Optimal Strategies for Combining Transcatheter Arterial Chemoembolization and Radiofrequency Ablation in Rabbit VX2 Hepatic Tumors

Mostafa, Elian M.; Ganguli, Suvranu; Faintuch, Salomão; Mertyna, Paweł; Goldberg, S. Nahum

doi:10.1016/j.jvir.2008.08.028

Cited by 46 publications

(33 citation statements)

References 40 publications

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“…It is known that embolization before RFA can increase efficacy of treatment. 10 By decreasing tumor blood flow and reducing the heat sink effect, embolization prior to RFA can increase tumor heating and coagulation, 49,]50 resulting in a larger zone of ablation. 10 Additionally, the tissues at the periphery of the tumor subjected to sublethal hypothermic temperatures experience an increase in blood flow 50,51 and this hyperemia is thought to further increase drug deposition 52 and potentially enhance the maximal coagulation diameter following RFA.…”

Section: Discussionmentioning

confidence: 99%

“…10 By decreasing tumor blood flow and reducing the heat sink effect, embolization prior to RFA can increase tumor heating and coagulation, 49,]50 resulting in a larger zone of ablation. 10 Additionally, the tissues at the periphery of the tumor subjected to sublethal hypothermic temperatures experience an increase in blood flow 50,51 and this hyperemia is thought to further increase drug deposition 52 and potentially enhance the maximal coagulation diameter following RFA. 53 We hypothesize that the mechanical effects of tissue destruction following RFA served to trap the nanoparticles already in the tumor and that the hyperemia induced in the tumor periphery allowed for additional nanoparticle to flow in and be deposited into the tumor, thus resulting in the increased uptake seen on PET/CT.…”

Section: Discussionmentioning

confidence: 99%

“…To improve local control rates, multimodality (TACE and RFA) treatment strategies, capitalizing on synergistic effects, have been proposed. 10–13 Recent studies have demonstrated the efficacy of combined RFA and TACE with 5-year survival rates of 41% for lesions greater than 5 cm and 75% for lesions less than 5 cm 11,14 as compared to a 38% 5-year survival rate for lesions smaller than 5 cm treated with RFA alone. 15 There is clearly an emerging role for the multimodality treatment of liver tumors and studies are needed to establish the most effective strategies.…”

Section: Introductionmentioning

confidence: 99%

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Imaging Intratumoral Nanoparticle Uptake After Combining Nanoembolization with Various Ablative Therapies in Hepatic VX2 Rabbit Tumors

Tam¹,

Melancon²,

Abdelsalam³

et al. 2016

j biomed nanotechnol

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Combining image-guided therapy techniques for the treatment of liver cancers is a strategy that is being used to improve local tumor control rates. Here, we evaluate the intratumoral uptake of nanoparticles used in combination with radiofrequency ablation (RFA), irreversible electroporation (IRE), or laser induced thermal therapy (LITT). Eight rabbits with VX2 tumor in the liver underwent one of four treatments: (i) nanoembolization (NE) with radiolabeled, hollow gold nanoparticles loaded with doxorubicin (64Cu-PEG-HAuNS-DOX); (ii) NE+RFA; (iii) NE+IRE; (iv) NE+LITT. Positron emission tomography/computed tomography (PET/CT) imaging was obtained 1-hr or 18-hrs after intervention. Tissue samples were collected for autoradiography and transmission electron microscopy (TEM) analysis. PET/CT imaging at 1-hr showed focal deposition of oil and nanoparticles in the tumor only after NE+RFA but at 18-hrs, all animals had focal accumulation of oil and nanoparticles in the tumor region. Autoradiograph analysis demonstrated nanoparticle deposition in the tumor and in the ablated tissues adjacent to the tumor when NE was combined with ablation. TEM results showed the intracellular uptake of nanoparticles in tumor only after NE+IRE. Nanoparticles demonstrated a structural change, suggesting direct interaction, potentially leading to drug release, only after NE+LITT. The findings demonstrate that a combined NE and ablation treatment technique for liver tumors is feasible, resulting in deposition of nanoparticles in and around the tumor. Depending on the ablative energy applied, different effects are seen on nanoparticle localization and structure. These effects should be considered when designing nanoparticles for use in combination with ablation technologies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Imaging Intratumoral Nanoparticle Uptake After Combining Nanoembolization with Various Ablative Therapies in Hepatic VX2 Rabbit Tumors

Tam¹,

Melancon²,

Abdelsalam³

et al. 2016

j biomed nanotechnol

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“…In the case of RF ablation, these treatments include, in addition to liposome-encapsulated doxorubicin therapy, treatments with intravenous liposomal cisplatin ( 18 ), liposomal 5-fl uorouracil ( 18 ), arsenic trioxide ( 20 ), and hydralazine ( 24 ); intravenous and intratumoral Pluronic block copolymers ( 28 ); intratumoral ethanol ( 11,39 ) and unencapsulated doxorubicin ( 12 ); intraperitoneal arsenic trioxide ( 20 ); interstitially implanted 5-fl uorouracil-laden polymer rods ( 27 ); oral sorafenib ( 21 ); and transarterial chemoembolization ( 19,23 ). In human trials, the benefi ts of combined RF ablation-intratumoral ethanol therapy ( 30,40,41 ) and combined RF ablation-transarterial chemoembolization ( 15,22,25,29,31,42 ) have been shown.…”

