively. CONCLUSION The injection of the cationic solution can greatly improve the performance of RFA treatment in terms of enlarging the ablation zone, which is due to the increase in the electrical conductivity of liver tissues surrounding the RF electrode. SIGNIFICANCE This study contributes to the improvement of RFA in the treatment of large tumors.
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Negative Predictive Value of Contrast-Enhanced Ultrasound of Liver and Kidney Thermal Ablation Sites for Local Tumour Progression During Long-term Follow-up: A Retrospective Consecutive Study. Can Assoc Radiol J 2019; 70:434-440. [PMID: 31585824 DOI: 10.1016/j.carj.2019.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/26/2019] [Accepted: 06/09/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To determine negative predictive value (NPV) of contrast-enhanced ultrasound (CEUS) to demonstrate local tumour progression (LTP) at thermal ablation (TA) sites. METHODS Our institutional review board approved this retrospective study; acquisition of consent was waived. Consecutive CEUS examinations performed between 2004-2014 for TA site evaluation on patients who could not undergo enhanced computed tomography (CT) or magnetic resonance imaging (MRI), or had inconclusive CT or MRI, were retrospectively reviewed. Those reported as no abnormal enhancement in or surrounding TA site were included. CEUS examination was considered true-negative based on stability or lack of enhancement/washout on follow-up imaging for at least 1 year, and false-negative (FN), if there was an arterially enhancing focus with wash-out at or surrounding TA site on subsequent follow-up imaging. RESULTS Study population included 56 tumours in 54 patients, 11 women, 43 men; mean age 71 years. Two patients had TA of two different hepatocellular carcinomas. Thirty-six examinations were for hepatic TA and twenty for renal TA. Lesion sizes ranged from 1 cm to 7 cm (mean 3.1 ± 1.2). Mean diameter of 7 recurrences was 13.8 mm. Overall FN rate was 12.5% (7/56). Corresponding numbers were 0% (0/20) for renal TA and 19.4% (7/36) for hepatic TA. Overall NPV of CEUS was 87.5% (49/56) (confidence interval [CI]: 78.8%-96.2%). NPV for renal TA was 100% (20/20) (CI: 100%-100%) and for hepatic TA 81.5% (29/36) (CI: 67.6 %-93.5%). CONCLUSION In this cohort, CEUS showed high NPV for exclusion of LTP at renal TA sites. NPV for hepatic TA sites was high but lower than renal TA.
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Lachenmayer A, Tinguely P, Maurer MH, Frehner L, Knöpfli M, Peterhans M, Weber S, Dufour JF, Candinas D, Banz V. Stereotactic image-guided microwave ablation of hepatocellular carcinoma using a computer-assisted navigation system. Liver Int 2019; 39:1975-1985. [PMID: 31276296 DOI: 10.1111/liv.14187] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/20/2019] [Accepted: 06/26/2019] [Indexed: 02/13/2023]
Abstract
BACKGROUND & AIMS Ablation plays an important role in the treatment of hepatocellular carcinoma. Because image-guided navigation technology has recently entered the clinical setting, we aimed to analyse its safety, therapeutic and procedural efficiency. METHODS Retrospective analysis of patients treated with stereotactic image-guided microwave ablation (SMWA) between January 2015 and December 2017. Interventions were performed using computertomography-guidance with needle trajectory, ablation planning and automatic single-marker patient registration. Needle placement and ablation coverage was controlled by image fusion under general anaesthesia with jet-ventilation. RESULTS In total 174 ablations were performed in 88 patients during 119 interventions. Mean age was 66 (46-84) years, 74 (84.1%) were men and 74% were Child Pugh Class A. Median tumour size was 16 (4-45) mm, 62.2% were BCLC A. Median lateral and longitudinal error of needle placement were 3.2 (0.2-14.1) and 1.6 (0-15.8) mm. Median one tumour (1-4) was ablated per session. One patient developed a Dindo IIIb (0.8%) complication, six minor complications. After re-ablation of 12 lesions, an efficacy rate of 96.3% was achieved. Local tumour progression was 6.3% (11/174). Close proximity to major vessels was significantly correlated with local tumour progression (P < .05). Median overall follow-up was 17.5 months after intervention and 24 months after initial diagnosis. BCLC stage, child class and previous treatment were significantly correlated with overall survival (P < .05). CONCLUSION Stereotactic image-guided microwave ablation is a safe and efficient treatment for HCC offering a curative treatment approach in general and in particular for lesions not detectable on conventional imaging or untreatable because of difficult anatomic locations.
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Affiliation(s)
- Anja Lachenmayer
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pascale Tinguely
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin H Maurer
- Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lorenz Frehner
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marina Knöpfli
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Stefan Weber
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Jean-François Dufour
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel Candinas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Vanessa Banz
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Wang GZ, He XH, Wang Y, Xu LC, Huang HZ, Wang YH, Shen Z, Qu XD, Ding XY, Yang JJ, Li WT. Clinical practice guideline for image-guided multimode tumour ablation therapy in hepatic malignant tumours. ACTA ACUST UNITED AC 2019; 26:e658-e664. [PMID: 31708659 DOI: 10.3747/co.26.5423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Multimode tumour ablation therapy is a treatment method that combines cryoablation with radiofrequency ablation, guided by medical imaging technology and based on precise planning, targeting, monitoring, and control of the thermal energy delivered, with the aim of achieving a whole-body antitumour immune response to malignant tumours. To develop standardized criteria for the application of multimode tumour ablation therapy to malignant hepatic tumours, to facilitate actualization of the criteria in various hospitals, and to ensure therapeutic efficacy and safety, the Society of Interventional Therapy of the Chinese Anti-Cancer Association and the Solid Tumor Theranostics Committee of the Shanghai Anti-Cancer Association assembled experts who specialize in oncology to discuss this treatment method and to arrive at a clinical practice consensus guideline for the indications, contraindications, and techniques of multimode tumour ablation therapy for malignant hepatic tumours.
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Affiliation(s)
- G Z Wang
- Department of Interventional Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R.C
| | - X H He
- Department of Interventional Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R.C
| | - Y Wang
- Department of Interventional Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R.C
| | - L C Xu
- Department of Interventional Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R.C
| | - H Z Huang
- Department of Interventional Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R.C
| | - Y H Wang
- Department of Interventional Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R.C
| | - Z Shen
- Department of Oncology, Affiliated Shanghai 6th People's Hospital, Shanghai Jiaotong University, Shanghai, P.R.C
| | - X D Qu
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, P.R.C
| | - X Y Ding
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P.R.C
| | - J J Yang
- Department of Interventional Radiology, Changhai Hospital, Naval Medical University, Shanghai, P.R.C
| | - W T Li
- Department of Interventional Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R.C
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Dei K, Schlunk S, Byram B. Computationally Efficient Implementation of Aperture Domain Model Image Reconstruction. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019; 66:1546-1559. [PMID: 31251180 PMCID: PMC6800222 DOI: 10.1109/tuffc.2019.2924824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Aperture domain model image reconstruction (ADMIRE) is a useful tool to mitigate ultrasound imaging artifacts caused by acoustic clutter. However, its lengthy run-time impairs its usefulness. To overcome this drawback, we evaluated the reduced model methods with otherwise similar performance to ADMIRE. We also assessed other approaches to speed up ADMIRE, including the use of different levels of short-time Fourier transform (STFT) window overlap and examining the degrees of freedom of the model fit. In this study, we conducted an analysis of the reduced models, including those using Gram-Schmidt orthonormalization (GSO), singular value decomposition (SVD), and independent component analysis (ICA). We evaluated these reduced models using the data from simulations, experimental phantoms, and in vivo liver scans. We then tested ADMIRE's performance using full, GSO, SVD, and ICA-fourth-order blind identification (ICA-FOBI) models. The results from simulations, experimental phantoms, and in vivo data indicate that a model reduced using the ICA-FOBI method is the most promising for accelerating ADMIRE implementation. In the in vivo liver data, the improvements in contrast relative to delay-and-sum (DAS) using a full model, GSO, SVD, and ICA-FOBI models are 6.29 ± 0.25 dB, 11.88 ± 0.90 dB, 9.01 ± 0.67 dB, and 6.36 ± 0.27 dB, respectively; whereas, the contrast-to-noise ratio (CNR) improvement values in the same order are 0.04 ± 0.06 dB, -1.70 ± 0.17 dB, -1.51 ± 0.19 dB, and 0.12 ± 0.07 dB, respectively. The implementation of ADMIRE using the reduced model methods can decrease ADMIRE's computational complexity over three orders of magnitude. The use of a 50% STFT window overlap reduces ADMIRE's serial run time by more than one order of magnitude without any remarkable loss of image quality, when compared to the use of a 90% window overlap used previously. Based on these findings, a combination of the ICA-FOBI model and the use of a 50% STFT window overlap makes the ADMIRE algorithm more computationally efficient.
