Overview of thermal ablation therapy for focal hepatic neoplasms

Percutaneous image-guided ablative therapies using thermal energy sources such as radiofrequency, microwave, high intensity focused ultrasound, cryotherapy, and laser have received much recent attention as minimally-invasive strategies for the treatment of focal malignancy in the liver. Potential benefits of these techniques include the ability to ablate tumor in non-surgical candidates, reduced morbidity as compared to surgery, and the potential to perform the procedure on an outpatient basis. This article will present an overview of the principles and techniques used for thermal ablation, as well as review the results of published clinical trials.

[1]  F. Garbagnati,et al.  Percutaneous treatment of small hepatic tumors by an expandable RF needle electrode. , 1998, AJR. American journal of roentgenology.

[2]  K. Hyodoh,et al.  Microwave coagulation therapy on hepatomas: CT and MR appearance after therapy , 1998, Journal of magnetic resonance imaging : JMRI.

[3]  H. Saitsu,et al.  [Investigation of microwave coagulo-necrotic therapy for 21 patients with small hepatocellular carcinoma less than 5 cm in diameter]. , 1993, Nihon Geka Gakkai zasshi.

[4]  B Rubinsky,et al.  Sonographic monitoring of hepatic cryosurgery in an experimental animal model. , 1985, AJR. American journal of roentgenology.

[5]  K. Hughes Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of indications for resection. Registry of Hepatic Metastases. , 1988, Surgery.

[6]  R. Hawes,et al.  High-intensity focused ultrasound. , 1994, Gastrointestinal endoscopy clinics of North America.

[7]  J. Overgaard,et al.  Hyperthermia as an adjuvant to radiotherapy. Review of the randomized multicenter studies of the European Society for Hyperthermic Oncology. , 1987, Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al].

[8]  N. Brown,et al.  Effect of cryosurgery on liver blood flow. , 1993, British Journal of Cancer.

[9]  F A Jolesz,et al.  MR monitoring during cryotherapy in the liver: Predictability of histologic outcome , 1993, Journal of magnetic resonance imaging : JMRI.

[10]  N. Petrelli,et al.  A prospective evaluation of hepatic resection for colorectal carcinoma metastases to the liver: Gastrointestinal Tumor Study Group Protocol 6584. , 1991, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  A Roggan,et al.  Internally cooled power laser for MR-guided interstitial laser-induced thermotherapy of liver lesions: initial clinical results. , 1998, Radiology.

[12]  S. G. Bown,et al.  Interstitial laser hyperthermia: a new approach for treating liver metastases. , 1992, British Journal of Cancer.

[13]  B. Wilson,et al.  Hepatic interstitial laser photocoagulation: demonstration and possible clinical importance of intravascular gas. , 1994, Radiology.

[14]  H. Holm,et al.  Ultrasound-Guided Percutaneous Nd:YAG Laser Diffuser Tip Hyperthermia of Liver Metastases , 1993 .

[15]  A. Terano,et al.  Percutaneous ethanol injection therapy for hepatocellular carcinoma: results in 146 patients. , 1993, AJR. American journal of roentgenology.

[16]  Eric R. Cosman,et al.  Theoretical aspects of radiofrequency lesions in the dorsal root entry zone. , 1984 .

[17]  N N Korpan,et al.  Hepatic cryosurgery for liver metastases. Long-term follow-up. , 1997, Annals of surgery.

[18]  E. Patterson,et al.  Radiofrequency ablation of porcine liver in vivo: effects of blood flow and treatment time on lesion size. , 1998, Annals of surgery.

[19]  R. F. Leveen,et al.  Laser hyperthermia and radiofrequency ablation of hepatic lesions , 1997 .

[20]  S. Nahum Goldberg,et al.  Percutaneous Treatment of Hepatic Neoplasms: A Review of Current Techniques , 1997, CardioVascular and Interventional Radiology.

[21]  J. Kuhlman,et al.  CT-monitored percutaneous cryoablation in a pig liver model: pilot study. , 1999, Radiology.

[22]  B. Cady,et al.  Experience with colorectal carcinoma metastatic to the liver. , 1989, The Surgical clinics of North America.

[23]  P R Mueller,et al.  Treatment of intrahepatic malignancy with radiofrequency ablation , 2000, Cancer.

[24]  Toshihito Seki,et al.  Percutaneous microwave coagulation therapy for solitary metastatic liver tumors from colorectal cancer: a pilot clinical study , 1999, American Journal of Gastroenterology.

