Thermal ablative therapy for malignant liver tumors: A critical appraisal

Ng, Kelvin K.; Lam, Chi‐Ming; Poon, Ronnie Tung‐Ping; Ai, Victor; Tso, WK; Fan, Sheung‐Tat

doi:10.1046/j.1440-1746.2003.02991.x

Cited by 60 publications

(44 citation statements)

References 140 publications

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“…4 More recently, RFA has been also successfully offered in patients eligible for liver resection or transplantation. 5,6 Few studies in literature evaluate the outcomes of percutaneous treatments in comparison with surgical treatment. [7][8][9] The aim of this study is to compare the prognosis of cirrhotic patients with HCC who were submitted to surgical resection or RFA.…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency Ablation Versus Surgical Resection for the Treatment of Hepatocellular Carcinoma in Cirrhosis

Guglielmi

Ruzzenente

Valdegamberi

et al. 2008

Journal of Gastrointestinal Surgery

142

107

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Section: Introductionmentioning

confidence: 99%

Radiofrequency Ablation Versus Surgical Resection for the Treatment of Hepatocellular Carcinoma in Cirrhosis

Guglielmi

Ruzzenente

Valdegamberi

et al. 2008

Journal of Gastrointestinal Surgery

142

107

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“…images, hepatic lesions with abnormal metabolic activity are sometimes overlooked [191]. Consequently, local recurrence after liver RFA as a result of these missed tumors remains one of the major factors in relapse [192], which is in the range of 3%-39% [193]. Thus, precise targeting of lesions remains a challenging task when guided solely by volumetric CT with or without contrast enhancement.…”

Section: Motivationmentioning

confidence: 99%

High-Performance 3D Image Processing Architectures for Image-Guided Interventions

Dandekar¹

2008

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Minimally invasive image-guided interventions (IGIs) are time and cost efficient, minimize unintended damage to healthy tissues, and lead to faster patient recovery. Advanced three-dimensional (3D) image processing is a critical need for navigation during IGIs. However, achieving on-demand performance, as required by IGIs, for these image processing operations using software-only implementations is challenging because of the sheer size of the 3D images, and memory and compute intensive nature of the operations. This dissertation, therefore, is geared toward developing high-performance 3D image processing architectures, which will enable improved intraprocedural visualization and navigation capabilities during IGIs.In this dissertation we present an architecture for real-time implementation of 3D filtering operations that are commonly employed for preprocessing of medical images. This architecture is approximately two orders of magnitude faster than corresponding software implementations and is capable of processing 3D medical images at their acquisition speeds. Report Documentation PageCombining complementary information through registration between pre-and intraprocedural images is a fundamental need in the IGI workflow. Intensity-based deformable registration, which is completely automatic and locally accurate, is a promising approach to achieve this alignment. These algorithms, however, are extremely compute intensive, which has prevented their clinical use. We present an FPGA-based architecture for accelerated implementation of intensity-based deformable image registration. This high-performance architecture achieves over an order of magnitude speedup when compared with a corresponding software implementation and reduces the execution time of deformable registration from hours to minutes while offering comparable image registration accuracy.Furthermore, we present a framework for multiobjective optimization of finite-precision implementations of signal processing algorithms that takes into account multiple conflicting objectives such as implementation accuracy and hardware resource consumption. The evaluation that we have performed in the context of FPGA-based image registration demonstrates that such an analysis can be used to enhance automated hardware design processes, and efficiently identify a system configuration that meets given design constraints. In addition, we also outline two novel clinical applications that can directly benefit from these developments and demonstrate the feasibility of our approach in the context of these applications. These advances will ultimately enable integration of 3D image processing into clinical workflow.