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Ben-David E, Nissenbaum I, Gurevich S, Cosman ER, Goldberg SN. Optimization and characterization of a novel internally-cooled radiofrequency ablation system with optimized pulsing algorithm in an ex-vivo bovine liver. Int J Hyperthermia 2019; 36:81-88. [DOI: 10.1080/02656736.2019.1617901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Eliel Ben-David
- Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Isaac Nissenbaum
- Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Svetlana Gurevich
- Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | | | - S. Nahum Goldberg
- Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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Biamonte E, Solbiati L, Ierace T, Colombo P, Lavezzi E, Mazziotti G, Lania A. Medullary thyroid carcinoma treated with percutaneous ultrasound-guided radiofrequency ablation. Endocrine 2019; 65:515-519. [PMID: 31273680 DOI: 10.1007/s12020-019-01995-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/23/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Minimally invasive image-guided thermal ablation has been proposed as alternative to surgery for treatment of benign thyroid nodules and recurrent differentiated thyroid carcinoma. Here, we report for the first time the use of radiofrequency ablation (RFA) in a patient with non-metastatic medullary thyroid carcinoma (MTC) who did not undergo surgery due to high anesthesiological risk. METHODS AND RESULTS A 64-year-old woman was referred to our institution for a routine endocrinological visit. No thyroid-related symptoms were present. She had a history of metabolic, cardiovascular and neurological diseases. On clinical examination, a nodular lesion of about 10 mm was palpable in the right thyroid lobe; ultrasonography (US) confirmed the presence of a 13 mm thyroid nodule in the lower pole of the right lobe, that was hypoechoic and with regular margins. Serum calcitonin (Ctn) level was significantly high (647 pg/mL). Fine-needle aspiration (FNA) of the thyroid nodule was negative for malignant cells, but the marked increase of Ctn level in the FNA wash-out fluid confirmed the diagnostic suspicion of MTC. Since patient refused surgery due to high anesthesiological risk, percutaneous US-guided RFA in single session was performed. At 6-months follow-up the serum Ctn level decreased from the initial value of 647 pg/mL, reaching near-normal range (15 pg/mL), and neck ultrasound showed a complete necrosis of the tumour. Afterward, serum Ctn slowly increased to 49 pg/mL at 15-month follow-up. The US performed at 6 and 12 months of follow-up revealed fibrotic tissue in place of the thyroid nodule, without evidence of cervical lymph-node metastases. CONCLUSIONS This clinical case suggests that RFA may be effective and safe for treatment of MTC when surgery cannot be performed.
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Affiliation(s)
- Emilia Biamonte
- Department of Biomedical Sciences, Humanitas Clinical and Research Center, Humanitas University, 20089, Rozzano, MI, Italy
- Endocrine, Diabetes and Andrology Unit, Humanitas Clinical and Research Center, 20089, Rozzano, MI, Italy
| | - Luigi Solbiati
- Department of Biomedical Sciences, Humanitas Clinical and Research Center, Humanitas University, 20089, Rozzano, MI, Italy
- Department of Radiology, Humanitas Clinical and Research Center, 20089, Rozzano, MI, Italy
| | - Tiziana Ierace
- Department of Radiology, Humanitas Clinical and Research Center, 20089, Rozzano, MI, Italy
| | - Paolo Colombo
- Endocrine, Diabetes and Andrology Unit, Humanitas Clinical and Research Center, 20089, Rozzano, MI, Italy
| | - Elisabetta Lavezzi
- Endocrine, Diabetes and Andrology Unit, Humanitas Clinical and Research Center, 20089, Rozzano, MI, Italy
| | - Gherardo Mazziotti
- Department of Biomedical Sciences, Humanitas Clinical and Research Center, Humanitas University, 20089, Rozzano, MI, Italy.
- Endocrine, Diabetes and Andrology Unit, Humanitas Clinical and Research Center, 20089, Rozzano, MI, Italy.
| | - Andrea Lania
- Department of Biomedical Sciences, Humanitas Clinical and Research Center, Humanitas University, 20089, Rozzano, MI, Italy
- Endocrine, Diabetes and Andrology Unit, Humanitas Clinical and Research Center, 20089, Rozzano, MI, Italy
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170
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Percutaneous Laser Ablation of Liver Metastases from Neuroendocrine Neoplasm. A Retrospective Study for Safety and Effectiveness. Cardiovasc Intervent Radiol 2019; 42:1571-1578. [PMID: 31410534 DOI: 10.1007/s00270-019-02308-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/05/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE To retrospectively assess safety and efficacy of laser ablation (LA) of multiple liver metastases (LM) from neuroendocrine neoplasms (NEN). METHODS Twenty-one patients with NEN and at least 3 LM ≤ 4 cm in diameter underwent ultrasonography-guided LA. Up to seven LM were ablated in a single session; if the number of LM exceeded seven, the remaining LM were ablated in further LA sessions with a time interval of 3-4 weeks. LA was performed according to the multifiber technique. The patients underwent contrast-enhanced CT 1 month after LA, and were subsequently monitored every 3 months for the first 2 years and then every 6 months. RESULTS In total, 189 LM were treated in 21 patients (mean 9 ± 8.2, median 6) in 41 LA sessions (range 1-5). The diameter of LM ranged from 5 to 35 mm (median 19 mm, mean 17.9 ± 6.4 mm). One grade 4 complication occurred (0.53%): a bowel perforation managed by surgery. Technical efficacy was 100%, primary efficacy rate 94.7%, and secondary efficacy rate 100%. Complete relief of hormone-related symptoms was obtained in all the 13 symptomatic patients. Median follow-up was 39 months (range 12-99). 1-, 2-, 3-, and 5-year survival rates were 95%, 86%, 66%, and 40%, respectively. Overall survival resulted higher for patients with Ki-67 expression ≤ 7% than for those with Ki-67 > 7% (p = 0.0347). CONCLUSIONS LA is a promising and safe technique to treat LM from NEN. A longer follow-up should provide definitive information on the long-term efficacy of this liver-directed therapy. LEVEL OF EVIDENCE Retrospective study, local non-random sample, level 3.
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171
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Zhang Z, Shao G, Zheng J, Wen S, Zeng H, Hao W, Luo J, Guo L. Electromagnetic navigation to assist with computed tomography-guided thermal ablation of liver tumors. MINIM INVASIV THER 2019; 29:275-282. [PMID: 31393746 DOI: 10.1080/13645706.2019.1649699] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Purpose: To evaluate the advantages and primary technical efficacy of an electromagnetic (EM) navigation system for computed tomography (CT)-guided thermal ablation of liver tumors.Material and methods: From August 2016 to January 2018, 40 patients scheduled for CT- guided thermal ablation were prospectively enrolled and divided into two groups. Twenty patients underwent CT-guided thermal ablation with an EM navigation system (navigation group), while the other 20 patients underwent conventional CT-guided thermal ablation (control group). Data on skin punctures, instrument adjustments, puncture time to target, CT scans, CT fluoroscopy time and dose-length-product (DLP) were compared between the two groups. Any postoperative complications were recorded and the primary technical efficacy was evaluated four to six weeks after the procedure.Results: All 20 patients in the navigation group successfully underwent EM navigation. Compared to the control group, there were fewer instrument adjustments (mean 2.40 vs. 4.95; p = .003), fewer CT scans (mean 7.10 vs. 10.30; p = .006), less CT fluoroscopy time (mean 40.47 vs. 59.98 s, p = .046), and less DLP (mean 807.39 vs. 1578.67 mGy × cm; p = .001). Although not statistically significant, EM navigation resulted in fewer skin punctures (mean 1.20 vs. 1.25; p = .803) and slightly longer puncture time to target (mean 16.50 vs. 15.20 min; p = .725). No patients experienced major complications and the primary efficacy rate was 90% and 84.21% in the navigation and control groups, respectively (p = .661).Conclusions: EM navigation system optimizes the thermal ablation process and reduces radiation exposure in patients. However, further studies are warranted to determine whether an EM navigation system can improve procedure time, complication rates, and primary technical efficiacy of thermal ablation.
