Journal articles: 'Cancer ablation'

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Sweeney, Jennifer, Nainesh Parikh, Ghassan El-Haddad, and Bela Kis. "Ablation of Intrahepatic Cholangiocarcinoma." Seminars in Interventional Radiology 36, no. 04 (October 2019): 298–302. http://dx.doi.org/10.1055/s-0039-1696649.

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AbstractIntrahepatic cholangiocarcinoma is the second most common primary liver cancer but represents only a small portion of all primary liver cancers. At the time of diagnosis, patients are often not surgical candidates due to tumor burden of other comorbidities. In addition, there is a very high rate of tumor recurrence after resection. Local regional therapies, specifically ablative therapies of radiofrequency ablation, microwave ablation, cryoablation, and irreversible electroporation, have proven to be beneficial with other hepatic tumors. The purpose of this review is to provide an overview and update of the medical literature demonstrating ablative therapy as a treatment option for intrahepatic cholangiocarcinoma.

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Liang, Allison, Sean Munier, and Shabbar Danish. "NIMG-68. MATHEMATICAL MODELING OF THERMAL DAMAGE ESTIMATE VOLUMES IN MAGNETIC RESONANCE-GUIDED LASER INTERSTITIAL THERMAL THERAPY." Neuro-Oncology 22, Supplement_2 (November 2020): ii163. http://dx.doi.org/10.1093/neuonc/noaa215.681.

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Abstract BACKGROUND Magnetic resonance-guided laser interstitial thermal therapy is a minimally invasive procedure that produces real-time thermal damage estimates of ablation (TDE). Orthogonal TDE-MRI slices provides an opportunity to mathematically estimate ablation volume. OBJECTIVE To mathematically model TDE volumes and validate with post-24 hours MRI ablation volumes. METHODS Ablations were performed with the Visualase Laser Ablation System (Medtronic). Using ellipsoidal parameters determined for dual-TDEs from orthogonal MRI planes, TDE volumes were calculated by two definite integral methods (A and B) implemented in Matlab (MathWorks). Post 24-hours MRI ablative volumes were measured in OsiriX (Pixmeo) by two-blinded raters and compared to TDE volumes via paired t-tests and Pearson’s correlations. RESULTS Twenty-two ablations for 20 patients with various intracranial pathologies were included. Average TDE volumes calculated with Method A was 3.44 ± 1.96 cm3 and with Method B was 4.83 ± 1.53 cm3. Method A TDE volumes were significantly different than post-24 hours volumes (P < 0.001). Method B TDE volumes were not significantly different than post-24 hours volumes (P = 0.39) and strongly correlated with each other (r = 0.85, R2 = 0.72, P < 0.0001). A total of 8/22 (36%) method A versus 17/22 (77%) method B TDE volumes were within 25% of the post 24-hours ablative volume. CONCLUSION We present the first iteration of a viable mathematical method that integrates dual-plane TDEs to calculate volumes resembling 24 hours post-operative volumes. Future iterations of our algorithm will need to determine additional calculated variables that improve the performance of volumetric calculations.

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Kim, Sang Hyun, Jae Min Lee, Kang Won Lee, Sang Hoon Kim, Se Hyun Jang, Han Jo Jeon, Seong Ji Choi, et al. "Irreversible electroporation of the bile duct in swine: A pilot study." Journal of Clinical Oncology 38, no. 4_suppl (February 1, 2020): 541. http://dx.doi.org/10.1200/jco.2020.38.4_suppl.541.

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541 Background: Irreversible electroporation (IRE) is a relatively new ablative method. However, the application of IRE ablation has not been attempted for the treatment of biliary disease. Minimally invasive approach using endoscopic retrograde cholangio-pancreatography (ERCP) can be a novel therapeutic modality for IRE ablation. In this study, we investigated the feasibility and effect of endoscopic IRE for biliary tract in animal model. Methods: A new catheter electrode was developed for endoscopic IRE ablation of biliary tract. The electrode for IRE ablation has two band-shaped electrodes on catheter tip. We performed ERCP and endoscopic IRE ablations on normal common bile duct in 6 Yorkshire pigs. Experimental parameters of IRE were 500V/cm, 1000V/cm and 2000V/cm (under 50 pulses, 100 µs length). Animals were sacrificed after 24 hours and ablated bile duct were collected. H & E stain, immunohistochemistry and western blot were performed. Results: Well-demarcated focal color changes were observed on the mucosa of the common bile duct under all experimental parameters. After IRE ablation, bile duct epithelium was disappeared around ablated area and it showed fibrotic change in H&E stain. Depth of change after IRE was different between each experimental parameters. Apoptotic change of bile duct was localized around mucosa in 500V. Diffuse transmural fibrosis of bile duct was shown after IRE ablation with 2000V. TUNEL immunohistochemistry showed the cell death of bile duct mucosa and submucosa along the electrode. Within 24 hours, no complication was observed in pigs after endoscopic IRE ablation. Conclusions: Endoscopic IRE ablation using ERCP was successfully performed on common bile duct by using catheter-shaped electrode. It can be a potential therapeutic option as minimally invasive ablation for treatment of biliary tumors.

