Local Therapies for Hepatocellular Carcinoma and Role of MRI-Guided Adaptive Radiation Therapy

Liu, Yi-Rong; Chou, B.; Yalamanchili, Amulya; Lim, S.N.; Dawson, Laura A.; Thomas, Tarita O.

doi:10.3390/jcm12103517

Cited by 2 publications

(3 citation statements)

References 155 publications

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“…Chemical ablation is carried out with PEI or percutaneous acetic acid injection (PAI). It is used in early-stage cases for patients with associated diseases [ 29 , 31 , 32 ].…”

Section: Bridging Therapies In Very Early Stage Early Stage and Inter...mentioning

confidence: 99%

Bridge Therapy before Liver Transplant for Advanced Hepatocellular Carcinoma

Bianchi,

Nure,

Nesci

et al. 2024

Medicina

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Hepatocellular carcinoma is the most common primary liver tumor. Orthotopic liver transplant is one of the best treatment options, but its waiting list has to be considered. Bridge therapies have been introduced in order to limit this issue. The aim of this study is to evaluate if bridge therapies in advanced hepatocellular carcinoma can improve overall survival and reduce de-listing. We selected 185 articles. The search was limited to English articles involving only adult patients. These were deduplicated and articles with incomplete text or irrelevant conclusions were excluded. Sorafenib is the standard of care for advanced hepatocellular carcinoma and increases overall survival without any significant drug toxicity. However, its survival benefit is limited. The combination of transarterial chemoembolization + sorafenib, instead, delays tumor progression, although its survival benefit is still uncertain. A few studies have shown that patients undergoing transarterial chemoembolization + radiation therapy have similar or even better outcomes than those undergoing transarterial chemoembolization or sorafenib alone for rates of histopathologic complete response (89% had no residual in the explant). Also, the combined therapy of transarterial chemoembolization + radiotherapy + sorafenib was compared to the association of transarterial chemoembolization + radiotherapy and was associated with a better survival rate (24 vs. 17 months). Moreover, immunotherapy revealed new encouraging perspectives. Combination therapies showed the most encouraging results and could become the gold standard as a bridge to transplant for patients with advanced hepatocellular carcinoma.

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“…Chemical ablation is carried out with PEI or percutaneous acetic acid injection (PAI). It is used in early-stage cases for patients with associated diseases [ 29 , 31 , 32 ].…”

Section: Bridging Therapies In Very Early Stage Early Stage and Inter...mentioning

confidence: 99%

Bridge Therapy before Liver Transplant for Advanced Hepatocellular Carcinoma

Bianchi,

Nure,

Nesci

et al. 2024

Medicina

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“…The benefits of these techniques are similar in terms of overall survival, complete ablation, recurrence-free survival and local tumor progression [21][22][23][24][25][26]. Potential complications such as bleeding, colon perforation, bile duct stenosis or hemothorax [16,27] are also the same. However, MW ablation induces more homogeneous thermal ablation than RF, and the faster heating process compared with RF ablation leads to less sensitivity to the heat-sink effect.…”

Section: Introductionmentioning

confidence: 98%

“…The tumor macro-and micro-environment is a complex physical medium to be considered when planning successful thermal therapy [12,14]. The two main techniques used in clinical routine to induce tissue necrosis by heating are microwave (MW) and radiofrequency (RF) ablations [15][16][17][18][19][20]. Both are based on the local generation of electromagnetic waves but working at different frequencies, 400-500 kHz for the RF and 900-2500 MHz for the MW.…”

Section: Introductionmentioning

confidence: 99%

In Vivo Thermal Ablation of Deep Intrahepatic Targets Using a Super-Convergent MRgHIFU Applicator and a Pseudo-Tumor Model

Lorton

Peloso

et al. 2023

Cancers

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Background: HIFU ablation of liver malignancies is particularly challenging due to respiratory motion, high tissue perfusion and the presence of the rib cage. Based on our previous development of a super-convergent phased-array transducer, we aimed to further investigate, in vivo, its applicability to deep intrahepatic targets. Methods: In a series of six pigs, a pseudo-tumor model was used as target, visible both on intra-operatory MRI and post-mortem gross pathology. The transcostal MRgHIFU ablation was prescribed coplanar with the pseudo-tumor, either axial or sagittal, but deliberately shifted 7 to 18 mm to the side. No specific means of protection of the ribs were implemented. Post-treatment MRI follow-up was performed at D7, followed by animal necropsy and gross pathology of the liver. Results: The pseudo-tumor was clearly identified on T1w MR imaging and subsequently allowed the MRgHIFU planning. The peak temperature at the focal point ranged from 58–87 °C. Gross pathology confirmed the presence of the pseudo-tumor and the well-delineated MRgHIFU ablation at the expected locations. Conclusions: The specific design of the transducer enabled a reliable workflow. It demonstrated a good safety profile for in vivo transcostal MRgHIFU ablation of deep-liver targets, graded as challenging for standard surgery.

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Local Therapies for Hepatocellular Carcinoma and Role of MRI-Guided Adaptive Radiation Therapy

Cited by 2 publications

References 155 publications

Bridge Therapy before Liver Transplant for Advanced Hepatocellular Carcinoma

Bridge Therapy before Liver Transplant for Advanced Hepatocellular Carcinoma

In Vivo Thermal Ablation of Deep Intrahepatic Targets Using a Super-Convergent MRgHIFU Applicator and a Pseudo-Tumor Model

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