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Affiliation(s)
- Zhewei Zhang
- Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Guoliang Shao
- Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Jiaping Zheng
- Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Song Wen
- Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Hui Zeng
- Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Weiyuan Hao
- Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Jun Luo
- Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Liwen Guo
- Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou, China
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172
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Precision Locoregional Therapies for Hepatocellular Carcinoma: Percutaneous Ablation and Radiotherapy. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/978-3-030-21540-8_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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173
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Barat M, Colleter L, Mongiat-Artus P, Jolibois Z, Quero L, Hennequin C, Desgrandchamps F, de Kerviler E. Salvage cryoablation for local recurrence of prostatic cancer after curative therapy. Diagn Interv Imaging 2019; 100:679-687. [PMID: 31331832 DOI: 10.1016/j.diii.2019.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/27/2019] [Accepted: 07/01/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE The purpose of this study was to determine the efficacy of salvage cryotherapy for intra-prostatic and local extraprostatic recurrences after curative treatment of prostate adenocarcinoma. MATERIAL AND METHOD Twenty-eight men (mean age, 69±6 [SD] years; range: 51-82 years) treated with cryoablation for prostatic (N=21) or extraprostatic (N=7) recurrent prostate cancer after radiotherapy with or without associated prostatectomy were included. Technical success, complication and recurrences were reported. Biological recurrence was defined as an elevation ≥2ng/mL of prostate specific antigen (PSA) serum level after the treatment. RESULTS The mean follow-up was 18 months. Among the 21 patients with intraprostatic recurrence, 14 had successful cryotherapy with a mean decrease in serum prostate-specific antigen (PSA) levels of -5.7±2.6 (SD) ng/mL (range: -2.1 to -16.9ng/mL). Four patients (19%) had early progression and three patients (14%) had delayed biological recurrence (mean time: 15 months). Among the 7 patients with extraprostatic recurrence, 2/7 (291%) had successful cryotherapy with a decrease in PSA serum level of -2.7±1.6 (SD) ng/mL (range: -0.5--5.5ng/mL) and 4/7 (57%) had early biological recurrence after cryotherapy that required androgen deprivation therapy, whereas 1/7 (4%) was lost to follow-up. No major complications were observed for both intra- and extraprostatic recurrence. CONCLUSION Salvage cryoablation of locally recurrent prostate cancer after curative treatment is feasible and safe when the half prostate is treated. It could delay initiation of androgen deprivation therapy in these patients.
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Affiliation(s)
- M Barat
- Department of Radiology, Hôpital Cochin, AP-HP, & Université de Paris-Descartes Paris 5,, 75014 Paris, France.
| | - L Colleter
- Department of Radiology, Hôpital Saint-Louis, APHP & Université de Paris-Diderot Paris 7, 75010 Paris, France
| | - P Mongiat-Artus
- Department of Urology, Hôpital Saint-Louis & Université de Paris-Diderot Paris 7, 75010 Paris, France
| | - Z Jolibois
- Department of Radiology, Hôpital Saint-Louis, APHP & Université de Paris-Diderot Paris 7, 75010 Paris, France
| | - L Quero
- Department of Radiation Oncology, Hôpital Saint-Louis & Université de Paris-Diderot Paris 7, 75010 Paris, France
| | - C Hennequin
- Department of Radiation Oncology, Hôpital Saint-Louis & Université de Paris-Diderot Paris 7, 75010 Paris, France
| | - F Desgrandchamps
- Department of Urology, Hôpital Saint-Louis & Université de Paris-Diderot Paris 7, 75010 Paris, France
| | - E de Kerviler
- Department of Radiology, Hôpital Saint-Louis, APHP & Université de Paris-Diderot Paris 7, 75010 Paris, France
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174
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Radiofrequency Ablation, Cryoablation, and Microwave Ablation for T1a Renal Cell Carcinoma: A Comparative Evaluation of Therapeutic and Renal Function Outcomes. J Vasc Interv Radiol 2019; 30:1035-1042. [DOI: 10.1016/j.jvir.2018.12.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 12/09/2018] [Accepted: 12/11/2018] [Indexed: 02/08/2023] Open
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175
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Aladağ Kurt S, Yücel C, Özhan Oktar S, Erbaş G, Sözen S, Öner AY. The effectiveness of RENAL nephrometry score in ablated renal tumors via radiofrequency ablation or cryoablation. Turk J Med Sci 2019; 49:761-768. [PMID: 31062941 PMCID: PMC7018310 DOI: 10.3906/sag-1811-131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim This study aimed to evaluate the clinical efficacy of radiofrequency ablation (RFA) and cryotherapy and to scrutinize the therapeutic success of the RENAL (radius, exophytic/endophytic, nearness to collecting system, anterior/posterior, and location) nephrometry score in terms of possible complications and the predictive status of oncological results. Materials and methods Forty-five patients with biopsy-proven renal cell carcinomas (32 males, 13 females) treated with RFA and cryotherapy were included. Patients were 22–90 years old (average: 59.2 years). Statistical analyses were performed using SPSS for Windows. Results A total of 79 lesions with dimensions varying between 0.9 and 4.5 cm (average: 2.2 cm) were ablated. Complete ablation was achieved for 72 (91.1%) lesions. Six repeat RFA sessions were applied for 4 (5%) lesions with residue/recurrence. The average RENAL nephrometry scores of lesions that underwent complete ablation and those that developed residue/recurrence were 6.3 and 7.7, respectively. The average recurrence-free survival time was 34.8 months (range: 3–55 months), while it was 44.6 months (range: 6–55 months) for cryotherapy and 28.6 months (range: 3–50 months) for RFA. Conclusion Ablative therapies are minimally invasive and effective methods for treating small renal tumors. RENAL nephrometry scoring is a valuable system for standardizing renal tumors and evaluating the success of ablative therapies, possible complications, and oncological results.
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Affiliation(s)
- Seda Aladağ Kurt
- Department of Radiology, Van Training and Research Hospital, Van, Turkey
| | - Cem Yücel
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Suna Özhan Oktar
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Gonca Erbaş
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Sinan Sözen
- Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ali Yusuf Öner
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
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176
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Abstract
Over the past decade, interventional oncology techniques have become integrated into the treatment plans of companion animals with cancer on a regular basis. Although procedures such as stenting are performed commonly, other less frequently utilized techniques for locoregional therapy, such as embolization and ablation, are emerging and demonstrating promise. Tumor ablation techniques are categorized into two subgroups: chemical ablation and energy-based ablation. Increased utilization of ablation will allow for the determination of specific indications and evaluation of outcomes for these techniques.
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177
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Samie HAA, Saeed M, Faisal SM, Kausar MA, Kamal MA. Recent Findings on Nanotechnology-based Therapeutic Strategies Against Hepatocellular Carcinoma. Curr Drug Metab 2019; 20:283-291. [DOI: 10.2174/1389200220666190308134351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 12/14/2018] [Accepted: 02/14/2019] [Indexed: 02/07/2023]
Abstract
Background:
Nanotechnology-based therapies are emerging as a promising new anticancer approach.
Early clinical studies suggest that nanoparticle-based therapeutics can show enhanced efficacy while reducing side
effects minimal, owing to targeted delivery and active intracellular uptake.
Methods:
To overcome the problems of gene and drug delivery, nanotechnology based delivery system gained interest
in the last two decades. Encouraging results from Nano formulation based drug delivery systems revealed that
these emerging restoratives can efficiently lead to more effective, targeted, selective and efficacious delivery of chemotherapeutic
agents to the affected target cells.
Results:
Nanotechnology not only inhibits targeted gene products in patients with cancer, but also taught us valuable
lessons regarding appropriate dosages and route of administrations. Besides, nanotechnology based therapeutics
holds remarkable potential as an effective drug delivery system. We critically highlight the recent findings on
nanotechnology mediated therapeutics strategies to combat hepatocellular carcinoma and discuss how nanotechnology
platform can have enhanced anticancer effects compared with the parent therapeutic agents they contain.
Conclusion:
In this review, we discussed the key challenges, recent findings and future perspective in the development
of effective nanotechnology-based cancer therapeutics. The emphasis here is focused on nanotechnology-based
therapies that are likely to affect clinical investigations and their implications for advancing the treatment of patients
with hepatocellular carcinoma.