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Wimmer, Thomas, Govindarajan Srimathveeravalli, Mikhail Silk, Sebastien Monette, Narendra Gutta, Majid Maybody, Joseph P. Erinjery, Jonathan A. Coleman, Stephen B. Solomon, and Constantinos T. Sofocleous. "Feasibility of a Modified Biopsy Needle for Irreversible Electroporation Ablation and Periprocedural Tissue Sampling." Technology in Cancer Research & Treatment 15, no. 6 (July 9, 2016): 749–58. http://dx.doi.org/10.1177/1533034615608739.

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Objectives: To test the feasibility of modified biopsy needles as probes for irreversible electroporation ablation and periprocedural biopsy. Methods: Core biopsy needles of 16-G/9-cm were customized to serve as experimental ablation probes. Computed tomography-guided percutaneous irreversible electroporation was performed in in vivo porcine kidneys with pairs of experimental (n = 10) or standard probes (n = 10) using a single parameter set (1667 V/cm, ninety 100 µs pulses). Two biopsy samples were taken immediately following ablation using the experimental probes (n = 20). Ablation outcomes were compared using computed tomography, simulation, and histology. Biopsy and necropsy histology were compared. Results: Simulation-suggested ablations with experimental probes were smaller than that with standard electrodes (455.23 vs 543.16 mm2), although both exhibited similar shape. Computed tomography (standard: 556 ± 61 mm2, experimental: 515 ± 67 mm2; P = .25) and histology (standard: 313 ± 77 mm2, experimental: 275 ± 75 mm2; P = .29) indicated ablations with experimental probes were not significantly different from the standard. Histopathology indicated similar morphological changes in both groups. Biopsies from the ablation zone yielded at least 1 core with sufficient tissue for analysis (11 of the 20). Conclusions: A combined probe for irreversible electroporation ablation and periprocedural tissue sampling from the ablation zone is feasible. Ablation outcomes are comparable to those of standard electrodes.

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Steinfort, Daniel P., Michael Christie, Phillip Antippa, Kanishka Rangamuwa, Robert Padera, Michael Rolf Müller, Louis B. Irving, and Arschang Valipour. "Bronchoscopic Thermal Vapour Ablation for Localized Cancer Lesions of the Lung: A Clinical Feasibility Treat-and-Resect Study." Respiration 100, no. 5 (2021): 432–42. http://dx.doi.org/10.1159/000514109.

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Background: Bronchoscopic thermal vapour ablation (BTVA) is an established and approved modality for minimally invasive lung volume reduction in severe emphysema. Preclinical data suggest potential for BTVA in minimally invasive ablation of lung cancer lesions. Objectives: The objective of this study is to establish the safety, feasibility, and ablative efficacy of BTVA for minimally invasive ablation of lung cancers. Methods: Single arm treat-and-resect clinical feasibility study of patients with biopsy-confirmed lung cancer. A novel BTVA for lung cancer (BTVA-C) system for minimally invasive treatment of peripheral pulmonary tumours was used to deliver 330 Cal thermal vapour energy via bronchoscopy to target lesion. Patients underwent planned lobectomy to complete oncologic care. Pre-surgical CT chest and post-resection histologic analysis were performed to evaluate ablative efficacy. Results: Six patients underwent BTVA-C, and 5 progressed to planned lobectomy. Median procedure duration was 12 min. No major procedure-related complications occurred. All 5 resected lesions were part-solid lung adenocarcinomas with median solid component size 1.32±0.36 cm. Large uniform ablation zones were seen in 4 patients where thermal dose exceeded 3 Cal/mL, with complete/near-complete necrosis of target lesions seen in 2 patients. Tumour positioned within ablation zones demonstrated necrosis in >99% of cross-sectional area examined. Conclusion: BTVA of lung tumours is feasible and well tolerated, with preliminary evidence suggesting high potential for effective ablation of tumours. Thermal injury is well demarcated, and uniform tissue necrosis is observed within ablation zones receiving sufficient thermal dose per volume of lung. Treatment of smaller volumes and ensuring adequate thermal dose may be important for ablative efficacy.

