Ablation,liver,lung,radiology,imaging,intervention

Cryoablation is commonly used in the kidney, lung, breast, and soft tissue, but is an uncommon choice in the liver where radiofrequency ablation (RFA) and microwave ablation (MWA) predominate. This is in part for historical reasons due to serious complications that occurred with open hepatic cryoablation using early technology. More current technology combined with image-guided percutaneous approaches has ameliorated these issues and allowed cryoablation to become a safe and effective thermal ablation modality for treating liver tumors...

BACKGROUND: Applicator-based local ablations under computed tomography (CT) guidance for the treatment of malignant tumors have found their way into clinical routine. OBJECTIVES: The basic principles of the different ablation technologies and their specific clinical field of application are described. MATERIALS AND METHODS: A comprehensive literature review regarding applicator-based ablation techniques was carried out. RESULTS: Radiofrequency (RFA) and microwave ablation (MWA) represent two image-guided hyperthermal treatment modalities that have been established for the treatment of primary and secondary liver malignancies...

PURPOSE: To evaluate the feasibility, safety, and efficacy of radiofrequency (RF) ablation using an ablation system (arfa RF ABLATION SYSTEMⓇ ; Japan Lifeline Co. Ltd.) for treating solid tumors in various organs. MATERIAL AND METHODS: Between October 2019 and August 2021, 80 patients (29 women, 51 men; median age, 70.0 yr) underwent 107 RF ablation sessions using the ablation system to treat 151 tumors in the liver ( n = 86), lung ( n = 51), adrenal gland ( n = 4), pleura ( n = 4), bone ( n = 3), lymph node ( n = 2), and kidney ( n = 1)...

Metastases are the main type of malignancy involving bone, which is the third most frequent site of metastatic carcinoma, after lung and liver. Skeletal-related events such as intractable pain, spinal cord compression, and pathologic fractures pose a serious burden on patients' quality of life. For this reason, mini-invasive treatments for the management of bone metastases were developed with the goal of pain relief and functional status improvement. These techniques include embolization, thermal ablation, electrochemotherapy, cementoplasty, and MRI-guided high-intensity focused ultrasound...

Microwave ablation systems allow for performing tumoral destruction in oncology. The objective of this study was to assess the early response and reliability of the microwave ablation zone size at one month for liver, kidney and lung lesions, as compared to the manufacturer's charts. Patients who underwent microwave ablation with the EmprintTM ablation system for liver, kidney and lung lesions between June 2016 and June 2018 were retrospectively reviewed. Local response and ablation zone size (major, L , and minor, l , axes) were evaluated on the one-month follow-up imaging...

PURPOSE: To determine whether histotripsy can create human-scale transcostal ablations in porcine liver without causing severe thermal wall injuries along the beam path. MATERIALS AND METHODS: Histotripsy was applied to the liver using a preclinical prototype robotic system through a transcostal window in six female swine. A 3.0 cm spherical ablation zone was prescribed. Duration of treatment (75 min) was longer than a prior subcostal treatment study (24 min, 15 s) to minimize beam path heating...

This article demonstrates the technique of using a coaxial guiding needle to perform combined percutaneous biopsy and microwave ablation via a single tract. From May 2019 to July 2020, 14 patients underwent combined biopsy and microwave ablation by using a coaxial guiding cannula. Tumors were in the kidney of six patients (43%), the liver of six patients (43%), and the lung in two patients (14%). The diagnostic yield of biopsy was 86% (12/14). Ablation technical success rate was 100%. In conclusion, using a coaxial guiding needle in microwave ablation and biopsy is safe and effective...

Recurrent or metastatic peri-urethral pelvic malignancies are a difficult-to-treat entity. Re-resection is recommended when possible but is frequently unfavorable due to scar tissue, fibrosis, and obliteration of tissue planes following previous interventions such as surgical resection and/or radiation therapy. Curative options for patients that have unresectable cancer are limited. Cryo-ablation has been extensively studied in the treatment of unresectable renal, liver and lung malignancies and has the potential to provide definitive treatment for recurrent pelvic malignancy...

PURPOSE: To assess the safety, feasibility, and efficacy of percutaneous thermal ablation (TA) in the treatment of metastatic gynecologic (GYN) tumors. MATERIALS AND METHODS: A study cohort of 42 consecutive women (mean age, 59. years; range, 25-78 years) with metastatic GYN tumors (119 metastatic tumors) treated with radiofrequency (n = 47 tumors), microwave (n = 47 tumors), or cryogenic (n = 30 tumors) ablation from over 2,800 ablations performed from January 2001 to January 2019 was identified...