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Affiliation(s)
- Hany A. Abdel Samie
- Department of Zoology, Faculty of Science, Menoufia University, Al Minufya, Egypt
| | - Mohd Saeed
- Department of Biology, College of Sciences, University of Hail, Hail, Saudi Arabia
| | - Syed Mohd Faisal
- Molecular Immunology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh-202002, India
| | - Mohd Adnan Kausar
- Department of Biochemistry, College of Medicine, University of Hail, Saudi Arabia
| | - Mohammad A. Kamal
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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178
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Yu J, Wu H, Meng XW, Mu MJ, Dou JP, Ahmed M, Liang P. Ultrasound-guided percutaneous microwave ablation of central intraductal papilloma: a prospective pilot study. Int J Hyperthermia 2019; 36:606-612. [PMID: 31179781 DOI: 10.1080/02656736.2019.1619849] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Han Wu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xian-Wei Meng
- CAS Key Laboratory of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing, China
| | - Meng-Juan Mu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jian-Ping Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Muneeb Ahmed
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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179
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Liu W, Yang Z, Zou R, Qiu J, Shen J, Liao Y, Wang C, Zhang Y, Wang Y, Yuan Y, Li K, Zuo D, He W, Zheng Y, Li B, Yuan Y. Resection vs Ablation for Multifocal Hepatocellular Carcinomas meeting the Barcelona-Clinic Liver Cancer A Classification: A Propensity Score Matching Study. J Cancer 2019; 10:2857-2867. [PMID: 31281462 PMCID: PMC6590028 DOI: 10.7150/jca.31246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 04/14/2019] [Indexed: 12/13/2022] Open
Abstract
With development of surgical technology, we aimed to investigate whether resection could challenge the standard treatment, ablation, in treating multifocal hepatocellular carcinomas meeting the Barcelona-Clinic Liver Cancer A stage. From January 2005 to January 2017, the oncological outcomes of patients undergoing resection (n = 72) or ablation (n = 63) were retrospectively analysed using propensity score matching. At baseline, patients in the ablation group had more tri-focal lesions (30.2% vs. 6.9%, P = 0.001) and smaller tumours (2.00 cm vs. 2.50 cm, P = 0.002) than resection group. After matching, the baseline was well-balanced between treatments (n = 46 pairs); resection provided comparable 5-year overall survival (77.0% vs. 83.6, P = 0.790) and superior 5-year recurrence-free survival (40.4% vs. 16.9%, P = 0.022) to ablation. The multivariate Cox model confirmed that ablation was not associated with worse overall survival (HR = 0.89; 95% CI, 0.33 - 2.42, P = 0.819), but identified ablation as an unfavourable predictor of recurrence-free survival (HR = 2.13; 95% CI, 1.27 - 3.57, P <0.001). For subgroup patients with multifocal tumours located in different segments, both treatments offered similar 5-year overall survival (74.3% vs. 95.5%, P = 0.190) and 5-year recurrence-free survival (42.9 vs. 25.9%, P = 0.170). Additionally, ablation resulted in less major complications than resection (3.2% vs 13.9%, P = 0.035). Compared with ablation, resection achieved comparable overall survival and even superior recurrence-free survival for patients with multifocal hepatocellular carcinomas meeting the BCLC A stage.
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Affiliation(s)
- Wenwu Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Zhiwen Yang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Ruhai Zou
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Ultrasound, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Jiliang Qiu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Jingxian Shen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Medical Imaging, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Yadi Liao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Chenwei Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Yuanping Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Yongjin Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Yichuan Yuan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Kai Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Dinglan Zuo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China
| | - Wei He
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Yun Zheng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Binkui Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
| | - Yunfei Yuan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.,Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China
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180
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Kim DK, Won JY, Park SY. Percutaneous cryoablation for renal cell carcinoma using ultrasound-guided targeting and computed tomography-guided ice-ball monitoring: radiation dose and short-term outcomes. Acta Radiol 2019; 60:798-804. [PMID: 30149751 DOI: 10.1177/0284185118798175] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Usefulness of ultrasound (US)-guided mass targeting and computed tomography (CT)-guided ice-ball monitoring in percutaneous cryoablation (PCA) for renal cell carcinoma (RCC) is still uncertain. PURPOSE To assess radiation dose and short-term outcomes of PCA for RCC using US-guided targeting and CT-guided ice-ball monitoring. MATERIAL AND METHODS Thirty-nine consecutive patients who underwent PCA for biopsy-proven RCC were included. Mass targeting was performed with US and ice-ball was monitored with CT guidance. Effective radiation dose of CT during PCA was recorded. Follow-up was conducted with contrast-enhanced CT or magnetic resonance imaging (MRI) (mean follow-up time = 10.1 ± 7.0 months). Local tumor progression was defined by the presence of focal enhancing areas at the ablation zone (CT, ≥ 20 HU; MRI, presence of focal enhancement on subtraction contrast-enhanced image). Technical success, major complication rate (e.g. Clavien-Dindo classification ≥ 3), and one-year local tumor progression-free survival (PFS) rate were analyzed. RESULTS Mean effective radiation dose in association with PCA was 12.1 ± 4.5 mSv (range = 7.0-25.2 mSv). Technical success was achieved in 100%. Local tumor progression occurred in a single patient (2.6%, 1/39), and one-year local tumor PFS rate was 95.7%. No major complication was found. CONCLUSION PCA using US-guided targeting and CT-guided ice-ball monitoring may allow acceptable local tumor control for RCC, as a radiation-reducing strategy.
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Affiliation(s)
- Dong Kyu Kim
- Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Yun Won
- Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Yoon Park
- Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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181
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Maciolek KA, Abel EJ, Posielski NM, Hinshaw JL, Lubner MG, Lee FT, Ziemlewicz TJ, Wells SA. Tumor location does not impact oncologic outcomes for percutaneous microwave ablation of clinical T1a renal cell carcinoma. Eur Radiol 2019; 29:6319-6329. [PMID: 31016448 DOI: 10.1007/s00330-019-06121-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/08/2019] [Accepted: 02/21/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the impact of anterior tumor location on oncologic efficacy, complication rates, and procedure duration for 151 consecutive biopsy-proven clinical T1a renal cell carcinoma (RCC) treated with percutaneous microwave (MW) ablation. METHODS This single-center retrospective study was performed under a waiver of informed consent. One hundred forty-eight consecutive patients (103 M/45 F; median age 67 years, IQR 61-73) with 151 cT1a biopsy-proven RCC (median diameter 2.4 cm, IQR 1.9-3.0) were treated with percutaneous MW ablation between March 2011 and August 2017. Patient and procedural data collected included Charlson comorbidity index (CCI), RENAL nephrometry score (NS), use of hydrodisplacement, MW antennas/generator output/time, and procedure time (PT). Data were stratified by anterior, posterior, and midline tumor location and compared with the Kruskal-Wallis or chi-squared tests. The Kaplan-Meier method was used for survival analyses. RESULTS Tumor size, NS, and use/volume of hydrodisplacement were similar for posterior and anterior tumors (p > 0.05). Patients with anterior tumors had a higher CCI (3 vs 4, p = 0.001). Median PT for posterior and anterior tumors was similar (100 vs 108 min, p = 0.26). Single session technical success and primary efficacy were achieved for all 151 tumors including 61 posterior and 67 anterior tumors. The 4 (3%) Clavien III-IV complications and 6 (4%) local recurrences were not associated with tumor location (p > 0.05). Three-year RFS, CSS, and OS were 95% (95% CI 0.87, 0.98), 100% (95% CI 1.0, 1.0), and 96% (95% CI 0.89, 0.98), respectively. CONCLUSIONS The safety and efficacy of percutaneous microwave ablation for anterior and posterior RCC are similar. KEY POINTS • The safety profile for percutaneous microwave ablation of anterior and posterior T1a renal cell carcinoma is equivalent. • Percutaneous microwave ablation of T1a renal cell carcinoma provides durable oncologic control regardless of tumor location. • Placement of additional microwave antennas and use of hydrodisplacement are associated with longer procedure times.
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Affiliation(s)
- Kim A Maciolek
- University of Wisconsin School of Medicine and Public Health, Health Sciences Learning Center, 750 Highland Avenue, Madison, WI, 53705, USA
| | - E Jason Abel
- Department of Urology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705, USA
| | - Natasza M Posielski
- Department of Urology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705, USA
| | - J Louis Hinshaw
- Department of Urology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705, USA
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/376 Clinical Science Center, Madison, WI, 53792, USA
| | - Meghan G Lubner
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/376 Clinical Science Center, Madison, WI, 53792, USA
| | - Fred T Lee
- Department of Urology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705, USA
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/376 Clinical Science Center, Madison, WI, 53792, USA
| | - Timothy J Ziemlewicz
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/376 Clinical Science Center, Madison, WI, 53792, USA
| | - Shane A Wells
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/376 Clinical Science Center, Madison, WI, 53792, USA.
