Laser-Induced Thermal Therapy for Tumor Ablation

Stafford, Jason; Fuentes, David; Elliott, Andrew M.; Weinberg, Jeffrey S.; Ahrar, Kamran

doi:10.1615/critrevbiomedeng.v38.i1.70

Cited by 208 publications

(156 citation statements)

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“…Energy is delivered with a thin needle (21G), through which a spherical area of necrosis is created. However, maximum diameter of coagulative necrosis is never bigger than 2 cm in diameter, so that multiple needles or multiple treatments are necessary to treat large nodules, thus increasing the risk of adverse effects (26). Mean volume reduction of both solid and cystic lesions is 44-73% (20).…”

Section: Discussionmentioning

confidence: 99%

Microwave ablation for thyroid nodules: a new string to the bow for percutaneous treatments?

Morelli¹,

Sacrini²,

Pompili³

et al. 2016

Gland Surg.

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Background: Thyroid nodules are a fairly common finding in general population and, even if most of them are benign, a treatment can be however necessary. In the last years, non surgical minimally invasive techniques have been developed to treat this pathology, starting from percutaneous ethanol injection (PEI), to laser ablation (LA), radiofrequency ablation (RFA) and, most recently, microwave ablation (MWA). Methods:We reviewed all medical literature searching in pubmed.gov the terms "microwave" & "thyroid".We found three original studies concerning MWA treatment, for a total of 263 patients (mean age 51.0 years; range, 15-80 years; male to female ratio 2.55) and 522 nodules.Results: A total of 522 nodules (338 solid, 22 cystic, 162 mixed) in 263 patients were treated. Studies have shown a mean reduction in volume of thyroid nodules ranging from 45.9% to 65%. No study reported a significant and definitive change in laboratory parameters, except for one case (Heck et al.). No studies have reported major complications after procedure.Conclusions: MWA is a new, promising technique among the minimally invasive treatments of thyroid nodules. Actually, the larger diameter of MW antenna seems to be the major limiting factor in the use of this technique. More studies are necessary to evaluate feasibility, safety and efficacy of the procedure.

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Section: Discussionmentioning

confidence: 99%

Microwave ablation for thyroid nodules: a new string to the bow for percutaneous treatments?

Morelli¹,

Sacrini²,

Pompili³

et al. 2016

Gland Surg.

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“…LA is based on the emission of photons by excited atoms within target tissue [56][57][58]. Tissue is destroyed by energy absorption.…”

Section: La Devices and Proceduresmentioning

confidence: 99%

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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Benign thyroid nodules are a common disease in the general population. Most often, they are completely asymptomatic and discovered occasionally during routine ultrasound examinations, and do not require any treatment. When thyroid nodules become symptomatic, surgical excision is still considered standard treatment. In the last few years, several experiences in the treatment of benign thyroid nodules through image-guided percutaneous thermal ablation have been reported with encouraging results, so that currently, these treatments are often proposed as first-choice options for patients with symptomatic benign thyroid nodules. In this paper, we discuss the present literature on the topic, focusing on different techniques available for image-guided percutaneous ablation, particularly radiofrequency (RFA), laser (LA), microwave (MWA), and high-intensity-focus ultrasound (HIFU). Little evidence about the efficacy of MWA and HIFU is now available. According to the literature, good results have been obtained with RFA and LA. Regarding RFA, volume reduction after ablative treatment has been found to range from 47 to 84 % at 3-6 months, and from 62 to 93 % at 1 year; LA also seems to be effective in achieving shrinkage of thyroid nodules, with volume reduction from 37 to 81 % at 3-6 months, and from 13 to 82 % at 1-year follow-up. Moreover, applications of advanced image-guidance modality, such as contrast-enhanced ultrasound and virtual navigation with fusion imaging, are discussed.Keywords Laser Á Radiofrequency Á Microwave Á Highintensity focused ultrasound Á Thyroid nodule SOMMARIO I noduli benigni della tiroide sono una evenienza comune nella popolazione generale. Più spesso vengono scoperti occasionalmente durante un esame ecografico fatto per altri motivi, sono asintomatici e non richiedono alcun trattamento. Qualora i noduli diventino sintomatici, l'escissione chirurgica è ancora considerato il trattamento standard. Tuttavia, negli ultimi anni, è cresciuta l'esperienza circa il trattamento di tali noduli tramite ablazione percutanea sotto guida ecografica tanto che, attualmente, questo viene spesso proposto come trattamento di scelta. Lo scopo del nostro lavoro è fare una revisione della letteratura riguardante l'argomento, con un particolare focus sulle differenti tecniche attualmente a disposizione, in particolare radiofrequenza (RFA), laser (LA), microonde (MWA) e high-intensity-focus ultrasound (HIFU). Al momento ci sono ancora poche evidenze sull'efficacia di MWA e HIFU. Secondo quanto riportato in letteratura, buoni risultati sono stati ottenuti con RFA e LA. Riguardo la radiofrequenza, la riduzione volumetrica dopo la procedura ablativa va da 47 a 84 % a 3-6 mesi e da 62 a 93 % a 1 anno; anche il laser sembra essere efficace nel causare la riduzione del nodulo, con percentuali che vanno da 37 a 81 % a 3-6-mesi a da 13 a 82 % a 1 anno di follow-up Abbiamo poi discusso brevemente le

