scholarly journals Volumetric Quantitative Ablation Margins for Assessment of Ablation Completeness in Thermal Ablation of Liver Tumors

2021 ◽  
Vol 11 ◽  
Author(s):  
Raluca-Maria Sandu ◽  
Iwan Paolucci ◽  
Simeon J. S. Ruiter ◽  
Raphael Sznitman ◽  
Koert P. de Jong ◽  
...  
Keyword(s):  
Thermal Ablation ◽  
Liver Tumors ◽  
Treatment Success ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Complete Coverage ◽  
Ct Guided ◽  
Ablation Volume ◽  
Novel Algorithm ◽  
Prospective Database

BackgroundIn thermal ablation of liver tumors, complete coverage of the tumor volume by the ablation volume with a sufficient ablation margin is the most important factor for treatment success. Evaluation of ablation completeness is commonly performed by visual inspection in 2D and is prone to inter-reader variability. This work aimed to introduce a standardized approach for evaluation of ablation completeness after CT-guided thermal ablation of liver tumors, using volumetric quantitative ablation margins (QAM).MethodsA QAM computation metric based on volumetric segmentations of tumor and ablation areas and signed Euclidean surface distance maps was developed, including a novel algorithm to address QAM computation in subcapsular tumors. The code for QAM computation was verified in artificial examples of tumor and ablation spheres simulating varying scenarios of ablation margins. The applicability of the QAM metric was investigated in representative cases extracted from a prospective database of colorectal liver metastases (CRLM) treated with stereotactic microwave ablation (SMWA).ResultsApplicability of the proposed QAM metric was confirmed in artificial and clinical example cases. Numerical and visual options of data presentation displaying substrata of QAM distributions were proposed. For subcapsular tumors, the underestimation of tumor coverage by the ablation volume when applying an unadjusted QAM method was confirmed, supporting the benefits of using the proposed algorithm for QAM computation in these cases. The computational code for developed QAM was made publicly available, encouraging the use of a standard and objective metric in reporting ablation completeness and margins.ConclusionThe proposed volumetric approach for QAM computation including a novel algorithm to address subcapsular liver tumors enables precision and reproducibility in the assessment of ablation margins. The quantitative feedback on ablation completeness opens possibilities for intra-operative decision making and for refined analyses on predictability and consistency of local tumor control after thermal ablation of liver tumors.

scholarly journals Stereotactic Thermal Ablation of Liver Tumors: 3D Planning, Multiple Needle Approach, and Intraprocedural Image Fusion Are the Key to Success—A Narrative Review

Biology ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 644
Author(s):  
Gregor Laimer ◽  
Peter Schullian ◽  
Reto Bale
Keyword(s):  
Image Fusion ◽  
Thermal Ablation ◽  
Clinical Evidence ◽  
Liver Tumors ◽  
Treatment Success ◽  
Safety Margin ◽  
Liver Malignancies ◽  
Stereotactic Techniques ◽  
Ct Guided ◽  
Invasive Method

Thermal ablation is an emerging, potentially curative approach in treating primary and metastatic liver cancer. Different technologies are available, with radiofrequency ablation (RFA) and microwave ablation (MWA) being the most widely used. Regardless of the technique, destruction of the entire tumor, including an adequate safety margin, is key. In conventional single-probe US- or CT-guided thermal ablation, the creation of such large necrosis zones is often hampered by technical limitations, especially for large tumors (i.e., >2–3 cm). These limitations have been overcome by stereotactic RFA (SRFA): a multiple needle approach with 3D treatment planning and precise stereotactic needle placement combined with intraprocedural image fusion of pre- and post-interventional CT scans for verification of treatment success. With these sophisticated tools and advanced techniques, the spectrum of locally curable liver malignancies can be dramatically increased. Thus, we strongly believe that stereotactic thermal ablation can become a cornerstone in the treatment of liver malignancies, as it offers all the benefits of a minimally invasive method while providing oncological outcomes comparable to surgery. This article provides an overview of current stereotactic techniques for thermal ablation, summarizes the available clinical evidence for this approach, and discusses its advantages.

scholarly journals Thermal Ablation of Bone Metastases

2018 ◽  
Vol 35 (04) ◽  
pp. 299-308 ◽  
Author(s):  
A. Kurup ◽  
Matthew Callstrom ◽  
Michael Moynagh
Keyword(s):  
Radiation Therapy ◽  
Bone Metastases ◽  
Thermal Ablation ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Pain Palliation ◽  
Local Tumor ◽  
Image Guided ◽  
Skeletal Related Events ◽  
Percutaneous Thermal Ablation

AbstractImage-guided, minimally invasive, percutaneous thermal ablation of bone metastases has unique advantages compared with surgery or radiation therapy. Thermal ablation of osseous metastases may result in significant pain palliation, prevention of skeletal-related events, and durable local tumor control. This article will describe current thermal ablation techniques utilized to treat bone metastases, summarize contemporary evidence supporting such thermal ablation treatments, and outline an approach to percutaneous ablative treatment.