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182
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Treatment of thyroid nodules with radiofrequency: a 1-year follow-up experience. J Ultrasound 2019; 22:193-199. [PMID: 30945239 DOI: 10.1007/s40477-019-00375-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 03/21/2019] [Indexed: 10/27/2022] Open
Abstract
PURPOSE The aim of this study is to assess the effectiveness and safety of radiofrequency ablation (RFA) in debulking benign solid thyroid nodules. MATERIALS AND METHODS This is a retrospective review of 77 patients with predominantly solid thyroid nodules treated with RFA in a single center between 2013 and 2016. All patients declined or were not eligible for surgery. Benign proven thyroid nodules causing compressive symptoms and cosmetic concerns were considered for treatment. Nodule volume, thyroid nodule related compressive symptoms, cosmetic concerns and thyroid function were evaluated. RESULTS All patients underwent a single treatment session. Mean nodule volume decreased from 17.9 ± 15.6 mL at baseline to 5.2 ± 7.4 after 12 months with a volume reduction ratio (VRR) of 70.9% ± 20.8%. There were no identifiable factors predictive of response to RFA. Median cosmetic and symptom scores of the entire population decreased from 3 [2-4] and 3 [0-10] to 1 [1-3] (p < 0.001) and 0 [0-5] (p < 0.001), respectively. No major complications occurred and RFA did not affect thyroid function when normal. CONCLUSION RFA induces substantial volume reduction of predominantly solid thyroid nodules and improves compressive symptoms and cosmetic concerns. RFA does not impact normal thyroid function and has an acceptable safety profile.
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183
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Lee HJ, Kim JW, Hur YH, Cho SB, Lee BC, Lee BK, Hwang EC, Cho YS, Seon HJ. Conventional Chemoembolization Plus Radiofrequency Ablation versus Surgical Resection for Single, Medium-Sized Hepatocellular Carcinoma: Propensity-Score Matching Analysis. J Vasc Interv Radiol 2019; 30:284-292.e1. [DOI: 10.1016/j.jvir.2018.09.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 09/08/2018] [Accepted: 09/24/2018] [Indexed: 12/26/2022] Open
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184
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Wang Y, He XH, Xu LC, Huang HZ, Li GD, Wang YH, Li WT, Wang GZ. CT-guided cryoablation for unresectable pelvic recurrent colorectal cancer: a retrospective study. Onco Targets Ther 2019; 12:1379-1387. [PMID: 30863104 PMCID: PMC6389010 DOI: 10.2147/ott.s189897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective The study aimed to investigate the efficacy of computed tomography (CT)-guided cryoablation debulking of unresectable pelvic recurrent colorectal cancer (CRC). Patients and methods From January 2013 to April 2016, 30 patients (18 males and 12 females; aged 57.8±10.5 years) with unresectable pelvic recurrent CRC who had previously received radiotherapy or chemotherapy were included. A total of 35 tumors ranging from 1.2 to 6.3 cm underwent cryoablation. Tumor response was evaluated 1 month after cryoablation according to the Modified Response Evaluation Criteria in Solid Tumors. Logistic regression was used to analyze the risk factors for tumor response. Degree of pain palliation was also determined using the Numerical Rating Scale. Cox proportional hazard models were used to identify predictors of outcomes. Results Cryoablation was successfully performed in all patients. Complete response (CR) was achieved for 27 tumors in 23 patients and partial response was achieved for eight tumors in seven patients 1 month after cryoablation. The rate of CR was 77.14%, and tumor size was an independent risk factor for CR. Pain relief was satisfactory in 21 symptomatic patients (P<0.001), and the median duration of pain relief was 6.0 months (95% CI: 2.67–9.33). Serum carcinoembryonic antigen (CEA) was significantly decreased after cryoablation in 15 patients with elevated CEA (P=0.005). The median progression-free survival (PFS) was 10.0 months (95% CI: 4.43–15.67). Multivariate analysis revealed that tumor size (HR =3.089, P<0.001), sex (HR =0.089, P=0.002), and elevated CEA (HR =7.015, P=0.002) were independent predictors of PFS. Conclusion CT-guided cryoablation is a safe and effective therapeutic option for pelvic recurrent CRC. Tumor size is an important predictor of poor outcomes.
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Affiliation(s)
- Ying Wang
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China, .,Department of Medical Oncology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China,
| | - Xin-Hong He
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China, .,Department of Medical Oncology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China,
| | - Li-Chao Xu
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China, .,Department of Medical Oncology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China,
| | - Hao-Zhe Huang
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China, .,Department of Medical Oncology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China,
| | - Guo-Dong Li
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China, .,Department of Medical Oncology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China,
| | - Yao-Hui Wang
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China, .,Department of Medical Oncology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China,
| | - Wen-Tao Li
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China, .,Department of Medical Oncology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People's Republic of China,
| | - Guang-Zhi Wang
- Department of Medical Imaging Center, Affiliated Hospital, Weifang Medical University, Weifang 261053, People's Republic of China,
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185
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Solbiati M, Muglia R, Goldberg SN, Ierace T, Rotilio A, Passera KM, Marre I, Solbiati L. A novel software platform for volumetric assessment of ablation completeness. Int J Hyperthermia 2019; 36:337-343. [PMID: 30729818 DOI: 10.1080/02656736.2019.1569267] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
| | - Riccardo Muglia
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
| | - S. Nahum Goldberg
- Department of Radiology, Hadassah Hebrew University Medical Centre, Jerusalem, Israel
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Tiziana Ierace
- Department of Radiology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | | | | | | | - Luigi Solbiati
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
- Department of Radiology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
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186
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Huang PC, Chaney EJ, Iyer RR, Spillman DR, Odintsov B, Sobh NA, Boppart SA. Interstitial magnetic thermotherapy dosimetry based on shear wave magnetomotive optical coherence elastography. BIOMEDICAL OPTICS EXPRESS 2019; 10:539-551. [PMID: 30800498 PMCID: PMC6377902 DOI: 10.1364/boe.10.000539] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 05/08/2023]
Abstract
While magnetic thermoseeds are often utilized in interstitial magnetic thermotherapy (iMT) to enable localized tumor ablation, we propose to extend their use as the perturbative source in magnetomotive optical coherence elastography (MM-OCE) so that the heat-induced elasticity alterations can be 'theranostically' probed. MM-OCE measurements were found to agree with indentation results. Tissue stiffening was visualized on iMT-treated porcine liver and canine soft tissue sarcoma specimens, where histology confirmed thermal damages. Additionally, the elasticity was found to increase exponentially and linearly with the conventional thermal dosage metrics and the deposited thermal energy, respectively. Collectively, a physiologically-meaningful, MM-OCE-based iMT dosimetry is feasible.
