Minimal invasive treatments for liver malignancies

Abstract

Minimal invasive therapies have proved useful in the management of primary and secondary hepatic malignancies. The most relevant aspects of all these therapies are their minimal toxicity profiles and highly effective tumor responses without affecting the normal hepatic parenchyma. These unique characteristics coupled with their minimally invasive nature provide an attractive therapeutic option for patients who previously may have had few alternatives. Combination of these therapies might extend indications to bring curative treatment to a wider selected population. The results of various ongoing combination trials of intraarterial therapies with targeted therapies are awaited to further improve survival in this patient group. This review focuses on the application of ablative and intra-arterial therapies in the management of hepatocellular carcinoma and hepatic colorectal metastasis.

Comparative Study of Pulsed Versus Continuous High‐Intensity Focused Ultrasound Ablation Using In Vitro and In Vivo Models

“…In recent years, the thermal effects of CHIFU have mainly provided a means to generate irreversible coagulation necrosis of target tissue . The results of this study suggest that PHIFU can generate liquefaction necrosis, indicating that the destruction of cells is primarily attributable to cavitation and thermal effects.…”

“…Its noninvasive, nonradiative, and conformal thermal ablation effects, which comply with the developing requirements for the noninvasive treatment of tumors, all contribute to the appeal of this technique . Currently, HIFU has been proven to be effective in the treatment of solid tumors of multiple organs or tissues, such as bone, liver, pancreas, breast, uterus, prostate, and soft tissue …”

“…At present, continuous high‐intensity focused ultrasound (CHIFU) is commonly used for thermal ablation of tumors in clinical practice. Continuous HIFU involves the output of a high dose of US energy as administered continuously over a short time in a single session and has been shown to effectively kill tumor cells . However, CHIFU is not without its liabilities, particularly when used for the ablation of large tumors or those located in deep regions of the body.…”

A case report of cryoablation and electrochemotherapy in kidney cancer

“…Percutaneous CA is a minimally invasive technique able to destroy targeted tissue through the application of extreme cold [6] . Rapid expansion of pressured argon gas within the cryoprobe leads to very low temperature (-40°C) of the tissue and the formation of an expanding iceball on the cryoprobe tip.…”

Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU): Overview of Emerging Applications (Part 2)

“…For the ablation of lesions in the liver dome, an iatrogenic intrapleural fluid infusion resulting in a pleural effusion could provide the necessary acoustic window [43]. While several studies using ultrasound-guided HIFU for the ablation of liver malignancies exist [44], only few case studies using MR-guided HIFU and demonstrating the feasibility of this approach have been published (▶ Fig. 4ae).…”