CT-Guided Percutaneous Cryoablation in Renal Cell Carcinoma: Factors Affecting Local Tumor Control

2015 ◽  
Vol 26 (8) ◽  
pp. 1147-1153 ◽  
Author(s):  
Takashi Yamanaka ◽  
Koichiro Yamakado ◽  
Tomomi Yamada ◽  
Masashi Fujimori ◽  
Haruyuki Takaki ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Local Tumor ◽  
Ct Guided ◽  
Factors Affecting ◽  
Percutaneous Cryoablation

scholarly journals Local tumor control and survival after image-guided thermal ablation of adrenal gland metastases

2017 ◽  
Vol 28 (2) ◽  
pp. S83 ◽  
Author(s):  
N Frenk ◽  
F Fintelmann ◽  
D Daye ◽  
P Shyn ◽  
R Arellano ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Thermal Ablation ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Local Tumor ◽  
Image Guided

Stereotactic Single-Dose Radiation Therapy of Liver Tumors: Results of a Phase I/II Trial

2001 ◽  
Vol 19 (1) ◽  
pp. 164-170 ◽  
Author(s):  
Klaus K. Herfarth ◽  
Jürgen Debus ◽  
Frank Lohr ◽  
Malte L. Bahner ◽  
Bernhard Rhein ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Single Dose ◽  
Radiation Treatment ◽  
Liver Tumors ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Local Tumor ◽  
Local Tumor Control Rate ◽  
Dose Radiation

PURPOSE: To investigate the feasibility and the clinical response of a stereotactic single-dose radiation treatment for liver tumors. PATIENTS AND METHODS: Between April 1997 and September 1999, a stereotactic single-dose radiation treatment of 60 liver tumors (four primary tumors, 56 metastases) in 37 patients was performed. Patients were positioned in an individually shaped vacuum pillow. The applied dose was escalated from 14 to 26 Gy (reference point), with the 80% isodose surrounding the planning target volume. Median tumor size was 10 cm3 (range, 1 to 132 cm3). The morbidity, clinical outcome, laboratory findings, and response as seen on computed tomography (CT) scan were evaluated. RESULTS: Follow-up data could be obtained from 55 treated tumors (35 patients). The median follow-up period was 5.7 months (range, 1.0 to 26.1 months; mean, 9.5 months). The treatment was well tolerated by all patients. There were no major side effects. Fifty-four (98%) of 55 tumors were locally controlled after 6 weeks at the initial follow-up based on the CT findings (22 cases of stable disease, 28 partial responses, and four complete responses). After a dose-escalating and learning phase, the actuarial local tumor control rate was 81% at 18 months after therapy. A total of 12 local failures were observed during follow-up. So far, the longest local tumor control is 26.1 months. CONCLUSION: Stereotactic single-dose radiation therapy is a feasible method for the treatment of singular inoperable liver metastases with the potential of a high local tumor control rate and low morbidity.

Impact of the size of metatases on the outcome of patients with non-resectable colorectal liver metastases treated with percutaneous laser-induced thermoablation (pLIT)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 13556-13556
Author(s):  
G. Aprile Esq. ◽  
M. Sponza ◽  
A. Vit ◽  
N. Pella ◽  
D. Gasparini ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Optical Fibers ◽  
Thermal Ablation ◽  
Wave Length ◽  
Local Treatment ◽  
Local Tumor Control ◽  
Maximum Diameter ◽  
Tumor Control ◽  
Kaplan Meier ◽  
One Year

13556 Background: whenever surgical resection of liver metastases from colorectal cancer is not possible, thermal ablation is a mini-invasive local treatment that can be considered as an alternative approach. Complete thermal ablation can be achieved by laser treatment. When thermoablation is obtained by radiofrequency, patients treated for a small dominant lesion (less than 3 cm) experience a better outcome. This evidence is less clear when pLIT is used. Patients and Methods: 30 patients (22 with a single lesion, 8 with up to three metastases) were consecutively treated. Maximum diameter of the dominant lesion was less than 3 cm in 20 pts and more than 3 cm in ten. With mild sedation and local anaesthesia, optical fibers were inserted directly into the tumor with echo-guided percutaneous needle placement. Each optical fiber was connected to a neodymium:yttrium-aluminium-garnet (ND:YAG) laser, which delivers concentrated light at a wave-length of 1064 nm, with a 5-Watt power and a 1800-Joule energy per single fiber. A minimum of two and a maximum of four needles were used, with a 5 to 8 mm distance from one needle to another. Results: all patients tolerated LIT procedure well, without major complications. Post-treatment CT-scan demonstrated complete thermonecrosis in 39 out of 44 (87%) of the treated lesions, and almost complete in the remaining 5, 4 of which of diameter larger than 3 cm. Local failure was reported in 12% of the lesions at six-month follow-up. The median Kaplan-Meier survival for all patients was 607 days, with survival rate of 82% at one year and 55% at three years. Patients treated for a smaller dominant lesion had a significantly better survival than the others (850 vs 420 days, p=0.04, logrank). Conclusions: pLIT permitted in most cases a complete ablation of liver metastases with a high local tumor control rate and a low complication rate. Patients with a smaller dominant lesion do best after pLIT procedure. Local treatment coupled with systemic chemotherapy offers a chance of prolonged survival in patients not amenable to hepatic surgery. No significant financial relationships to disclose.

Percutaneous thermal ablation of sacral metastases: Assessment of pain relief and local tumor control

2021 ◽  
Author(s):  
Roberto L. Cazzato ◽  
Pierre De Marini ◽  
Ian Leonard-Lorant ◽  
Danoob Dalili ◽  
Guillaume Koch ◽  
...  
Keyword(s):  
Pain Relief ◽  
Thermal Ablation ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Local Tumor ◽  
Percutaneous Thermal Ablation
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