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“…Temperature monitoring of live tissue is an important technique that provides feedback information needed for guidance of thermal therapies, such as laser interstitial thermotherapy, high-intensity focused ultrasound, radio frequency ablation, and cryoablation. [1][2][3] Temperature readings collected in real time around the treated areas help warranting safety and efficiency of the therapeutic procedure. 4 Noninvasive temperature monitoring is unanimously preferred among the clinicians, especially when there are crucial requirements to minimize collateral thermal damage to the adjacent normal tissues and zones of innervation.…”

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confidence: 99%

Red blood cell as a universal optoacoustic sensor for non-invasive temperature monitoring

Петрова

Oraevsky

Ermilov

2014

Applied Physics Letters

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Optoacoustic (photoacoustic) temperature imaging could provide improved spatial resolution and temperature sensitivity as compared to other techniques of non-invasive thermometry used during thermal therapies for safe and efficient treatment of lesions. However, accuracy of the reported optoacoustic methods is compromised by biological variability and heterogeneous composition of tissues. We report our findings on the universal character of the normalized temperature dependent optoacoustic response (ThOR) in blood, which is invariant with respect to hematocrit at the isosbestic point of hemoglobin. The phenomenon is caused by the unique homeostatic compartmentalization of blood hemoglobin exclusively inside erythrocytes. On the contrary, the normalized ThOR in aqueous solutions of hemoglobin showed linear variation with respect to its concentration and was identical to that of blood when extrapolated to the hemoglobin concentration inside erythrocytes. To substantiate the conclusions, we analyzed optoacoustic images acquired from the samples of whole and diluted blood as well as hemoglobin solutions during gradual cooling from þ37 to À15 C. Our experimental methodology allowed direct observation and accurate measurement of the temperature of zero optoacoustic response, manifested as the sample's image faded into background and then reappeared in the reversed (negative) contrast. These findings provide a framework necessary for accurate correlation of measured normalized optoacoustic image intensity and local temperature in vascularized tissues independent of tissue composition. Temperature monitoring of live tissue is an important technique that provides feedback information needed for guidance of thermal therapies, such as laser interstitial thermotherapy, high-intensity focused ultrasound, radio frequency ablation, and cryoablation. 1-3 Temperature readings collected in real time around the treated areas help warranting safety and efficiency of the therapeutic procedure. 4 Noninvasive temperature monitoring is unanimously preferred among the clinicians, especially when there are crucial requirements to minimize collateral thermal damage to the adjacent normal tissues and zones of innervation. Several imaging and sensing modalities have been proposed for noninvasive temperature monitoring during thermal therapies, including ultrasound imaging, magnetic resonance imaging, and optoacoustic (photoacoustic) imaging and sensing. [5][6][7] The potential advantages of optoacoustic temperature imaging techniques reside in enhanced spatial resolution, temperature sensitivity, and faster data acquisition. [8][9][10] During the past decade, optoacoustic imaging has attracted significant attention from researchers and clinicians due to its success in a variety of biomedical applications that involve high resolution deep tissue imaging of optical absorbers (blood, water, and near infrared contrast agents) unattainable with other modalities. [11][12][13] The premium quality of optoacoustic images, as compared to other imagin...

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Laser-Induced Thermal Therapy for Tumor Ablation

Cited by 208 publications

References 0 publications

Microwave ablation for thyroid nodules: a new string to the bow for percutaneous treatments?

Microwave ablation for thyroid nodules: a new string to the bow for percutaneous treatments?

Image-guided thermal ablation of benign thyroid nodules

Red blood cell as a universal optoacoustic sensor for non-invasive temperature monitoring

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