Malignant liver tumors treated with MR imaging-guided laser-induced thermotherapy: technique and prospective results.

Vogl, Thomas J.; Müller, P.; Hammerstingl, R; Weinhold, Niels; Mack, Martin G.; Philipp, Carsten M.; Deimling, M.; Beuthan, J.; Pegios, W.; Rieß, H.

doi:10.1148/radiology.196.1.7540310

Cited by 335 publications

(181 citation statements)

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“…The observed cumulative survival curves are entirely comparable with those reported in other series of HCCs treated with percutaneous ablative therapies [6][7][8][9][10][11][12][16][17][18]33 or surgical resection. [13][14][15] Recently, randomized clinical trials showed that RFA is superior to percutaneous chemical injection in terms of both local tumor control and survival.…”

Section: Discussionsupporting

confidence: 85%

“…3,4 When surgery is not possible, there are several minimally invasive options for chemical or thermal tumor ablation. [5][6][7][8] One of the most effective is radiofrequency ablation (RFA), 9 which is now considered potentially curative for early-stage HCCs in patients with or without surgical prospects. 3,4,[10][11][12] Local tumor control and survival are the parameters most widely used to assess the efficacy of surgical and nonsurgical treatments for HCC.…”

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confidence: 99%

“…3,4,[10][11][12] Local tumor control and survival are the parameters most widely used to assess the efficacy of surgical and nonsurgical treatments for HCC. [6][7][8][9][10][11][12][13][14][15][16] Data on local control are fairly easy to interpret: disease relapse at the treated tumor site is regarded as a treatment failure. Survival data are more difficult to interpret.…”

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confidence: 99%

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Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: A long-term cohort study

et al. 2010

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In most patients with cirrhosis, successful percutaneous ablation or surgical resection of hepatocellular carcinoma (HCC) is followed by recurrence. Radiofrequency ablation (RFA) has proven effective for treating HCC nodules, but its repeatability in managing recurrences and the impact of this approach on survival has not been evaluated. To this end, we retrospectively analyzed a prospective series of 706 patients with cirrhosis (ChildPugh class B7) who underwent RFA for 859 HCC 35 mm in diameter (1-2 per patient). The results of RFA were classified as complete responses (CRs) or treatment failures. CRs were obtained in 849 nodules (98.8%) and 696 patients (98.5%). During follow-up (median, 29 months), 465 (66.8%) of the 696 patients with CRs experienced a first recurrence at an incidence rate of 41 per 100 person-years (local recurrence 6.2; nonlocal 35). Cumulative incidences of first recurrence at 3 and 5 years were 70.8% and 81.7%, respectively. RFA was repeated in 323 (69.4%) of the 465 patients with first recurrence, restoring disease-free status in 318 (98.4%) cases. Subsequently, RFA was repeated in 147 (65.9%) of the 223 patients who developed a second recurrence after CR of the first, restoring disease-free status in 145 (98.6%) cases. Overall, there were 877 episodes of recurrence (1-8 per patient); 577 (65.8%) of these underwent RFA that achieved CRs in 557 (96.5%) cases. No procedure-related deaths occurred in 1,921 RFA sessions. Estimated 3-and 5-year overall and disease-free (after repeated RFAs) survival rates were 67.0% and 40.1% and 68.0 and 38.0%, respectively. Conclusion: RFA is safe and effective for managing HCC in patients with cirrhosis, and its high repeatability makes it particularly valuable for controlling intrahepatic recurrences. (HEPATOLOGY 2011;53:136-147)

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Section: Discussionsupporting

confidence: 85%

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confidence: 99%

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confidence: 99%

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Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: A long-term cohort study

et al. 2010

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“…12,13 Laser interstitial thermal ablation therapy has the advantage of being less painful, but the application is usually limited by the relatively small zone of coagulation produced per each probe placement, as similar to MCT. 14,15 Cryoablation therapy is also known to be an effective alternative treatment modality for unresectable liver tumors, but the complication rates have been reported to be relatively high (Ϸ20%). 16,17 The limitations of this study are as follows.…”

Section: Discussionmentioning

confidence: 99%

“…9 According to the American Association for the Study of Liver Diseases (AASLD) practice guidelines, PEI is safe and highly effective for small HCC and should be the standard against which any new therapy is compared. 4 Other alternative nonsurgical treatments include percutaneous acetic acid injection (PAI), 10,11 microwave coagulation therapy (MCT), [12][13][14] laser interstitial thermal ablation therapy, 14,15 cryoablation therapy, 16,17 and radiofrequency ablation (RFA). [18][19][20][21][22][23][24] Among these therapies, RFA is a promising and recently developed thermo-coagulative ablation technique.…”

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Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies

et al. 2008

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According to the American Association for the Study of Liver Diseases guidelines, percutaneous ethanol injection (PEI) is a safe and highly effective treatment for small hepatocellular carcinomas (HCC) and should be the standard against which any new therapy is compared. The primary purpose of this study was to identify survival benefit of any percutaneous ablation therapy as compared with PEI in the treatment of patients with unresectable HCC. The secondary endpoints were initial tumor response, local tumor progression, and complications. Randomized controlled trials that compared pecutaneous ablative therapies with PEI were included. MEDLINE, the Cochrane Library, CANCERLIT, and manual search from 1978 to July 2008 were used. To control the potential heterogeneity, the random effects model of DerSimonian and Laird was used for a meta-analysis. Egger's test was performed to test a potential publication bias. We identified seven randomized controlled trials (RCTs), but only four RCTs including 652 patients that compared radiofrequency ablation (RFA) with PEI met the inclusion criteria to perform a meta-analysis assessing 3-year survival.

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Advances in Biomedical Imaging

Tempany

McNeil²

2001

JAMA

130

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In the 21st century, diseases will be diagnosed and treated using increasingly less invasive, more sophisticated imaging and image-guided procedures. During the past 100 years, the field of biomedical imaging has developed from Roentgen's original discovery of the x-ray to the imaging tools of today, such as magnetic resonance imaging, computed tomography, positron emission tomography, and ultrasonography. The benefits of using these sophisticated noninvasive imaging tools are already evident: more accurate and timely diagnosis of disease has translated into improved patient care. Recent advances in imaging research have shown the potential to change many aspects of clinical medicine within the next decade. Major new areas of research focus on development of the molecular, functional, cellular, and genetic imaging tools of the future, aided by new information technology and image fusion/integration capabilities. Image-guided therapy is growing rapidly, with advances in computer science, technology, and noninvasive treatment methods, such as focused ultrasonography. Undoubtedly, these and other new imaging techniques will enhance the ability to accurately diagnose and recognize disease and allow understanding of the molecular mechanisms of diseases and their respective responses to therapy. Given this explosion in new technologies, the next 25 years promise to result in dramatic changes in diagnostic imaging, particularly with respect to detection and recognition of disease.

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Malignant liver tumors treated with MR imaging-guided laser-induced thermotherapy: technique and prospective results.

Abstract: MR imaging-guided LITT of liver metastases is a safe and promising therapy for liver metastases.

Cited by 335 publications

References 0 publications

Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: A long-term cohort study

Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: A long-term cohort study

Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies

Advances in Biomedical Imaging

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