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Affiliation(s)
- Pin-Chieh Huang
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 N Mathews Ave, Urbana, IL 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, 1406 W Green St, Urbana, IL 61801, USA
| | - Eric J. Chaney
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 N Mathews Ave, Urbana, IL 61801, USA
| | - Rishyashring R. Iyer
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 N Mathews Ave, Urbana, IL 61801, USA
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, 306 N Wright St, Urbana, IL 61801, USA
| | - Darold R. Spillman
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 N Mathews Ave, Urbana, IL 61801, USA
| | - Boris Odintsov
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 N Mathews Ave, Urbana, IL 61801, USA
| | - Nahil A. Sobh
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 N Mathews Ave, Urbana, IL 61801, USA
| | - Stephen A. Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 N Mathews Ave, Urbana, IL 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, 1406 W Green St, Urbana, IL 61801, USA
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, 306 N Wright St, Urbana, IL 61801, USA
- Carle-Illinois College of Medicine, University of Illinois at Urbana-Champaign, 807 S Wright St, Champaign, Illinois 61820, USA
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187
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Acosta Ruiz V, Ladjevardi S, Brekkan E, Häggman M, Lönnemark M, Wernroth L, Magnusson A. Periprocedural outcome after laparoscopic partial nephrectomy versus radiofrequency ablation for T1 renal tumors: a modified R.E.N.A.L nephrometry score adjusted comparison. Acta Radiol 2019; 60:260-268. [PMID: 29911400 DOI: 10.1177/0284185118780891] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Comparable oncological outcomes have been seen after surgical nephrectomy and thermal ablation of renal tumors recently. However, periprocedural outcome needs to be assessed for aiding treatment decision. PURPOSE To compare efficacy rates and periprocedural outcome (technical success, session time, hospitalization time, and complications) after renal tumor treatment with laparoscopic partial nephrectomy (LPN) or radiofrequency ablation (RFA). MATERIAL AND METHODS The initial experience with 49 (treated with LPN) and 84 (treated with RFA) consecutive patients for a single renal tumor (diameter ≤ 5 cm, limited to the kidney) during 2007-2014 was evaluated. Patient and tumor characteristics, efficacy rates, and periprocedural outcome were collected retrospectively. The stratified Mantel Haenzel and Van Elteren tests, adjusted for tumor complexity (with the modified R.E.N.A.L nephrometry score [m-RNS]), were used to assess differences in treatment outcomes. RESULTS Primary efficacy rate was 98% for LPN and 85.7% for RFA; secondary efficacy rate was 93.9% for LPN and 95.2% for RFA; and technical success rate was 87.8% for LPN and 100% for RFA. Median session (m-RNS adjusted P < 0.001; LPN 215 min, RFA 137 min) and median hospitalization time were longer after LPN (m-RNS adjusted P < 0.001; LPN 5 days, RFA 2 days). Side effects were uncommon (LPN 2%, RFA 4.8%). Complications were more frequent after LPN (m-RNS adjusted P < 0.001; LPN 42.9%, RFA 10.7%). CONCLUSION Both methods achieved equivalent secondary efficacy rates. RFA included several treatment sessions, but session and hospitalization times were shorter, and complications were less frequent than for LPN. The differences remained after adjustment for renal tumor complexity.
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Affiliation(s)
- Vanessa Acosta Ruiz
- Department of Surgical Sciences – Radiology, Uppsala University, Uppsala, Sweden
| | - Sam Ladjevardi
- Department of Surgical Sciences – Urology, Uppsala University, Uppsala Sweden
| | - Einar Brekkan
- Uppsala University Hospital – Urology, Uppsala, Sweden
| | - Michael Häggman
- Department of Surgical Sciences – Urology, Uppsala University, Uppsala Sweden
| | - Maria Lönnemark
- Department of Surgical Sciences – Radiology, Uppsala University, Uppsala, Sweden
| | - Lisa Wernroth
- Department of Medical Sciences – Molecular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Anders Magnusson
- Department of Surgical Sciences – Radiology, Uppsala University, Uppsala, Sweden
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188
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Initial experience with irreversible electroporation of liver tumours. Eur J Radiol Open 2019; 6:62-67. [PMID: 30723754 PMCID: PMC6351588 DOI: 10.1016/j.ejro.2019.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/14/2019] [Accepted: 01/17/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction Thermal ablation of liver tumours is an established technique used in selected patients with relatively small tumours that can be ablated with margin. Thermal ablation methods are not advisable near larger bile ducts that are sensitive to thermal injury causing strictures and severe morbidity. Irreversible electroporation (IRE) has the possibility to treat these tumours without harming the bile tree. The method is relatively new and has been proven to be feasible and safe with promising oncological results. Methods 50 treatments were performed on 42 patients that were not resectable or treatable by thermal ablation (12 women and 30 men) with 59 tumours in total. 51% were colorectal cancer liver metastases (CRCLM) and 34% were hepatocellular carcinomas (HCC). 70% of the treatments were performed using stereotactic CT-guidance for needle placement. Results 81% of the treatments were performed with initial success. All patients with missed ablations were re-treated. Local recurrence rate at 3 months was 3% and 37% at one year. The complication rate was low with 2 patients having major complications (Clavien-Dindo grade 3b-5) and without 30-day mortality. Conclusion IRE is safe for treating tumours not suitable for thermal ablation with 63% of patients being without local recurrence after one year in a group of patients with tumours deemed unresectable. IRE has a role in the treatment of unresectable liver tumours close to heat-sensitive structures not suitable for thermal ablation. Level of Evidence: Level 4, Case Series.
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189
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Tomasian A, Hillen TJ, Jennings JW. Percutaneous CT-Guided Skull Biopsy: Feasibility, Safety, and Diagnostic Yield. AJNR Am J Neuroradiol 2019; 40:309-312. [PMID: 30655252 DOI: 10.3174/ajnr.a5949] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 12/08/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND PURPOSE Although percutaneous musculoskeletal biopsies are routinely performed in the axial and appendicular skeleton, there are no published data on the systematic evaluation of the feasibility, safety, and diagnostic accuracy of percutaneous skull biopsy. In certain clinical encounters such as patients with primary skull tumors or patients with known cancer and isolated skull lesions suspected of calvarial metastasis or synchronous primary tumor, percutaneous skull biopsy may be considered a viable option. The purpose of this study was to evaluate the feasibility, safety profile, and diagnostic yield of percutaneous CT-guided skull biopsy. MATERIALS AND METHODS Percutaneous CT-guided skull biopsy was performed in 14 patients. Patient demographics, cancer history, indication for initial imaging, imaging technique of diagnosis, skull tumor anatomic location, and final histologic diagnosis were documented. Preprocedural imaging of each skull lesion was reviewed to determine tumor size and characteristics. Procedural notes were reviewed to determine the total conscious sedation time or anesthesia time, type of biopsy needle, and the number and length of obtained core specimens. Procedure-related complications were also documented according to the Society of Interventional Radiology classification. RESULTS All CT-guided percutaneous skull biopsy procedures were performed as preoperatively planned and were technically successful. Procedures were performed with the patient under conscious sedation in 93% (13/14) of cases. Definitive histologic diagnosis was achieved in 86% (12/14) of cases. There were no acute or delayed procedure-related complications. CONCLUSIONS The results of this retrospective initial study suggest that percutaneous CT-guided skull biopsy is feasible with an excellent safety profile, affords a high diagnostic yield for histologic characterization, and may obviate more invasive open skull biopsies.
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Affiliation(s)
- A Tomasian
- From the Department of Radiology (A.T.), University of Southern California, Los Angeles, California
| | - T J Hillen
- Mallinckrodt Institute of Radiology (T.J.H., J.W.J.), St. Louis, Missouri
| | - J W Jennings
- Mallinckrodt Institute of Radiology (T.J.H., J.W.J.), St. Louis, Missouri
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190
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Lee D, Park S, Ang MJC, Park JG, Yoon S, Kim C, Lee SK, Cho KO, Choi J. Evaluation of liver lesions by use of shear wave elastography and computed tomography perfusion imaging after radiofrequency ablation in clinically normal dogs. Am J Vet Res 2019; 79:1140-1149. [PMID: 30372151 DOI: 10.2460/ajvr.79.11.1140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate acute changes of the liver by use of shear wave elastography (SWE) and CT perfusion after radiofrequency ablation (RFA). ANIMALS 7 healthy Beagles. PROCEDURES RFA was performed on the liver (day 0). Stiffness of the ablation lesion, transitional zone, and normal parenchyma were evaluated by use of SWE, and blood flow, blood volume, and arterial liver perfusion of those regions were evaluated by use of CT perfusion on days 0 and 4. All RFA lesions were histologically examined on day 4. RESULTS Examination of the SWE color-coded map distinctly revealed stiffness of the liver tissue, which increased from the normal parenchyma to the transitional zone and then to the ablation zone. For CT perfusion, blood flow, blood volume, and arterial liver perfusion decreased from the transitional zone to the normal parenchyma and then to the ablation zone. Tissue stiffness and CT perfusion variables did not differ significantly between days 0 and 4. Histologic examination revealed central diffuse necrosis and peripheral hyperemia with infiltration of lymphoid cells and macrophages. CONCLUSIONS AND CLINICAL RELEVANCE Coagulation necrosis induced a loss of blood perfusion and caused tissue hardening (stiffness) in the ablation zone. Hyperemic and inflammatory changes of the transitional zone resulted in increased blood perfusion. Acute changes in stiffness and perfusion of liver tissue after RFA could be determined by use of SWE and CT perfusion. These results can be used to predict the clinical efficacy of RFA and to support further studies, including those involving hepatic neoplasia.