[25]  T. Ravikumar,et al.  Experimental and clinical observations on hepatic cryosurgery for colorectal metastases. , 1991, Cancer research.

[26]  J. McGahan,et al.  Hepatic ablation with use of radio-frequency electrocautery in the animal model. , 1992, Journal of vascular and interventional radiology : JVIR.

[27]  G. Ballantyne,et al.  Surgical treatment of liver metastases in patients with colorectal cancer , 1993, Cancer.

[28]  S L Dawson,et al.  Tissue ablation with radiofrequency: effect of probe size, gauge, duration, and temperature on lesion volume. , 1995, Academic radiology.

[29]  S. Thomsen PATHOLOGIC ANALYSIS OF PHOTOTHERMAL AND PHOTOMECHANICAL EFFECTS OF LASER–TISSUE INTERACTIONS , 1991, Photochemistry and photobiology.

[30]  M. L. Weaver,et al.  Hepatic cryosurgery in treating colorectal metastases , 1995, Cancer.

[31]  L Solbiati,et al.  Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. , 1999, Radiology.

[32]  G. Gazelle,et al.  Radiofrequency tissue ablation: increased lesion diameter with a perfusion electrode. , 1996, Academic radiology.

[33]  L Solbiati,et al.  Percutaneous radiofrequency tissue ablation: does perfusion-mediated tissue cooling limit coagulation necrosis? , 1998, Journal of vascular and interventional radiology : JVIR.

[34]  H Uchida,et al.  Percutaneous hot saline injection therapy for hepatic tumors: an alternative to percutaneous ethanol injection therapy. , 1994, Radiology.

[35]  W. B. Ross,et al.  CEA reduction after cryotherapy for liver metastases from colon cancer predicts survival. , 1994, The Australian and New Zealand journal of surgery.

[36]  Eric Jones,et al.  Magnetic resonance image-guided thermal therapy with a radio frequency phased array , 1999, Photonics West - Biomedical Optics.

[37]  Toshihito Seki,et al.  Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma , 1994, Cancer.

[38]  René M. Botnar,et al.  Monitoring of radio frequency tissue ablation in an interventional magnetic resonance environment. Preliminary ex vivo and in vivo results. , 1997, Investigative radiology.

[39]  Zeng-chen Ma,et al.  Clinical evaluation of cryosurgery in the treatment of primary liver cancer Report of 60 Cases , 1988, Cancer.

[40]  D. E. Matthews,et al.  Evaluation of high-intensity therapeutic ultrasound irradiation in the treatment of experimental hepatoma. , 1989, Journal of pediatric surgery.

[41]  P Schneede,et al.  Coagulative interstitial laser-induced thermotherapy of benign prostatic hyperplasia: online imaging with a T2-weighted fast spin-echo MR sequence--experience in six patients. , 1999, Radiology.

[42]  Percutaneous microwave coagulation therapy in liver tumors , 1997, Acta radiologica.

[43]  EMBEDDED INSULATED ANTENNAS FOR COMMUNICATION AND HEATING , 1981 .

[44]  L. Ellis,et al.  Radiofrequency Ablation of Unresectable Primary and Metastatic Hepatic Malignancies: Results in 123 Patients , 1999 .

[45]  T J Flotte,et al.  Ablation of rabbit liver, stomach, and colon with a pulsed holmium laser. , 1989, Gastroenterology.

[46]  W. R. Lees,et al.  Liver Tumor Ablation by Interstitial Laser Photocoagulation: Review of Experimental and Clinical Studies , 1993 .

[47]  William H. Nau,et al.  Prostate thermal therapy with interstitial and transurethral ultrasound applicators: a feasibility study , 1998, Photonics West - Biomedical Optics.

[48]  Hyperthermia for brain tumors: improved delivery with a new cooling system. , 1988, Neurosurgery.

[49]  M. Ogawa,et al.  Complications and Management of Microwave Coagulation Therapy for Primary and Metastatic Liver Tumors , 1998, Surgery Today.

[50]  R. van Hillegersberg,et al.  Importance of eliminating portal flow to produce large intrahepatic lesions with interstitial laser coagulation , 1997, The British journal of surgery.

[51]  F A Jolesz,et al.  Focused US system for MR imaging-guided tumor ablation. , 1995, Radiology.

[52]  M H Seegenschmiedt,et al.  Interstitial Thermoradiotherapy: Review on Technical and Clinical Aspects , 1990, American journal of clinical oncology.

