Laser Thermal Ablation in the Treatment of Small Hepatocellular Carcinoma: Results in 74 Patients

Pacella, Claudio Maurizio; Bizzarri, Giancarlo; Magnolfi, Fabrizio; Cecconi, Pietro; Caspani, B.; Anelli, Vincenzo; Bianchini, A.; Valle, D.; Pacella, Sara; Manenti, Guglielmo; Rossi, Z.

doi:10.1148/radiol.2213001501

Cited by 148 publications

(118 citation statements)

References 42 publications

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“…The high selectivity, low invasiveness, and capability of dealing with both small and large tumors make thermal ablation a popular therapy. The three main procedures involving thermal ablation are RFA [5][6][7][8]; microwave ablation [9][10][11], in which heat is generated by Joule effect through an electromagnetic (EM) field; and laser ablation, where a laser is used [12]. RFA is the most common and less invasive procedure, and can usually be handled as an outpatient procedure.…”

Section: Introductionmentioning

confidence: 99%

Fiber-optic combined FPI/FBG sensors for monitoring of radiofrequency thermal ablation of liver tumors: ex vivo experiments

et al. 2014

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We present a biocompatible, all-glass, 0.2 mm diameter, fiber-optic probe that combines an extrinsic Fabry-Perot interferometry and a proximal fiber Bragg grating sensor; the probe enables dual pressure and temperature measurement on an active 4 mm length, with 40 Pa and 0.2°C nominal accuracy. The sensing system has been applied to monitor online the radiofrequency thermal ablation of tumors in liver tissue. Preliminary experiments have been performed in a reference chamber with uniform heating; further experiments have been carried out on ex vivo porcine liver, which allowed the measurement of a steep temperature gradient and monitoring of the local pressure increase during the ablation procedure.

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Section: Introductionmentioning

confidence: 99%

Fiber-optic combined FPI/FBG sensors for monitoring of radiofrequency thermal ablation of liver tumors: ex vivo experiments

et al. 2014

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“…2,3 Among several alternative methods, microwave ablation entails many benefits in comparison with the others such as laser ablation, cryoablation and ethanol ablation. [4][5][6][7][8] Microwave ablation method is much safer and easily manageable 9 and can, in principle, offer material-specific responsiveness, where tissues with high water content such as cancer are preferentially heated and damaged. 10,11 This characteristic of microwaves makes microwave ablation well suited for local treatment of early stage of breast cancer.…”

mentioning

confidence: 99%

High‐frequency microwave ablation method for enhanced cancer treatment with minimized collateral damage

Yoon

Cho

Kim

et al. 2011

Intl Journal of Cancer

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To overcome the limits of conventional microwave ablation, a new frequency spectrum above 6 GHz has been explored for low-power and low collateral damage ablation procedure. A planar coaxial probe-based applicator, suitable for easy insertion into the human body, was developed for our study to cover a wideband frequency up to 30 GHz. Thermal ablations with small input power (1-3 W) at various microwave frequencies were performed on nude mice xenografted with human breast cancer. Comparative study of ablation efficiencies revealed that 18-GHz microwave results in the largest difference in the temperature rise between cancer and normal tissues as well as the highest ablation efficiency, reaching 20 times that of 2 GHz. Thermal profile study on the composite region of cancer and fat also showed significantly reduced collateral damage using 18 GHz. Application of low-power (1 W) 18-GHz microwave on the nude mice xenografted with human breast cancer cells resulted in recurrence-free treatment. The proposed microwave ablation method can be a very effective process to treat small-sized tumor with minimized invasiveness and collateral damages.Breast cancer is a major threat to women's health psychologically as well as physically. 1 Despite the high potential of fatality, most women show reluctance for large-scale breast removal due to cosmetic concerns, which brings about the need for local surgical control. For this reason, minimally invasive techniques to achieve better local surgical control have collected extensive attention as a possible first-line treatment in lieu of conservative breast surgery procedures such as lumpectomy. 2,3 Among several alternative methods, microwave ablation entails many benefits in comparison with the others such as laser ablation, cryoablation and ethanol ablation. [4][5][6][7][8] Microwave ablation method is much safer and easily manageable 9 and can, in principle, offer material-specific responsiveness, where tissues with high water content such as cancer are preferentially heated and damaged. 10,11 This characteristic of microwaves makes microwave ablation well suited for local treatment of early stage of breast cancer. So far, the frequencies used in the existing microwave ablation systems have been limited to the low-frequency spectrum such as 915 MHz or 2.4 GHz. Because of the inherent low radiation efficiency, very high microwave input power of several tens of Watts is required at these frequencies, thus greatly increasing the cost and size of the equipment. 12 Moreover, because of the self-heating of the applicator by the excessive microwave power, additional means for cooling the applicator are required to avoid the damage of healthy tissues near the passage of the applicator. 13 Besides, the conventional low-frequency spectrum ablation has poor material selectivity when compared to the alternative high-frequency spectrum proposed in our work.To overcome the limitations of the existing microwave ablation methods, we have investigated the properties of microwaves up to 30 GHz wit...

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“…A complete response rate of 78% was observed following laser ablation in a study of 432 patients, while the local recurrence rate was found to be 20%, with 3-and 5-year survival rates as high as 61% and 34% respectively [48][49][50] . The safety of laser ablation has also been found to be comparable with other percutaneous modalities like RFA with major and minor complication rates of 1.5% and 6.2% respectively, and a mortality rate of 0.8% as reported by an Italian study [51] .…”

Section: Laser Ablationmentioning

confidence: 99%

Ablative techniques in hepatocellular carcinoma treatment

Naeem¹,

Abid²

2018

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Hepatocellular carcinoma has been known to arise commonly in the setting of chronic liver disease. Due to its association with cirrhosis, patients with hepatocellular carcinoma often present with markedly diminished hepatic functional reserve, making them poor surgical candidates. For such patients, image-guided percutaneous ablative modalities have provided a viable alternate curative therapy. Although treatment allocation is a decision based on a number of factors, patients eligible for percutaneous ablation generally include those with early stage disease, hepatocellular carcinoma with disease limited to the liver and no extra-hepatic metastases. While percutaneous ethanol injection is the seminal technique, newer developments have led to it being replaced by percutaneous radiofrequency ablation as the most commonly employed procedure, due to a better efficacy as well as safety profile. Other ablative modalities including microwave ablation, laser ablation and cryotherapy are not as widely available. Furthermore, data comparing their effectiveness with well-established procedures like radiofrequency ablation is limited.

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Laser Thermal Ablation in the Treatment of Small Hepatocellular Carcinoma: Results in 74 Patients

Cited by 148 publications

References 42 publications

Fiber-optic combined FPI/FBG sensors for monitoring of radiofrequency thermal ablation of liver tumors: ex vivo experiments

Fiber-optic combined FPI/FBG sensors for monitoring of radiofrequency thermal ablation of liver tumors: ex vivo experiments

High‐frequency microwave ablation method for enhanced cancer treatment with minimized collateral damage

Ablative techniques in hepatocellular carcinoma treatment

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