The use of implanted closed-tip catheters for the introduction of thermometry probes during local hyperthermia treatment series

Abstract

In the past two and a half years custom-made closed-tip catheters have been used to allow extensive temperature monitoring with multi-junction thermocouple probes during local hyperthermia. Data from animal experiments indicate that the use of thermometry probes within such a catheter provides reliable temperature measurements.In order to reduce stress to the patient the catheters were fixed so that they could stay in place during the total treatment series. The catheters, outer diameter 1' 22 mm, were introduced through hollow needles under sterile conditions before the first hyperthermia session, and fixed using Histo-acryl (tissue adhesive) and Tegaderm (transparent adhesive).Recently, the data concerning the first 180 catheters placed in 74 treatment areas were evaluated. In one patient, an abscess developed 10 days after removal of the (3) catheters, which required surgical intervention, but it was not clear whether these problems had developed as a result of catheter placement. There were no problems with 139 of the remaining 177 catheters (79 per cent) and in 50 treatment fields (68 per cent), respectively, for a duration of 9-55 (mean 23) days. Ten catheters (6 per cent) were lost during the treatment series after 1-22 (mean 10) days. With 28 catheters (16 per cent) infection was observed, 14-27 (mean 19) days after insertion, which necessitated catheter removal before the last treatment session in 11 cases (6 per cent). The complication rate decreased with increasing experience; from 29 per cent (25/85) in the early period to 14 per cent (13/92) in the later period.We conclude that the use of closed-tip catheters under proper control generally causes few, if any, problems. This results in the acquisition of a substantial amount of reliable temperature data at reproducible sites, and it is well tolerated by the patient. 337 Int J Hyperthermia Downloaded from informahealthcare.com by Queen's University on 01/05/15 For personal use only. Int J Hyperthermia Downloaded from informahealthcare.com by Queen's University on 01/05/15 For personal use only.

CT fluoroscopy-guided closed-tip catheter placement before regional hyperthermia treatment of soft tissue sarcomas: 5-Year experience in 35 consecutive patients

“…This is why for most STS after interdisciplinary discussion with the referring oncologists we decided to insert approximately two catheters (mean 1.7 ± 0.7, range 1-4) per treatment area, depending on the tumour size. This is in line with Feldmann et al [11] and van der Zee et al [12] who mainly placed one to three catheters in each treatment area. [11,12], which was comparable to our standard catheter length of 35 cm.…”

“…This is in line with Feldmann et al [11] and van der Zee et al [12] who mainly placed one to three catheters in each treatment area. [11,12], which was comparable to our standard catheter length of 35 cm. In former trials the time period for which the catheters stayed in place was significantly longer (mean 23 days, range 3-6 weeks) [11][12][13], while we usually removed the catheters after only two RHT sessions (4.1 ± 1.8 days, maximum of 10 days).…”

“…To our knowledge, there were only a few publications from more than 20 years ago that broached the subject of sequential CT-guided (not CT fluoroscopy-guided) catheter placement in patients designated for hyperthermia treatment [10][11][12][13]24]. In the following we compare technical parameters, placement techniques and complications.…”

“…There are different possibilities for guidance of the placement of closed-tip catheters within tumours for thermal mapping such as computed tomography (CT) or open surgical guidance [9]. All studies focusing on closed-tip catheter placement guided by CT used sequential CT-guidance [10][11][12][13]. In contrast to sequential CT-guidance, CT fluoroscopy-guided interventions can be performed faster, safer, and with a lower effective patient radiation dose [14][15][16].…”

Validation of MR thermometry: Method for temperature probe sensor registration accuracy in head and neck phantoms

“…This situation can arise for a variety of reasons, e.g. operator-dependent probe insertion variability, kinks near the catheter tip, catheter bore variability [34]. Ultimately, this circumstance will cause a temperature probe/MRT image localisation error, and therefore misregistration between probe and MRT data.…”