[53]  M. Niemz Laser-Tissue Interactions , 1996 .

[54]  R. Kane Ultrasound-Guided Hepatic Cryosurgery for Tumor Ablation , 1993 .

[55]  W Thurrell,et al.  Computed tomography-pathologic assessment of laser-induced necrosis in rat liver. , 1993, Investigative radiology.

[56]  G S Gazelle,et al.  Percutaneous radiofrequency tissue ablation: optimization of pulsed-radiofrequency technique to increase coagulation necrosis. , 1999, Journal of vascular and interventional radiology : JVIR.

[57]  J Hahl,et al.  Laser‐Induced hyperthermia in the treatment of liver tumors , 1990, Lasers in surgery and medicine.

[58]  K. Foster,et al.  Dielectric properties of tumor and normal tissues at radio through microwave frequencies. , 1981, The Journal of microwave power.

[59]  Evan B. Douple,et al.  Interstitial Hyperthermia: Physics, Biology and Clinical Aspects , 2023 .

[60]  What are the issues in the double reading of mammograms? , 1994, Radiology.

[61]  W R Lees,et al.  Local treatment of colorectal liver metastases: a comparison of interstitial laser photocoagulation (ILP) and percutaneous alcohol injection (PAI). , 1993, Clinical radiology.

[62]  L Solbiati,et al.  Saline-enhanced radio-frequency tissue ablation in the treatment of liver metastases. , 1997, Radiology.

[63]  M. Onji,et al.  Microwave coagulation therapy for hepatocellular carcinoma. , 1996, Gastroenterology.

[64]  K. Kopecky,et al.  Liver cancer ablation with extracorporeal high-intensity focused ultrasound. , 1993, European urology.

[65]  R Fiocca,et al.  Percutaneous US-guided radio-frequency tissue ablation of liver metastases: treatment and follow-up in 16 patients. , 1997, Radiology.

[66]  S. Rogers,et al.  Laparoscopic thermal ablation of hepatic neuroendocrine tumor metastases. , 1997, Surgery.

[67]  Patient selection and factors affecting results following resection for hepatic metastases from colorectal carcinoma. , 1991, International surgery.

[68]  R. Mcloughlin,et al.  CT of the liver after cryotherapy of hepatic metastases: imaging findings. , 1995, AJR. American journal of roentgenology.

[69]  W. Lees,et al.  Interstitial laser hyperthermia. , 1992, BMJ.

[70]  B. Cady,et al.  The role of surgical resection of liver metastases in colorectal carcinoma. , 1991, Seminars in oncology.

[71]  Thomas Kahn,et al.  Improved quantitative MR thermometry using a 1.5-T scanner to monitor cooled applicator systems during laser-induced interstitial thermotherapy (LITT) , 1999, Photonics West - Biomedical Optics.

[72]  T. Ryan,et al.  Comparison of six microwave antennas for hyperthermia treatment of cancer: sar results for single antennas and arrays. , 1991, International journal of radiation oncology, biology, physics.

[73]  F. Fry,et al.  High-intensity focused ultrasound in the treatment of experimental liver cancer. , 1991, Archives of surgery.

[74]  A. Cavallari,et al.  Percutaneous US-guided ablation of liver metastases. , 1997, Radiology.

[75]  I. Treilleux,et al.  Hepatic cryosurgery precision evaluation of ultrasonography, thermometry, and impedancemetry in a pig model , 1996, Journal of surgical oncology.

[76]  David G. Bostwick,et al.  Temperature-correlated histo pathologic changes following microwave thermoablation of obstructive tissue in patients with benign prostatic hyperplasia , 1996 .

[77]  M. Choti,et al.  Hepatic tumors treated by cryosurgery: normal CT appearance. , 1996, AJR. American journal of roentgenology.

[78]  R. Shapiro,et al.  Cryoablation of unresectable malignant liver tumors. , 1996, American journal of surgery.

[79]  T. Murakami,et al.  Percutaneous microwave hepatic tumor coagulation with segmental hepatic blood flow occlusion in seven patients. , 1999, AJR. American journal of roentgenology.

[80]  R Hamazoe,et al.  Intraoperative microwave tissue coagulation as treatment for patients with nonresectable hepatocellular carcinoma , 1995, Cancer.

[81]  W R Lees,et al.  Hepatic metastases: interstitial laser photocoagulation with real-time US monitoring and dynamic CT evaluation of treatment. , 1993, Radiology.

