Lesion progression with time and the effect of vascular occlusion following radiofrequency ablation of the liver

Wiersinga, W. Joost; Jansen, Matthijs; Straatsburg, Irene H.; Davids, P. H. P.; Klaase, Joost M.; Gouma, Dirk J.; Gulik, Thomas M. Van

doi:10.1002/bjs.4040

Cited by 60 publications

(56 citation statements)

References 23 publications

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“…Several studies have demonstrated tumor necrosis following hyperthermia. 25,26 For example, Nikfarjam et al 26 reported cell death and vascular injury after laser-induced hyperthermia treatment to the liver and colorectal metastases.…”

Section: Discussionmentioning

confidence: 99%

Hyperthermia mediated by dextran-coated La0.7Sr0.3MnO3 nanoparticles: in vivo studies

Haghniaz

Umrani

Paknikar

2016

IJN

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Purpose The aim of this study was to evaluate radiofrequency-induced dextran-coated lanthanum strontium manganese oxide nanoparticles-mediated hyperthermia to be used for tumor regression in mice. Materials and methods Nanoparticles were injected intra-tumorally in melanoma-bearing C57BL/6J mice and were subjected to radiofrequency treatment. Results Hyperthermia treatment significantly inhibited tumor growth (~84%), increased survival (~50%), and reduced tumor proliferation in mice. Histopathological examination demonstrated immense cell death in treated tumors. DNA fragmentation, increased terminal deoxynucleotidyl transferase-dUTP nick end labeling signal, and elevated levels of caspase-3 and caspase-6 suggested apoptotic cell death. Enhanced catalase activity suggested reactive oxygen species-mediated cell death. Enhanced expression of heat shock proteins 70 and 90 in treated tumors suggested the possible development of “antitumor immunity”. Conclusion The dextran-coated lanthanum strontium manganese oxide-mediated hyperthermia can be used for the treatment of cancer.

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Section: Discussionmentioning

confidence: 99%

Hyperthermia mediated by dextran-coated La0.7Sr0.3MnO3 nanoparticles: in vivo studies

Haghniaz

Umrani

Paknikar

2016

IJN

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“…This is supported by Goldberg et al (23), who reported the role of the adjuvant effect of chemotherapy on RF ablation in a subcutaneous tumor model and noted that at least 48 hours were required before coagulation fully evolved. The development and evolution of thermally ablated tissue over time at hematoxylin-eosin staining has been explored by others (24,25). It is agreed that a clear appearance of cell damage in the ablated area does not manifest on hematoxylin-eosinstained images within 1 or 2 days after thermal ablation.…”

Section: Experimental Studies: Contrast-enhanced Us For Monitoring Anmentioning

confidence: 99%

Real-time Monitoring of Radiofrequency Ablation and Postablation Assessment: Accuracy of Contrast-enhanced US in Experimental Rat Liver Model

Wu¹,

Wilkins²,

Ziats³

et al. 2014

Radiology

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Purpose:To examine the accuracy of the unenhanced zone at contrast material-enhanced ultrasonography (US) in predicting coagulative necrosis during and 21 days after radiofrequency (RF) ablation by using radiologic-pathologic comparison. Materials and methods:Animal studies were approved by the Institutional Animal Care and Use Committee. The livers of 28 rats underwent US-guided RF ablation. In four animals, contrast-enhanced US was performed during ablation and 2 hours and 2, 7, 14, and 21 days after ablation. The unenhanced zone area on US images was measured. DiI-labeled microbubbles were administered during ablation at 2, 4, and 6 minutes or at 2 hours and 2, 7, 14, and 21 days after ablation in the remaining 24 animals (n = 3 at each time point). One minute later, the animal was euthanized, and the ablated liver was harvested. Tissue samples were imaged to quantify total fluorescence, and NADH staining was performed on the same slice. Hematoxylin-eosin staining was also performed. The findings on fluorescence images, NADH-stained images, and hematoxylin-eosin-stained images were compared. The areas of DiI bubble-negative zones, NADH-negative zones, and lightly NADH-staining zones were measured. Data were analyzed by using one-way analysis of variance. Results:The area of the unenhanced zone on contrast-enhanced US images increased during RF ablation and reached a maximum within 2 days after ablation. At histopathologic examination, a transition zone manifested adjacent to the coagulation zone until 2 days after ablation. The DiI-bubble negative zone on fluorescence images and the damaged zone (transition zone plus coagulation zone) on NADH-stained images increased rapidly within 2 hours after ablation, then slowly reached the maximum on day 2. The ratios of the mean areas of these two zones at hour 2 to those at day 2 were 94.6% and 95.6%, respectively. High uniformity between the damaged zone on NADH-stained images and the DiI bubble-negative zone on fluorescence images was noted at all time points. Conclusion:The temporary transition zone in NADH staining is partially damaged and should transition to nonviability 2 days after ablation. These results demonstrate that contrast-enhanced US can help delineate the maximum area of cell damage (to within 5% of the maximum) as early as 2 hours after ablation. Contrast-enhanced US may be a simple and accurate tool for monitoring the effects of RF ablation and quantifying the size of thermal damage after treatment.q RSNA, 2013

