Nonthermal Ablation of Liver Lesions

Gill, Gunvir; Bagherpour, Arya; Masood, Irfan

doi:10.1016/b978-0-323-61204-3.00099-3

Cited by 3 publications

(8 citation statements)

References 64 publications

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“… 119 When compared with RFA systems, PEI was able to achieve a complete ablation of lesions ≤3 cm with a lower rate of adverse events and comparable treatment outcomes. 119 Such direct comparison work has largely been abandoned and understudied, with widespread adoption of RFA and MWA for HCC. Other less common applications of PEI include ablating pancreatic tumors, 120 - 122 gastrointestinal stromal tumors, 123 and ablating the vascular supply to thyroid and parathyroid tumors.…”

Section: Ethanol Ablationmentioning

confidence: 94%

“… 118 Typically, administration of ethanol into a tumor is performed under US guidance for attempted real-time monitoring of dispersion of the injected solution. 119 Repositioning of the injection site is often needed to cover the entire lesion. This goal can be complicated by leakage of ethanol along fascial planes, low-interstitial-pressure conduits, or into hepatic veins and arteries, portal vein, or other nontarget, nontumor regions.…”

Section: Ethanol Ablationmentioning

confidence: 99%

“…This goal can be complicated by leakage of ethanol along fascial planes, low-interstitial-pressure conduits, or into hepatic veins and arteries, portal vein, or other nontarget, nontumor regions. 119 Ethanol ablation can effectively treat liver metastases up to 5 cm in diameter. 119 When compared with RFA systems, PEI was able to achieve a complete ablation of lesions ≤3 cm with a lower rate of adverse events and comparable treatment outcomes.…”

Section: Ethanol Ablationmentioning

confidence: 99%

“… 119 Ethanol ablation can effectively treat liver metastases up to 5 cm in diameter. 119 When compared with RFA systems, PEI was able to achieve a complete ablation of lesions ≤3 cm with a lower rate of adverse events and comparable treatment outcomes. 119 Such direct comparison work has largely been abandoned and understudied, with widespread adoption of RFA and MWA for HCC.…”

Section: Ethanol Ablationmentioning

confidence: 99%

“…PEI treatment has diminished efficacy for larger lesions and nonencapsulated tumors compared with RFA and MWA. 119 In nonencapsulated tumors, the ethanol often leaks outside of the injection site through retrograde backflow up the needle pathway or through crack formation in heterogeneous tissues leading to fluid extravasation to channels of low interstitial pressures, and accumulation in nearby structures. 126 Ethanol leakage and large injected volume risk damage to adjacent structures and other organs, which could lead to complications.…”

Section: Ethanol Ablationmentioning

confidence: 99%

See 4 more Smart Citations

Locoregional Thermal and Chemical Tumor Ablation: Review of Clinical Applications and Potential Opportunities for Use in Low- and Middle-Income Countries

Quang,

Yang,

Mikhail

et al. 2023

JCO Global Oncology

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Section: Ethanol Ablationmentioning

confidence: 94%

Section: Ethanol Ablationmentioning

confidence: 99%

Section: Ethanol Ablationmentioning

confidence: 99%

Section: Ethanol Ablationmentioning

confidence: 99%

Section: Ethanol Ablationmentioning

confidence: 99%

See 3 more Smart Citations

Locoregional Thermal and Chemical Tumor Ablation: Review of Clinical Applications and Potential Opportunities for Use in Low- and Middle-Income Countries

Quang,

Yang,

Mikhail

et al. 2023

JCO Global Oncology

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In Vivo Evaluation of Safety and Efficacy of Ethyl Cellulose-Ethanol Tissue Ablation in a Swine Cervix Model

Quang,

Yang,

Kaluzienski

et al. 2023

Bioengineering

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Current therapies for treating cervical dysplasia are often inaccessible in low and middle-income countries (LMICs), highlighting the need for novel low-cost therapies that can be delivered at the point of care. Ethanol ablation is a low-cost therapy designed to treat locoregional cancers, which we augmented into an ethyl cellulose (EC)-ethanol gel formulation to enhance its efficacy. Here, we evaluated whether EC-ethanol ablation is able to safely achieve an ablation zone comparable to thermocoagulation, a commonly used therapy for cervical dysplasia. The study was performed in 20 female Yorkshire pigs treated with either a single 500 µL injection of EC-ethanol into the 12 o’clock position of the cervix or a single application of thermocoagulation at 100 °C for 20 s. The average temperature, heart rate, respiratory rate, and blood oxygen remained within normal ranges throughout the EC-ethanol procedure and were similar to the thermocoagulation group. No major side effects were observed. The reproductive tracts were excised after 24 h to examine ablation zones. Comparable depths of necrosis were seen for EC-ethanol (18.6 ± 1.6 mm) and thermocoagulation (19.7 ± 4.1 mm). The volumes of necrosis induced by a single injection of EC-ethanol (626.2 ± 122.8 µL) were comparable to the necrotic volumes induced by thermocoagulation in the top half of the cervices (664.6 ± 168.5 µL). This suggests that two EC-ethanol injections could be performed (e.g., at the 12 and 6 o’clock positions) to achieve comparable total necrotic volumes to thermocoagulation and safely and effectively treat women with cervical dysplasia in LMICs. This is the first study to systematically evaluate EC-ethanol ablation in a large animal model and compare its safety and efficacy to thermocoagulation, a commonly used ablative therapy for cervical dysplasia.

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Locoregional Therapies for Hepatobiliary Tumors: Contemporary Strategies and Novel Applications

Jipa,

Makary

2024

Cancers

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A large majority of primary hepatobiliary tumors are hepatocellular carcinomas (HCC), with the remainer being cholangiocarcinoma. While surgical resection remains the gold standard treatment for hepatobiliary tumors, relatively few patients are operative candidates, and systemic treatments have limited effectiveness. Locoregional therapies offer significant promise in the management of HCC. Ablation and radioembolization may offer similar outcomes to surgery for early-stage hepatocellular carcinoma while radioembolization and chemoembolization are valuable in the management of advanced disease. There is significantly less evidence for the role of locoregional therapy in the treatment of cholangiocarcinoma, although it appears to be well tolerated.

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Nonthermal Ablation of Liver Lesions

Cited by 3 publications

References 64 publications

Locoregional Thermal and Chemical Tumor Ablation: Review of Clinical Applications and Potential Opportunities for Use in Low- and Middle-Income Countries

Locoregional Thermal and Chemical Tumor Ablation: Review of Clinical Applications and Potential Opportunities for Use in Low- and Middle-Income Countries

In Vivo Evaluation of Safety and Efficacy of Ethyl Cellulose-Ethanol Tissue Ablation in a Swine Cervix Model

Locoregional Therapies for Hepatobiliary Tumors: Contemporary Strategies and Novel Applications

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