[82]  C. Diederich,et al.  Angular directivity of thermal coagulation using air-cooled direct-coupled interstitial ultrasound applicators. , 1999, Ultrasound in medicine & biology.

[83]  C R Hill,et al.  Review article: high intensity focused ultrasound--potential for cancer treatment. , 1995, The British journal of radiology.

[84]  William H. Nau,et al.  Ultrasound applicators with internal cooling for interstitial thermal therapy , 1999, Photonics West - Biomedical Optics.

[85]  T. Starzl,et al.  Experience in hepatic resection for metastatic colorectal cancer: analysis of clinical and pathologic risk factors. , 1994, Surgery.

[86]  T. Livraghi,et al.  Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. , 1995, Radiology.

[87]  Copper Is Cryogenic surgery: a new method of destruction or extirpation of benign or malignant tissues. , 1963 .

[88]  S. Torp-Pedersen,et al.  Interstitial hyperthermia of colorectal liver metastases with a US-guided Nd-YAG laser with a diffuser tip: a pilot clinical study. , 1993, Radiology.

[89]  F. Garbagnati,et al.  Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. , 1996, AJR. American journal of roentgenology.

[90]  L Solbiati,et al.  Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes. , 1997, Radiology.

[91]  H. Saitsu,et al.  [Microwave coagulo-necrotic therapy for hepatocellular carcinoma]. , 1993, Nihon rinsho. Japanese journal of clinical medicine.

[92]  D I Rosenthal,et al.  Radiofrequency tissue ablation: importance of local temperature along the electrode tip exposure in determining lesion shape and size. , 1996, Academic radiology.

[93]  B.S. Trembly,et al.  Theoretical and experimental analysis of air cooling for intracavitary microwave hyperthermia applicators , 1994, IEEE Transactions on Biomedical Engineering.

[94]  M. Sato,et al.  Laparoscopic microwave coagulo-necrotic therapy for hepatocellular carcinoma: a feasible study of an alternative option for poor-risk patients. , 1995, Journal of laparoendoscopic surgery.

[95]  A Paolicchi,et al.  Hepatocellular carcinoma treatment with percutaneous ethanol injection: evaluation with contrast-enhanced color Doppler US. , 1998, Radiology.

[96]  D. Morris,et al.  Hepatic cryotherapy: double-freeze cycles achieve greater hepatocellular injury in man. , 1995, Cryobiology.

[97]  N. Habib,et al.  Clinical short-term results of radiofrequency ablation in primary and secondary liver tumors. , 1999, American journal of surgery.

[98]  M Deimling,et al.  Malignant liver tumors treated with MR imaging-guided laser-induced thermotherapy: technique and prospective results. , 1995, Radiology.

[99]  M Takahashi,et al.  Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation. , 1995, AJR. American journal of roentgenology.

[100]  T. Ravikumar,et al.  A 5-year study of cryosurgery in the treatment of liver tumors. , 1991, Archives of surgery.

[101]  M. Reiser,et al.  The use of CT in monitoring cryosurgery. , 1983, European journal of radiology.

[102]  Y. Yamashita,et al.  CT appearance of hepatic tumors after microwave coagulation therapy. , 1998, AJR. American journal of roentgenology.

[103]  Thomas P. Ryan,et al.  Comparison of simulation and experimental results for rf thermal treatment devices with or without cooling , 1999, Photonics West - Biomedical Optics.

[104]  J S Lewin,et al.  A method for simultaneous RF ablation and MRI , 1998, Journal of magnetic resonance imaging : JMRI.

[105]  S. Nakamura,et al.  Results of extensive surgery for liver metastases in colorectal carcinoma , 1992, The British journal of surgery.

[106]  A. Dachman,et al.  US-guided percutaneous laser ablation of liver tissue in a chronic pig model. , 1990, Radiology.

[107]  A. Cuschieri,et al.  Ultrasonographic characterization of hepatic cryolesions. An ex vivo study. , 1995, Archives of surgery.

[108]  Toshihito Seki,et al.  Percutaneous microwave coagulation therapy for patients with small hepatocellular carcinoma , 1999, Cancer.

[109]  J. Lewin,et al.  MR monitoring of MR‐guided radiofrequency thermal ablation of normal liver in an animal model , 1998, Journal of magnetic resonance imaging : JMRI.

[110]  E F Halpern,et al.  Radio-frequency tissue ablation: effect of pharmacologic modulation of blood flow on coagulation diameter. , 1998, Radiology.