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Hagmeyer, Lars. "Bronchoskopische Thermoablation beim Lungenkarzinom: Ermutigende Daten eines experimentellen Verfahrens." Kompass Pneumologie 9, no. 4 (2021): 189–91. http://dx.doi.org/10.1159/000517810.

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Background: Bronchoscopic thermal vapour ablation (BTVA) is an established and approved modality for minimally invasive lung volume reduction in severe emphysema. Preclinical data suggest potential for BTVA in minimally invasive ablation of lung cancer lesions. Objectives: The objective of this study is to establish the safety, feasibility, and ablative efficacy of BTVA for minimally invasive ablation of lung cancers. Methods: Single arm treat-and-resect clinical feasibility study of patients with biopsy-confirmed lung cancer. A novel BTVA for lung cancer (BTVA-C) system for minimally invasive treatment of peripheral pulmonary tumours was used to deliver 330 Cal thermal vapour energy via bronchoscopy to target lesion. Patients underwent planned lobectomy to complete oncologic care. Pre-surgical CT chest and post-resection histologic analysis were performed to evaluate ablative efficacy. Results: Six patients underwent BTVA-C, and 5 progressed to planned lobectomy. Median procedure duration was 12 min. No major procedure-related complications occurred. All 5 resected lesions were part-solid lung adenocarcinomas with median solid component size 1.32 ± 0.36 cm. Large uniform ablation zones were seen in 4 patients where thermal dose exceeded 3 Cal/mL, with complete/near-complete necrosis of target lesions seen in 2 patients. Tumour positioned within ablation zones demonstrated necrosis in >99% of cross-sectional area examined. Conclusion: BTVA of lung tumours is feasible and well tolerated, with preliminary evidence suggesting high potential for effective ablation of tumours. Thermal injury is well demarcated, and uniform tissue necrosis is observed within ablation zones receiving sufficient thermal dose per volume of lung. Treatment of smaller volumes and ensuring adequate thermal dose may be important for ablative efficacy.

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Ito, Toshikazu, Shoji Oura, Naohito Yamamoto, Shinji Nagamine, Masato Takahashi, Hirokazu Tanino, Noboru Yamamichi, et al. "Radiofrequency ablation (RFA) of breast cancer: A multicenter retrospective analysis." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 1119. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.1119.

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1119 Background: Local ablative therapy of breast cancer represents the next frontier in the minimally invasive breast-conservation treatment. We performed a retrospective study of ultrasound-guided percutaneous radiofrequency ablation (RFA) of breast cancers to determine safety and complication related to this treatment. Methods: Four hundred and ninety-seven patients with core biopsy proven breast carcinoma in 10 institutions of non-surgical ablaton study group underwent RFA without surgical excision were enrolled in this study. Results: Mean patient age was 54 years (range 22 - 92 years). Mean tumor size was 1.6 cm. Four hundred and twenty-five tumors ( 86 %) were ≤ 2 cm. The median follow-up period was 50 months (range 3 – 92 months). The mean required for ablation was 19 minutes (range, 4- 72 minutes), and the average temperature of the tumor after ablation was 91 degrees Celsius. The local recurrence rate after RFA was higher in tumors of negative estrogen receptor (8 of 78, 10%) than in tumors of positive estrogen receptor (17 of 437, 4%; p<0.05), and was higher in tumors of positive HER2/neu than in tumors of negative HER2/neu (14.9% vs. 3.2%; p<0.01). The local recurrence rate after RFA was higher in tumors of positive node than in tumors of negative node (9.8% vs. 3.6%), and was higher in tumors without irradiation than in tumors with irradiation (18.2% vs. 3.2%; p<0.001). The local recurrence rate after RFA was higher in tumors of > 2 cm (13 of 72, 18%) than in tumors of ≤ 2 cm (11 of 425, 3%; p<0.001). RFA-relating adverse events were observed in 17 patients of local pain, 14 patients of skin burn and 4 patients of retraction of nipple. Conclusions: RFA is considered to be a safe and promising minimally invasive treatment of small breast cancer ≤ 2 cm in diameter. Further studies are necessary to optimize the technique and evaluate its future role as local therapy for breast cancer.