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“…A percutaneous approach is possible, but so far cryotherapy has mostly been used intraoperatively. Potential complications such as bleeding, crack formation, hepatic abscess, pleural effusion, thrombocytopenia, renal failure (generally attributed to myoglobinuria) and even death (due to "cryo-shock") must be considered [22]. Preliminary data with RFA and LITT suggest possible survival benefits and even complete remissions in individual cases.…”

Section: Thermoablative Techniquesmentioning

confidence: 99%

Primary hepatoma – guidelines for interdisciplinary treatment

Cerwenka

Bacher

2006

Eur Surg

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Zusammenfassung. Grundlagen: Die laufenden Entwicklungen bei den operativen und nicht-operativen Behandlungsmöglichkeiten haben das therapeutische Spektrum für primäre Lebermalignome beträchtlich erweitert, führen aber auch zur Notwendigkeit der exakten Auswertung ihrer Erfolge und der Erstellung von Richtlinien zu ihrer Anwendung.Methodik: Aktuelle Publikationen und die Ergebnisse der Konsensuskonferenzen werden zur Beurteilung der derzeitigen Therpiemöglichkeiten bei primären Lebermalignomen herangezogen.Ergebnisse: Entsprechend den Mailänder Kriterien sind nur wenige Patienten mit hepatozellulärem Karzinom für eine Lebertransplantation geeignet. Die Früherken-nung dieser Tumore durch Überwachung der Zirrhosepatienten ist entscheidend für den Erfolg des Transplantationskonzepts. Die Resektionsraten für das hepatozelluläre sowie für das intrahepatische und hiläre cholangiozelluläre Karzinom betragen etwa 10 bis 20 Prozent, wobei ein breiter Konsens darüber besteht, dass die R0-Resektion einen bedeutenden Prognosefaktor darstellt. Die Mehrheit der Patienten kann weder mit Transplantation noch mit Resektion behandelt werden. Für diese schwierige Patientengruppe wird eine Vielzahl von Therapiemöglichkei-ten angegeben, ihre Wirksamkeit ist aufgrund der Verfäl-schung der Ergebnisse durch die Patientenauswahl und bedingt durch die großen Unterschiede zwischen den einzelnen Patienten sowie zwischen den behandelnden Institutionen schwer vergleichbar. Besonders zu den Eingriffen mit bislang vielversprechenden Ergebnissen wie zum Beispiel zur Radiofrequenz-Ablation brauchen wir weitere Studien, um klinische Entscheidungen auf der Grundlage eines hohen Evidenzgrades zu ermöglichen.Schlussfolgerungen: Primäre Lebermalignome sollten in spezialisierten Zentren behandelt werden, von einem Team, das mit den speziellen Problemen dieser Patienten gut vertraut ist. Regelmäßige interdisziplinäre Konferenzen tragen entscheidend zur Optimierung des multimodalen Therapieansatzes bei. Richtlinien sind für das Therapiemanagement hilfreich, müssen jedoch individuell modifiziert und der spezifischen Situation jedes einzelnen Patienten angepasst werden.Summary. Background: Though recent developments in operative and non-operative therapy have added considerably to the therapeutic spectrum for primary hepatoma, there is a need for exact evaluation of their success and guidelines for their application.Methods: Current therapeutic options for primary hepatoma are rated on the basis of recent publications and results of consensus conferences.Results: According to the Milan criteria only a few patients with hepatocellular carcinoma are eligible for liver transplantation. Early detection of these tumours by surveillance of cirrhotic patients is essential for the success of the transplantation concept. Resection rates for hepatocellular and intrahepatic or hilar cholangiocellular carcinoma amount to about 10-20%; there is wide consensus that R0-resection is a crucial prognostic factor. For the majority of patients neither transplantation nor rese...

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Thermal ablative therapy for malignant liver tumors: A critical appraisal

Cited by 60 publications

References 140 publications

Radiofrequency Ablation Versus Surgical Resection for the Treatment of Hepatocellular Carcinoma in Cirrhosis

Radiofrequency Ablation Versus Surgical Resection for the Treatment of Hepatocellular Carcinoma in Cirrhosis

High-Performance 3D Image Processing Architectures for Image-Guided Interventions

Primary hepatoma – guidelines for interdisciplinary treatment

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