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“…Die größte Serie neuroendokriner Lebermetastasen wurde von Seifert et al [7] berichtet, der 13 Patienten mit 52 Leberherden therapierte. In dieser Serie konnte bei 5 von 7 symptomatischen Patienten eine Symptomfreiheit erreicht werden.…”

Section: Kryoablationunclassified

“…1 und 2). Ein wesentlicher Vorteil des offenen Zugangswegs ist die Möglichkeit, die Leberperfusion temporär mittels Pringle-Manöver zu unterbrechen; hierdurch wird die Größe der Ablationsnekrose erhöht und die Variabilität deutlich verringert [12,13]. In den oben genannten Übersichtsarbeiten wurden jeweils über 5000 publizierte Ablationen mit Angaben zum Follow-up für einen Zeitraum von mindestens 6 Monaten ausgewertet.…”

Section: Stippelunclassified

Neuroendokrine Tumoren: Lokal ablative Verfahren – RFA, LITT, Alkoholinjektion, Kryoablation

Stippel¹

2010

Viszeralmedizin

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Neuroendokrine Tumoren sind eine seltene, heterogene Tumorentität, bei der sich die Hälfte der Patienten mit Lebermetastasen präsentiert. Aufgrund des häufig dominanten Leberbefalls und des langsamen Wachstums kommen lokal ablative Verfahren in Betracht. Die Radiofrequenzablation und die laserinduzierte Thermotherapie haben die perkutane Ethanol-Injektion und die Kryoablation aufgrund von Daten bei anderen Tumorentitäten auch in dieser Indikation wegen der überlegenen Tumorkontrolle und Sicherheit weitgehend abgelöst. Die Datenlage zu Patienten mit neuroendokrinen Lebermetastasen ist jedoch auf einzelne Serien mit jeweils weniger als 63 Patienten beschränkt. Als Indikationen bestehen die Erweiterung der Indikation zur Resektion mit kurativem Ansatz durch Ablation kleiner nichtresektabler Metastasen, die Zytoreduktion mit dem Debulking von >90% der Tumormasse und die palliative Indikation bei Patienten mit Symptomen durch eine endokrine Sekretion der Lebermetastasen. In 95% gelingt die lokale Tumorkontrolle bei Anwendung von State-of-the-art-Ablations systemen bei Metastasen bis 3 cm Durchmesser. Die Prognose bezüglich eines intra- und extrahepatischen Rezidivs korreliert wesentlich mit biologischen Faktoren des neuroendokrinen Tumors (Ki67, Serum-Chromogranin A).

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Lesion progression with time and the effect of vascular occlusion following radiofrequency ablation of the liver

Abstract: The efficacy of RFA in liver increases with occlusion of the portal vein or hepatic artery. The extent of secondary heat-induced necrosis in liver parenchyma should be considered for determination of the final size of the ablated area.

Cited by 60 publications

References 23 publications

Hyperthermia mediated by dextran-coated La0.7Sr0.3MnO3 nanoparticles: in vivo studies

Hyperthermia mediated by dextran-coated La0.7Sr0.3MnO3 nanoparticles: in vivo studies

Real-time Monitoring of Radiofrequency Ablation and Postablation Assessment: Accuracy of Contrast-enhanced US in Experimental Rat Liver Model

Neuroendokrine Tumoren: Lokal ablative Verfahren – RFA, LITT, Alkoholinjektion, Kryoablation

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