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Monitoring of Thermal-Induced Changes in Liver Stiffness During Controlled Hyperthermia and Microwave Ablation in an Ex Vivo Bovine Model Using Point Shear Wave Elastography. Cardiovasc Intervent Radiol 2019; 42:744-750. [DOI: 10.1007/s00270-018-02152-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022]
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192
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Pulmonary Cryoablation Zones: More Aggressive Ablation Is Warranted In Vivo. AJR Am J Roentgenol 2019; 212:195-200. [DOI: 10.2214/ajr.18.19527] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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193
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Scapaticci R, Lopresto V, Pinto R, Cavagnaro M, Crocco L. Monitoring Thermal Ablation via Microwave Tomography: An Ex Vivo Experimental Assessment. Diagnostics (Basel) 2018; 8:E81. [PMID: 30563280 PMCID: PMC6316129 DOI: 10.3390/diagnostics8040081] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 11/27/2018] [Accepted: 12/02/2018] [Indexed: 12/19/2022] Open
Abstract
Thermal ablation treatments are gaining a lot of attention in the clinics thanks to their reduced invasiveness and their capability of treating non-surgical patients. The effectiveness of these treatments and their impact in the hospital's routine would significantly increase if paired with a monitoring technique able to control the evolution of the treated area in real-time. This is particularly relevant in microwave thermal ablation, wherein the capability of treating larger tumors in a shorter time needs proper monitoring. Current diagnostic imaging techniques do not provide effective solutions to this issue for a number of reasons, including economical sustainability and safety. Hence, the development of alternative modalities is of interest. Microwave tomography, which aims at imaging the electromagnetic properties of a target under test, has been recently proposed for this scope, given the significant temperature-dependent changes of the dielectric properties of human tissues induced by thermal ablation. In this paper, the outcomes of the first ex vivo experimental study, performed to assess the expected potentialities of microwave tomography, are presented. The paper describes the validation study dealing with the imaging of the changes occurring in thermal ablation treatments. The experimental test was carried out on two ex vivo bovine liver samples and the reported results show the capability of microwave tomography of imaging the transition between ablated and untreated tissue. Moreover, the discussion section provides some guidelines to follow in order to improve the achievable performances.
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Affiliation(s)
- Rosa Scapaticci
- National Research Council of Italy-Institute for the Electromagnetic Sensing of the Environment, 80124 Napoli, Italy.
| | - Vanni Lopresto
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Division of Health Protection Technologies, Casaccia Research Center, 00123 Rome, Italy.
| | - Rosanna Pinto
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Division of Health Protection Technologies, Casaccia Research Center, 00123 Rome, Italy.
| | - Marta Cavagnaro
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy.
| | - Lorenzo Crocco
- National Research Council of Italy-Institute for the Electromagnetic Sensing of the Environment, 80124 Napoli, Italy.
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194
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Fang Z, Moser M, Zhang E, Zhang WJC, Zhang B. Design of a Novel Electrode of Radiofrequency Ablation for Large Tumors: In Vitro Validation and Evaluation. J Biomech Eng 2018; 141:2718212. [PMID: 30516246 DOI: 10.1115/1.4042179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Indexed: 11/08/2022]
Abstract
In the present study, a monopolar expandable electrode (MEE) in radiofrequency ablation (RFA) proposed in our previous study was validated and evaluated using the in vitro experiment and computer simulation. Two commercial RF electrodes (conventional electrode, CE and umbrella electrode, UE) was used to compare the ablation results with MEE using the in vitro egg white model (experiment and computer simulation) and in vivo liver tumor model (computer simulation) to verify the efficacy of MEE in the large tumor ablation. The sharp increase in impedance during RFA procedures was taken as the termination of RFA protocols. The volume and sphericity of ablation zone generated by MEE, CE, and UE in the in vitro egg white experiment were 75.3 1.6 cm3, 2.7 0.4 cm3, 12.4 1.8 cm3 (P <0.001), and 88.1 0.9%, 12.9 1.3%, 62.0 3.0% (P <0.001), respectively. Correspondingly, a similar result was obtained in the egg white simulation. In the liver tumor simulation, the volume and sphpericity of ablation zone generated by MEE, CE, and UE were 35.4 cm3 and 86.8%, 3.7 cm3 and 17.7%, and 12.7 cm3 and 59.6%, respectively. In summary, MEE has the potential to achieve complete ablation in the treatment of large tumors (>3 cm in diameter) compared with CE and UE due to the larger electrode-tissue interface and more round shape of hooks.
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Affiliation(s)
- Zheng Fang
- School of Mechanical and Power Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Michael Moser
- Department of Surgery, University of Saskatchewan, Saskatoon, SK S7N 0W8, Canada
| | - Edwin Zhang
- Division of Vascular & Interventional Radiology, Department of Medical Imaging, University of Toronto, ON M5T 1W7, Canada
| | - W J Chris Zhang
- Fellow ASME, School of Mechanical and Power Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Bing Zhang
- Mem. ASME, Tumor Ablation Group, Biomedical Science and Technology Research Center, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
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195
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Kaye EA, Cornelis FH, Petre EN, Tyagi N, Shady W, Shi W, Zhang Z, Solomon SB, Sofocleous CT, Durack JC. Volumetric 3D assessment of ablation zones after thermal ablation of colorectal liver metastases to improve prediction of local tumor progression. Eur Radiol 2018; 29:2698-2705. [PMID: 30402706 DOI: 10.1007/s00330-018-5809-0] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/13/2018] [Accepted: 09/27/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE The goal of this study was to develop and evaluate a volumetric three-dimensional (3D) approach to improve the accuracy of ablation margin assessment following thermal ablation of hepatic tumors. METHODS The 3D margin assessment technique was developed to generate the new 3D assessment metrics: volumes of insufficient coverage (VICs) measuring volume of tissue at risk post-ablation. VICs were computed for the tumor and tumor plus theoretical 5- and 10-mm margins. The diagnostic accuracy of the 3D assessment to predict 2-year local tumor progression (LTP) was compared to that of manual 2D assessment using retrospective analysis of a patient cohort that has previously been reported as a part of an outcome-centered study. Eighty-six consecutive patients with 108 colorectal cancer liver metastases treated with radiofrequency ablation (2002-2012) were used for evaluation. The 2-year LTP discrimination power was assessed using receiver operating characteristic area under the curve (AUC) analysis. RESULTS A 3D assessment of margins was successfully completed for 93 out of 108 tumors. The minimum margin size measured using the 3D method had higher discrimination power compared with the 2D method, with an AUC value of 0.893 vs. 0.790 (p = 0.01). The new 5-mm VIC metric had the highest 2-year LTP discrimination power with an AUC value of 0.923 (p = 0.004). CONCLUSIONS Volumetric semi-automated 3D assessment of the ablation zone in the liver is feasible and can improve accuracy of 2-year LTP prediction following thermal ablation of hepatic tumors. KEY POINTS • More accurate prediction of local tumor progression risk using volumetric 3D ablation zone assessment can help improve the efficacy of image-guided percutaneous thermal ablation of hepatic tumors. • The accuracy of evaluation of ablation zone margins after thermal ablation of colorectal liver metastases can be improved using a volumetric 3D semi-automated assessment approach and the volume of insufficient coverage assessment metric. • The new 5-mm volume-of-insufficient-coverage metric, indicating the volume of tumor plus 5-mm margin that remained untreated, had the highest 2-year local tumor progression discrimination power.