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Patel, Vipulkumar, Charles A. Ritchie, Carlos Padula, and J. Mark McKinney. "Radiofrequency Ablation, Where It Stands in Interventional Radiology Today." Seminars in Interventional Radiology 36, no. 05 (December 2019): 398–404. http://dx.doi.org/10.1055/s-0039-1697945.

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AbstractRadiofrequency ablation (RFA) is one of the first developed minimally invasive definitive cancer therapies. The safety and efficacy of RFA is well documented and has led to its incorporation into multiple international societal guidelines. By expanding on the body of knowledge acquired during the clinical use of RFA, alternative ablative technologies have emerged and are successfully competing for locoregional therapy market share. The adaption of newer ablative technologies is leading to a rapid decline in the utilization of RFA by interventional radiologists despite the lack of proven superiority. In their 2010 article, Hong and Georgiades stated “… RFA is likely to remain the mainstay of ablations for small tumors until sufficient experience emerges for the widespread acceptance for alternative ablative modalities.” Within a decade of this publication, has this time arrived?

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Tsai, Tsung-Han, Chao Zhou, Hsiang-Chieh Lee, Yuankai K. Tao, Osman O. Ahsen, Marisa Figueiredo, Desmond C. Adler, et al. "Comparison of Tissue Architectural Changes between Radiofrequency Ablation and Cryospray Ablation in Barrett’s Esophagus Using Endoscopic Three-Dimensional Optical Coherence Tomography." Gastroenterology Research and Practice 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/684832.

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Two main nonsurgical endoscopic approaches for ablating dysplastic and early cancer lesions in the esophagus have gained popularity, namely, radiofrequency ablation (RFA) and cryospray ablation (CSA). We report a uniquely suited endoscopic and near-microscopic imaging modality, three-dimensional (3D) optical coherence tomography (OCT), to assess and compare the esophagus immediately after RFA and CSA. The maximum depths of architectural changes were measured and compared between the two treatment groups. RFA was observed to induce 230~260 μm depth of architectural changes after each set of ablations over a particular region, while CSA was observed to induce edema-like spongiform changes to ~640 μm depth within the ablated field. The ability to obtain micron-scale depth-resolved images of tissue structural changes following different ablation therapies makes 3D-OCT an ideal tool to assess treatment efficacy. Such information could be potentially used to provide real-time feedback for treatment dosing and to identify regions that need further retreatment.

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Camacho, Juan C., Elena N. Petre, and Constantinos T. Sofocleous. "Thermal Ablation of Metastatic Colon Cancer to the Liver." Seminars in Interventional Radiology 36, no. 04 (October 2019): 310–18. http://dx.doi.org/10.1055/s-0039-1698754.

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AbstractColorectal cancer (CRC) is responsible for approximately 10% of cancer-related deaths in the Western world. Liver metastases are frequently seen at the time of diagnosis and throughout the course of the disease. Surgical resection is often considered as it provides long-term survival; however, few patients are candidates for resection. Percutaneous ablative therapies are also used in the management of this patient population. Different thermal ablation (TA) technologies are available including radiofrequency ablation, microwave ablation (MWA), laser, and cryoablation. There is growing evidence about the role of interventional oncology and image-guided percutaneous ablation in the management of metastatic colorectal liver disease. This article aims to outline the technical considerations, outcomes, and rational of TA in the management of patients with CRC liver metastases, focusing on the emerging role of MWA.

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Vetshev, P. S., A. V. Chzhao, D. A. Ionkin, Yu A. Stepanova, O. I. Zhavoronkova, Yu V. Kulezneva, O. V. Melekhina, et al. "Minimally invasive technologies for ablation of pancreatic malignancies." Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery 24, no. 3 (September 22, 2019): 87–98. http://dx.doi.org/10.16931/1995-5464.2019387-98.

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Minimally invasive ablative technologies is a promising direction in the treatment of some cancer patients including pancreatic cancer. Cryodestruction, radiofrequency ablation, irreversible electroporation and ultrasound ablation show encouraging results regarding destruction of tumor tissue, cytoreduction. These methods are associated with small number of complications and relatively easy to tolerate by patients. However, there is no single approach to their use in the complex treatment of these patients. Accumulation of data followed by comparative analysis of various ablation techniques is being carried out in many specialized clinics of the world including national hospitals. Ablation mechanisms of technologies, literature data and the authors' own experience in the treatment of pancreatic cancer are reported in the article. Further randomized prospective trials are required to determine the role of ablation methods in the complex treatment of tumors of parenchymal organs including pancreatic cancer.

