MRI-guided laser ablation of neuroendocrine tumor hepatic metastases

Abstract

BackgroundNeuroendocrine tumors (NET) represent a therapeutically challenging and heterogeneous group of malignancies occurring throughout the body, but mainly in the gastrointestinal system.PurposeTo describe magnetic resonance imaging (MRI)-guided laser ablation of NET liver metastases and assess its role within the current treatment options and methods.Material and MethodsTwo patients with NET tumor hepatic metastases were treated with MRI-guided interstitial laser ablation (LITT). Three tumors were treated. Clinical follow-up time was 10 years.ResultsBoth patients were successfully treated. There were no local recurrences at the ablation site during the follow-up. Both patients had survived at 10-year follow-up. One patient is disease-free.ConclusionMRI-guided laser ablation can be used to treat NET tumor liver metastases but combination therapy and a rigorous follow-up schedule are recommended.

Management of Gastrointestinal Neuroendocrine Tumors

“…Thermal ablation is widely achieved by radiofrequency ablation. Other energy sources such as laser 163 and cryoablation 164 have been reported to be used in the treatment of NET liver metastasis. The locally ablative techniques require laparoscopy or imaging guidance (US, CT or MRI, 163 PET/CT 165 ) of the needle/probe to the target lesion to deliver energy.…”

CT-guided percutaneous laser ablation of metastatic lung cancer: three cases report and literature review

“…Recently, PLA has been increasingly applied in the treatment of benign and malignant diseases in the liver and thyroid through the guidance of ultrasonography (US) as well as Magnetic Resonance Imaging (MRI) [ 24 - 28 ]. In particular, CT-guided PLA showed a safe, minimally invasive and promising therapy in some lesions such as adrenal metastases and osteoid osteomas [ 23 , 29 ].…”

Theoretical model for laser ablation outcome predictions in brain: calibration and validation on clinical MR thermometry images

“…While this work focuses on laser ablation in brain, there are diverse organs that receive laser ablation at various levels of clinical maturity, including breast (69), liver (70), pancreas, prostate (71), and spine (72, 73), sometimes with therapeutic enhancing agents, e.g., nanoparticles and dyes (74–76). At this time, it is not clear to the authors whether or not the proposed steady state model within a train-and-predict paradigm is widely applicable to other body sites.…”

“…Other sites may benefit if the assumptions of fast heating and prior treatment can be relaxed. E.g., laser ablation of liver can take >15 minutes (69). However, even if the model can be predictive in other body sites, the clinical context is crucially relevant.…”