Section: Discussionmentioning

confidence: 99%

Combination Radiofrequency Ablation and Intravenous Radiolabeled Liposomal Doxorubicin: Imaging and Quantification of Increased Drug Delivery to Tumors

Head¹,

Dodd²,

Bao³

et al. 2010

Radiology

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Purpose:To identify, with noninvasive imaging, the zone of radiopharmaceutical uptake after combination therapy with radiofrequency (RF) ablation and intravenous administration of technetium 99m ( 99m Tc) liposomal doxorubicin in a small-animal tumor model, and to quantify and correlate the uptake by using imaging and tissue counting of intratumoral doxorubicin accumulation. Materials and Methods:This study was approved by the animal care committee. Two phases of animal experiments were performed. In the fi rst experiment, a single human head-and-neck squamous cell carcinoma tumor was grown in each of 10 male nude rats. Seven of these animals were treated with intravenous 99m Tc-liposomal doxorubicin followed by RF tumor ablation at a mean temperature of 70°C 6 2 for 5 minutes, and three were treated with intravenous 99m Tc-liposomal doxorubicin only. Combination single photon emission computed tomography-computed tomography (SPECT/CT) was performed at 15 minutes, 4 hours, and 20 hours after therapy. In the second experiment, two tumors each were grown in 11 rats, but only one of the tumors was ablated after intravenous administration of 99m Tc-liposomal doxorubicin. SPECT/CT and planar scintigraphy were performed at the same posttreatment intervals applied in the fi rst experiment, with additional planar imaging performed at 44 hours. After imaging, tissue counting in the excised tumors was performed. Radiotracer uptake, as determined with imaging and tissue counting, was quantifi ed and compared. In a subset of three animals, intratumoral doxorubicin accumulation was determined with fl uorimetry and correlated with the imaging and tissue-counting data. Results:At both SPECT/CT and planar scintigraphy, increased uptake of Conclusion:Study results show that increased delivery of intravenous liposomal doxorubicin to tumors combined with RF ablation can be depicted and quantifi ed with noninvasive imaging.

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“…The British Journal of Radiology, November 2012 e989 perpendicular to the line of the RFA electrode tract [19]. The ablation zones were lesions that were tan to charcoal grey in color ( Figure 3b) [7].…”

Section: Analysis Of the Ablation Zone On Ct Images And Pathological mentioning

confidence: 99%

Radiofrequency ablation combined with transcatheter arterial embolisation in rabbit liver: investigation of the ablation zone according to the time interval between the two therapies

Lee

Kim

et al. 2012

The British Journal of Radiology

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Objectives: This study was designed to evaluate the extent of the radiofrequency ablation zone in relation to the time interval between transcatheter arterial embolisation (TAE) and radiofrequency ablation (RFA) and, ultimately, to determine the optimal strategy of combining these two therapies for hepatocellular carcinoma. Methods: 15 rabbits were evenly divided into three groups: Group A was treated with RFA alone; Group B was treated with TAE immediately followed by RFA; and Group C was treated with TAE followed by RFA 5 days later. All animals underwent perfusion CT (PCT) scans immediately after RFA. Serum liver transaminases were measured to evaluate acute liver damage. Animals were euthanised for pathological analysis of ablated tissues 10 days after RFA. Non-parametric analyses were conducted to compare PCT indices, the RFA zone and liver transaminase levels among the three experimental groups. Results: Group B showed a significantly larger ablation zone than the other two groups. Arterial liver perfusion and hepatic perfusion index represented well the perfusion decrease after TAE on PCT. Although Group B showed the most elevated liver transaminase levels at 1 day post RFA, the enzymes decreased to levels that were not different from the other groups at 10 days post-RFA. Conclusions: When combined TAE and RFA therapy is considered, TAE should be followed by RFA as quickly as possible, as it can be performed safely without serious hepatic deterioration, despite the short interval between the two procedures.

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Optimal Strategies for Combining Transcatheter Arterial Chemoembolization and Radiofrequency Ablation in Rabbit VX2 Hepatic Tumors

Cited by 46 publications

References 40 publications

Imaging Intratumoral Nanoparticle Uptake After Combining Nanoembolization with Various Ablative Therapies in Hepatic VX2 Rabbit Tumors

Imaging Intratumoral Nanoparticle Uptake After Combining Nanoembolization with Various Ablative Therapies in Hepatic VX2 Rabbit Tumors

Combination Radiofrequency Ablation and Intravenous Radiolabeled Liposomal Doxorubicin: Imaging and Quantification of Increased Drug Delivery to Tumors

Radiofrequency ablation combined with transcatheter arterial embolisation in rabbit liver: investigation of the ablation zone according to the time interval between the two therapies

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