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Affiliation(s)
- Elena A Kaye
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Room S1212B, New York, NY, 10065, USA.
| | - Francois H Cornelis
- Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.,Department of Radiology, Sorbonne Université -ISCD / APHP - HUEP, Tenon Hospital, 4 rue de la Chine, 75020, Paris, France
| | - Elena N Petre
- Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Neelam Tyagi
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Room S1212B, New York, NY, 10065, USA
| | - Waleed Shady
- Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.,Department of Radiology, Mallinckrodt Institute of Radiology, 216 S Kingshighway Blvd, St. Louis, MO, USA
| | - Weiji Shi
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Zhigang Zhang
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Stephen B Solomon
- Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Constantinos T Sofocleous
- Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Jeremy C Durack
- Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
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196
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Treatment of metastatic, imatinib refractory, gastrointestinal stroma tumor with image-guided high-dose-rate interstitial brachytherapy. Brachytherapy 2018; 18:63-70. [PMID: 30385116 DOI: 10.1016/j.brachy.2018.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/12/2018] [Accepted: 09/25/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE Evaluation of efficacy and safety of CT- or MRI-guided high-dose-rate interstitial brachytherapy (iBT) in the treatment of advanced, imatinib refractory, metastatic gastrointestinal stroma tumors (GISTs) was the objective of this retrospective study. METHODS AND MATERIALS A cumulative number of 40 unresectable metastases (30 hepatic, 10 peritoneal) were treated with iBT in 10 selected patients with histologically proven GISTs. Six patients had peritoneal disease, and 5 patients were even progressing under sunitinib (second line)-thus iBT was applied as a salvage maneuver. IBT uses an interstitially introduced 192iridium source in a high-dose-rate irradiation regime to destroy vital cells in a single fraction. Response to treatment was assessed clinically and with acquisition of MRI/CT every 3 months. RESULTS Local tumor control was reached in 97.5% of all treated metastases during a median time of 25 months-only one local relapse was observed during followup. The median diameter of the irradiated lesions was 2.4 cm (range 0.6-11.2 cm); a median dose of 15 Gy (range 6.7-21.96 Gy) was applied. The median progression-free survival after iBT was 6.8 (range 3.0-20.2) months; the median overall survival was 37.3 months (range 11.4-89.7). Two major complications (Common Terminology for Adverse Events grade 3) occurred following the intervention: local hemorrhage and pneumothorax, successfully dealt with by angiographic embolization and pleural drainage, respectively. CONCLUSIONS In selected patients with metastatic, imatinib refractory GISTs, iBT safely enables high rates of local tumor control and presents an alternative, anti-neoplastic treatment option even in a salvage situation.
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197
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Bensalah K, Albiges L, Bernhard JC, Bigot P, Bodin T, Boissier R, Correas JM, Gimel P, Hetet JF, Long JA, Nouhaud FX, Ouzaïd I, Rioux-Leclercq N, Méjean A. Recommandations françaises du Comité de Cancérologie de l’AFU – Actualisation 2018–2020 : prise en charge du cancer du rein. Prog Urol 2018; 28 Suppl 1:R5-R33. [DOI: 10.1016/j.purol.2019.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 09/15/2018] [Indexed: 12/15/2022]
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198
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Kim TH, Choi HI, Kim BR, Kang JH, Nam JG, Park SJ, Lee S, Yoon JH, Lee DH, Joo I, Lee JM. No-Touch Radiofrequency Ablation of VX2 Hepatic Tumors In Vivo in Rabbits: A Proof of Concept Study. Korean J Radiol 2018; 19:1099-1109. [PMID: 30386141 PMCID: PMC6201983 DOI: 10.3348/kjr.2018.19.6.1099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 07/23/2018] [Indexed: 02/06/2023] Open
Abstract
Objective In a proof of concept study, we compared no-touch radiofrequency ablation (NtRFA) in bipolar mode with conventional direct tumor puncture (DTP) in terms of local tumor control (LTC), peritoneal seeding, and tumorigenic factors, in the rabbit VX2 subcapsular hepatic tumor model. Materials and Methods Sixty-two rabbits with VX2 subcapsular hepatic tumors were divided into three groups according to the procedure: DTP-RFA (n = 25); NtRFA (n = 25); and control (n = 12). Each of the three groups was subdivided into two sets for pathologic analysis (n = 24) or computed tomography (CT) follow-up for 6 weeks after RFA (n = 38). Ultrasonography-guided DTP-RFA and NtRFA were performed nine days after tumor implantation. LTC was defined by either achievement of complete tumor necrosis on histopathology or absence of local tumor progression on follow-up CT and autopsy. Development of peritoneal seeding was also compared among the groups. Serum hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) were measured via ELISA (Elabscience Biotechnology Co.) after RFA for tumorigenic factor evaluation. Results Regarding LTC, there was a trend in NtRFA (80%, 20/25) toward better ablation than in DTP-RFA (56%, 14/25) (p = 0.069). Complete tumor necrosis was achieved in 54.5% of DTP-RFA (6/11) and 90.9% of NtRFA (10/11). Peritoneal seeding was significantly more common in DTP-RFA (71.4%, 10/14) than in NtRFA (21.4%, 3/14) (p = 0.021) or control (0%). Elevations of HGF, VEGF or IL-6 were not detected in any group. Conclusion No-touch radiofrequency ablation led to lower rates of peritoneal seeding and showed a tendency toward better LTC than DTP-RFA.
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Affiliation(s)
- Tae-Hyung Kim
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Hyoung In Choi
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Bo Ram Kim
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Ji Hee Kang
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Ju Gang Nam
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Sae Jin Park
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Seunghyun Lee
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Dong Ho Lee
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Ijin Joo
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 03080, Korea
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199
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Bensalah K, Albiges L, Bernhard JC, Bigot P, Bodin T, Boissier R, Correas JM, Gimel P, Hetet JF, Long JA, Nouhaud FX, Ouzaïd I, Rioux-Leclercq N, Méjean A. RETRACTED: Recommandations françaises du Comité de Cancérologie de l’AFU – Actualisation 2018–2020 : prise en charge du cancer du reinFrench ccAFU guidelines – Update 2018–2020: Management of kidney cancer. Prog Urol 2018; 28:S3-S31. [PMID: 30473002 DOI: 10.1016/j.purol.2018.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 09/15/2018] [Indexed: 12/15/2022]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy).
Cet article est retiré de la publication à la demande des auteurs car ils ont apporté des modifications significatives sur des points scientifiques après la publication de la première version des recommandations.
Le nouvel article est disponible à cette adresse: DOI:10.1016/j.purol.2019.01.004.
C’est cette nouvelle version qui doit être utilisée pour citer l’article.
This article has been retracted at the request of the authors, as it is not based on the definitive version of the text because some scientific data has been corrected since the first issue was published.
The replacement has been published at the DOI:10.1016/j.purol.2019.01.004.
That newer version of the text should be used when citing the article.
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Affiliation(s)
- K Bensalah
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033, Rennes cedex, France.
| | - L Albiges
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Département d'oncologie génito-urinaire, Gustave-Roussy, 94805, Villejuif cedex, France
| | - J-C Bernhard
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie et transplantation rénale, CHU de Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux, France
| | - P Bigot
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie, CHU d'Angers, 4, rue Larrey, 49000, Angers, France
| | - T Bodin
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Centre d'urologie Prado-Louvain, 188, rue du Rouet, 13008, Marseille, France
| | - R Boissier
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie et transplantation rénale, CHU Conception, 147, boulevard Baille, 13005, Marseille, France
| | - J-M Correas
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'imagerie médicale (radiologie), hôpital universitaire Necker-Enfants-malades, 149, rue de Sèvres, 75015, Paris, France
| | - P Gimel
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Centre d'urologie, site Médipôle, 5, avenue Ambroise-Croizat, 66330, Cabestany, France
| | - J-F Hetet
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service de chirurgie urologique, clinique Jules-Verne, 2-4, route de Paris, 44314, Nantes, France
| | - J-A Long
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service de chirurgie urologique et de la transplantation rénale, hôpital Michallon, CHU Grenoble, boulevard de la Chantourne, 38700, La Tronche, France
| | - F-X Nouhaud
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie, CHU de Rouen, 1, rue de Germont, 76000, Rouen, France
| | - I Ouzaïd
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Clinique urologique, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018, Paris, France
| | - N Rioux-Leclercq
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'anatomie et cytologie pathologiques, CHU Pontchaillou, 2, rue Henri-le-Guilloux, 35033, Rennes cedex 9, France
| | - A Méjean
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie, hôpital européen Georges-Pompidou, université Paris Descartes, AP-HP, 75015, Paris, France
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200
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Tomasian A, Jennings JW. Percutaneous Radiofrequency Ablation of Spinal Osteoid Osteomas Using a Targeted Navigational Bipolar Electrode System. AJNR Am J Neuroradiol 2018; 39:2385-2388. [PMID: 30361430 DOI: 10.3174/ajnr.a5831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 07/24/2018] [Indexed: 11/07/2022]
Abstract
Safe and effective percutaneous CT-guided radiofrequency ablation of spinal osteoid osteomas can be performed using a targeted navigational bipolar electrode system. Articulating bipolar electrodes with built-in thermocouples along an electrode shaft and variable generator wattage settings allow optimal nidus access, particularly in challenging locations; provide precise real-time monitoring of ablation zone volume and geometry; and minimize the risk of undesired thermal injury.
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Affiliation(s)
- A Tomasian
- From the Department of Radiology (A.T.), University of Southern California, Los Angeles, California
| | - J W Jennings
- Mallinckrodt Institute of Radiology (J.W.J.), St. Louis, Missouri
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