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Minami, Yasunori, Tomohiro Minami, Kazuomi Ueshima, Yukinobu Yagyu, Masakatsu Tsurusaki, Takuya Okada, Masatoshi Hori, Masatoshi Kudo, and Takamichi Murakami. "Three-Dimensional Radiological Assessment of Ablative Margins in Hepatocellular Carcinoma: Pilot Study of Overlay Fused CT/MRI Imaging with Automatic Registration." Cancers 13, no. 6 (March 23, 2021): 1460. http://dx.doi.org/10.3390/cancers13061460.

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Background: We investigate the feasibility of image fusion application for ablative margin assessment in radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) and possible causes for a wrong initial evaluation of technical success through a side-by-side comparison. Methods: A total of 467 patients with 1100 HCCs who underwent RFA were reviewed retrospectively. Seventeen patients developed local tumor progressions (LTPs) (median size, 1.0 cm) despite initial judgments of successful ablation referring to contrast-enhanced images obtained in the 24 h after ablation. The ablative margins were reevaluated radiologically by overlaying fused images pre- and post-ablation. Results: The initial categorizations of the 17 LTPs had been grade A (absolutely curative) (n = 5) and grade B (relatively curative) (n = 12); however, the reevaluation altered the response categories to eight grade C (margin-zero ablation) and nine grade D (existence of residual HCC). LTP occurred in eight patients re-graded as C within 4 to 30.3 months (median, 14.3) and in nine patients re-graded as D within 2.4 to 6.7 months (median, 4.2) (p = 0.006). Periablational hyperemia enhancements concealed all nine HCCs reevaluated as grade D. Conclusion: Side-by-side comparisons carry a risk of misleading diagnoses for LTP of HCC. Overlay fused imaging technology can be used to evaluate HCC ablative margin with high accuracy.

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Khan, Nasir A., Mark O. Baerlocher, Richard J. T. Owen, Stephen Ho, John R. Kachura, Stephen T. Kee, and Dave M. Liu. "Ablative Technologies in the Management of Patients with Primary and Secondary Liver Cancer: An Overview." Canadian Association of Radiologists Journal 61, no. 4 (October 2010): 217–22. http://dx.doi.org/10.1016/j.carj.2009.12.009.

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Interventional ablative technologies have played an increasingly important role in the management of patients with primary or secondary liver malignancies. Ethanol and acetic acid ablation were the primary modalities available 2 decades ago. Today, several new technologies are available, including radiofrequency ablation, cryoablation, and microwave ablation. Radiofrequency ablation is the most widely practiced, however, cryoablation and microwave ablation are reasonable choices in certain situations. Irreversible electroporation is a newer technique, which has yet to enter clinical practice, but shows promising preliminary results. Herein, we provide a brief overview of the above-mentioned technologies with a focus on principles of ablation and technique. We also describe the use of these techniques in the context of cytoreduction, a noncurative approach aimed at reducing the overall tumour burden and providing concomitant survival benefit.

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Mauri, Giovanni, Francesco Alessandro Mistretta, Guido Bonomo, Nicola Camisassi, Andrea Conti, Paolo Della Vigna, Matteo Ferro, et al. "Long-Term Follow-Up Outcomes after Percutaneous US/CT-Guided Radiofrequency Ablation for cT1a-b Renal Masses: Experience from Single High-Volume Referral Center." Cancers 12, no. 5 (May 7, 2020): 1183. http://dx.doi.org/10.3390/cancers12051183.

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Image-guided thermal ablations are increasingly applied in the treatment of renal cancers, under the guidance of ultrasound (US) or computed tomography (CT). Sometimes, multiple ablations are needed. The aim of the present study was to evaluate the long-term results in patients with renal mass treated with radiofrequency ablation (RFA) with both US and CT, with a focus on the multiple ablations rate. 149 patients (median age 67 years) underwent RFA from January 2008 to June 2015. Median tumor diameter was 25 mm (IQR 17–32 mm). Median follow-up was 54 months (IQR 44–68). 27 (18.1%) patients received multiple successful ablations, due to incomplete ablation (10 patients), local tumor progression (8 patients), distant tumor progression (4 patients) or multiple tumor foci (5 patients), with a primary and secondary technical efficacy of 100%. Complications occurred in 13 (8.7%) patients (6 grade A, 5 grade C, 2 grade D). 24 patients died during follow-up, all for causes unrelated to renal cancer. In conclusion, thermal ablations with the guidance of US and CT are safe and effective in the treatment of renal tumors in the long-term period, with a low rate of patients requiring multiple treatments over the course of their disease.

