RFA for Liver Tumors: Does It Really Work?

Higgins, Heather; Berger, David L.

doi:10.1634/theoncologist.11-7-801

Cited by 38 publications

(24 citation statements)

References 55 publications

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“…Complete necrosis was achieved in 68 patients (41%). This procedure is not an anodyne one, literature data suggests morbidty rates under 10% and mortality under 0.5% (59). In our series morbidity was 12% and mortality rate was 1.2%.…”

Section: Discussionsupporting

confidence: 40%

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Curative Intent Treatment of Hepatocellular Carcinoma - 844 Cases Treated in a General Surgery and Liver Transplantation Center

Grigorie¹,

Alexandrescu²,

Smira³

et al. 2017

chr

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RezumatObiectivul acestui studiu este acela de a evalua rezultatele pacienţilor trataţi pentru hepatocarcinom (CHC) într-un centru de Chirurgie Generalã şi Transplant Hepatic. Material şi metode: Acest studiu retrospectiv include 844 pacienţi diagnosticaţi cu CHC şi trataţi chirurgical cu intenţie de radicalitate. Singurele metode de tratament curativ pentru CHC, la ora actualã sunt reprezentate de rezecţia hepaticã (RH) şi transplantul hepatic (TH). Ablaţia tumoralã poate fi indicatã în tratamentul CHC precoce, în cazurile la care rezecţia sau transplantul hepatic nu se pot efectua. La 518 pacienţi s-a practicat rezecţie hepaticã, 162 au beneficiat de transplant hepatic, iar 164 pacienţi au fost trataţi prin distrucţie cu radiofrecvenţã (RFA). 615 pacienţi (73%) au prezentat cirozã hepaticã. Rezultate: Morbiditatea şi mortalitatea înregistrate pentru întreg lotul de pacienţi au fost de 30% şi respectiv 4,3%. Supravieţuirea la 5 ani a fost de 39% cu diferenţe semnificative statistic între pacienţii la care s-a practicat RH comparativ cu cei transplantaţi şi Chirurgia (2017)

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Section: Discussionsupporting

confidence: 40%

“…The best results are achieved for tumors no larger than 3 cm, although some authors consider these methods viable for larger tumors (58,59). In our series survival rates were significantly better for patients with tumor diameter of maximum 3 cm (p<0.05) (Fig.…”

Section: Discussionmentioning

confidence: 51%

Curative Intent Treatment of Hepatocellular Carcinoma - 844 Cases Treated in a General Surgery and Liver Transplantation Center

Grigorie¹,

Alexandrescu²,

Smira³

et al. 2017

chr

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“…images, hepatic lesions with abnormal metabolic activity are sometimes overlooked [191]. Consequently, local recurrence after liver RFA as a result of these missed tumors remains one of the major factors in relapse [192], which is in the range of 3%-39% [193]. Thus, precise targeting of lesions remains a challenging task when guided solely by volumetric CT with or without contrast enhancement.…”

Section: Motivationmentioning

confidence: 99%

High-Performance 3D Image Processing Architectures for Image-Guided Interventions

Dandekar¹

2008

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Minimally invasive image-guided interventions (IGIs) are time and cost efficient, minimize unintended damage to healthy tissues, and lead to faster patient recovery. Advanced three-dimensional (3D) image processing is a critical need for navigation during IGIs. However, achieving on-demand performance, as required by IGIs, for these image processing operations using software-only implementations is challenging because of the sheer size of the 3D images, and memory and compute intensive nature of the operations. This dissertation, therefore, is geared toward developing high-performance 3D image processing architectures, which will enable improved intraprocedural visualization and navigation capabilities during IGIs.In this dissertation we present an architecture for real-time implementation of 3D filtering operations that are commonly employed for preprocessing of medical images. This architecture is approximately two orders of magnitude faster than corresponding software implementations and is capable of processing 3D medical images at their acquisition speeds. Report Documentation PageCombining complementary information through registration between pre-and intraprocedural images is a fundamental need in the IGI workflow. Intensity-based deformable registration, which is completely automatic and locally accurate, is a promising approach to achieve this alignment. These algorithms, however, are extremely compute intensive, which has prevented their clinical use. We present an FPGA-based architecture for accelerated implementation of intensity-based deformable image registration. This high-performance architecture achieves over an order of magnitude speedup when compared with a corresponding software implementation and reduces the execution time of deformable registration from hours to minutes while offering comparable image registration accuracy.Furthermore, we present a framework for multiobjective optimization of finite-precision implementations of signal processing algorithms that takes into account multiple conflicting objectives such as implementation accuracy and hardware resource consumption. The evaluation that we have performed in the context of FPGA-based image registration demonstrates that such an analysis can be used to enhance automated hardware design processes, and efficiently identify a system configuration that meets given design constraints. In addition, we also outline two novel clinical applications that can directly benefit from these developments and demonstrate the feasibility of our approach in the context of these applications. These advances will ultimately enable integration of 3D image processing into clinical workflow.

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“…Since its acceptance into clinical practice in 1990s, thermal ablation has been widely used as a viable minimally invasive treatment for kidney 1 and liver 2 tumor therapy and is fast becoming the preferred therapy over the standard invasive procedure. In the liver and kidney organs in particular, each and every functional unit-the hepatic acinus in the liver and the nephron in the kidney-that can be saved, counts in a surgeon's attempt to preserve as much functional organ tissue as possible in their oncological patients.…”

Section: Introductionmentioning

confidence: 99%

Temperature profile of ex-vivo organs during radio frequency thermal ablation by fiber Bragg gratings

et al. 2016

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, "Temperature profile of ex-vivo organs during radio frequency thermal ablation by fiber Bragg gratings," J. Biomed. Opt. 21 (11) Abstract. We report on the integration of fiber optic sensors with commercial medical instrumentation for temperature monitoring during radio frequency ablation for tumor treatment. A suitable configuration with five fiber Bragg grating sensors bonded to a bipolar radio frequency (RF) probe has been developed to monitor the area under treatment. A series of experiments were conducted on ex-vivo animal kidney and liver and the results confirm that we were able to make a multipoint measurement and to develop a real-time temperature profile of the area, with a temperature resolution of 0.1°C and a spatial resolution of 5 mm during a series of different and consecutive RF discharges. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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RFA for Liver Tumors: Does It Really Work?

Cited by 38 publications

References 55 publications

Curative Intent Treatment of Hepatocellular Carcinoma - 844 Cases Treated in a General Surgery and Liver Transplantation Center

Curative Intent Treatment of Hepatocellular Carcinoma - 844 Cases Treated in a General Surgery and Liver Transplantation Center

High-Performance 3D Image Processing Architectures for Image-Guided Interventions

Temperature profile of ex-vivo organs during radio frequency thermal ablation by fiber Bragg gratings

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