Sarcoma is rare and heterogenous with various subtypes having a different prognostic. Desmoid is a tumour with a local aggressiveness; GIST with KIT mutation responds massively to target treatment as IMATINIB, whereas soft tissue sarcoma and leiomyosarcoma are very aggressive with poor response to systemic therapies. Interventional radiology plays an important role in the diagnosis of sarcomas with image-guided percutaneous core needle biopsy being the most commonly used biopsy technique in the diagnosis of sarcomas...

In bone and soft tissue sarcomas (STS), surgery was to the only local curative treatment, but recently, radiation therapy and interventional radiology has evolved to potentially curative treatment, namely in small size tumours. Indication for local treatment in STS needs validation in multidisciplinary team. Most will agree on local treatment for single metastatic location in a well-controlled disease and for no local treatment in a rapidly evolving multi-metastatic disease. The challenge is in patients who are in between, for whom benefit of disease control on overall survival should be evaluated...

Neuroendocrine tumors from gastro-pancreatic origin (GEP-NET) can be responsible for liver metastases. Such metastases can be the dominant part of the disease as well due to the tumor burden itself or the symptoms related to such liver metastases. Intra-arterial therapies are commonly used in liver only or liver-dominant disease and encompass trans-arterial chemoembolization (TACE), trans-arterial embolization (TAE), and radioembolization (RE). TACE performed with drug emulsified in Lipiodol has been used for the past 20 years with reported overall survival in the range of 3-4 years, with objective response up to 75%...

PURPOSE: To identify malfunction of implanted cardiac devices during or after thermal ablation of tumors in lung, kidney, liver or bone, using radiofrequency (RF) or microwave (MW) energy. MATERIALS AND METHODS: After providing written consent, 19 patients (15 men and 4 women; mean age 78 years) with pacemakers or pacemaker/defibrillators underwent 22 CT image-guided percutaneous RF or MW ablation of a variety of tumors. Before and after each procedure, cardiac devices were interrogated and reprogrammed by a trained cardiac electrophysiology fellow...

The article considers new and potential uses for contrast-enhanced ultrasound (CEUS) in radiology. CEUS could become an early, sensitive and inexpensive tool for managing tumor ablation in patients in whom microvascular imaging adds diagnostic information, especially in inflammatory diseases. Its sensitivity in detecting focal liver lesions is comparable to that of other imaging modalities such as computed tomography or magnetic resonance imaging, and it provides a high accuracy in lesion characterization. The main indications in renal diseases are characterization of complicated cysts, arterial infarction and masses in the collecting system and renal vein...

No abstract text is available yet for this article.

Percutaneous radiofrequency thermal ablation (RFA) has been used to treat primary and secondary liver tumors under ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) guidance for the past decade [Park et al., Radiol Clin North Am 38:545-561, 2000; Siperstein and Gotomirski, Cancer J 6:S293-S301, 2000; Kelekis et al., Eur Radiol 13:1100-1105, 2003]. RFA is a low-cost, minimally invasive treatment that has recently attracted attention for treating tumors in different solid organs with promising results [Dupuy and Goldberg, J Vasc Interv Radiol 12:1135-1148, 2001; Friedman et al...

Interventional radiology (IR) plays an increasing role in the supportive care of the cancer patient from the placement of catheters to treating the offending tumor via image-guided methods. These methods entail the use of both local and regional means, with thermal ablative technology comprising the former and intra-arterial embolization with radioactive particles the latter. Direct placement of the radiofrequency or cryotherapy probes into tumors that are accessible using computed tomography (CT), ultrasound, or magnetic resonance imaging (MRI) guidance provides reliable symptomatic relief of single or multiple tumors in liver, kidney, lung, bone, or soft tissue...

No abstract text is available yet for this article.

Percutaneous interstitial tumor ablation therapy is a relatively new and steadily growing field within interventional radiology. Radiofrequency ablation (RFA) became one of the most accepted techniques among hyperthermal ablation procedures, presumably due to its superior relation between probe diameter and efficacy. The first part of this review provided an overview of the underlying principles, technical background and application techniques. This second part describes the indications, techniques and results of clinical RFA applied to primary and secondary liver tumors as well as experiences with extrahepatic RFA applied to kidney, bone and lung, together with a discussion of the current literature...

Interventional Radiology can be defined as minimally invasive closed percutaneous procedures for diagnosis or treatment and guided by imaging techniques. Parallel to the development of Interventional vascularRadiology, non vascular techniques have evolved. Margulis coined the term "Interventional Radiology" describing percutaneous extraction of residual gallstones. Fluoroscopy guided biopsy of the lung and mediastinum were described in the thorax by Nordenstrom. Percutaneous approach to the bile ducts was clinically applied by Wiechel, Lunderquist and Wallace...