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Ahmad, Aziz, Steven L. Chen, Maihgan A. Kavanagh, David P. Allegra, and Anton J. Bilchik. "Radiofrequency Ablation of Hepatic Metastases from Colorectal Cancer: Are Newer Generation Probes Better?" American Surgeon 72, no. 10 (October 2006): 875–79. http://dx.doi.org/10.1177/000313480607201007.

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Second-generation radiofrequency ablation (RFA) probes and their successors have more power, shorter ablation times, and an increased area of ablation compared with the first-generation probes used before 2000. We examined whether the use of the newer probes has improved the clinical outcome of RFA for hepatic metastases of colorectal cancer at our tertiary cancer center. Of 160 patients who underwent RFA between 1997 and 2003, 52 had metastases confined to the liver: 21 patients underwent 46 ablations with the first-generation probes and 31 patients underwent 58 ablations with the newer probes. The two groups had similar demographic characteristics. At a median follow-up of 26.2 months, patients treated with the newer probes had a longer median disease-free survival (16 months vs 8 months, P < 0.01) and a lower rate of margin recurrence (5.2% vs 17.4%); eight patients had no evidence of disease and one patient was alive with disease. By contrast, of the 46 patients treated with the first-generation probes, 2 patients had no evidence of disease and 1 patient was alive with disease. Newer-generation probes are associated with lower rates of margin recurrence and higher rates of disease-free survival after RFA of hepatic metastases from colorectal cancer.

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Woodrum, David A., Akira Kawashima, Krzysztof R. Gorny, and Lance A. Mynderse. "Magnetic Resonance–Guided Prostate Ablation." Seminars in Interventional Radiology 36, no. 05 (December 2019): 351–66. http://dx.doi.org/10.1055/s-0039-1697001.

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AbstractIn 2019, the American Cancer Society (ACS) estimates that 174,650 new cases of prostate cancer will be diagnosed and 31,620 will die due to the prostate cancer in the United States. Prostate cancer is often managed with aggressive curative intent standard therapies including radiotherapy or surgery. Regardless of how expertly done, these standard therapies often bring significant risk and morbidity to the patient's quality of life with potential impact on sexual, urinary, and bowel functions. Additionally, improved screening programs, using prostatic-specific antigen and transrectal ultrasound-guided systematic biopsy, have identified increasing numbers of low-risk, low-grade “localized” prostate cancer. The potential, localized, and indolent nature of many prostate cancers presents a difficult decision of when to intervene, especially within the context of the possible comorbidities of aggressive standard treatments. Active surveillance has been increasingly instituted to balance cancer control versus treatment side effects; however, many patients are not comfortable with this option. Although active debate continues on the suitability of either focal or regional therapy for the low- or intermediate-risk prostate cancer patients, no large consensus has been achieved on the adequate management approach. Some of the largest unresolved issues are prostate cancer multifocality, limitations of current biopsy strategies, suboptimal staging by accepted imaging modalities, less than robust prediction models for indolent prostate cancers, and safety and efficiency of the established curative therapies following focal therapy for prostate cancer. In spite of these restrictions, focal therapy continues to confront the current paradigm of therapy for low- and even intermediate-risk disease. It has been proposed that early detection and proper characterization may play a role in preventing the development of metastatic disease. There is level-1 evidence supporting detection and subsequent aggressive treatment of intermediate- and high-risk prostate cancer. Therefore, accurate assessment of cancer risk (i.e., grade and stage) using imaging and targeted biopsy is critical. Advances in prostate imaging with MRI and PET are changing the workup for these patients, and advances in MR-guided biopsy and therapy are propelling prostate treatment solutions forward faster than ever.

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Minami, Yasunori, Tomohiro Minami, Hirokazu Chishina, Masashi Kono, Tadaaki Arizumi, Masahiro Takita, Norihisa Yada, et al. "US-US Fusion Imaging in Radiofrequency Ablation for Liver Metastases." Digestive Diseases 34, no. 6 (2016): 687–91. http://dx.doi.org/10.1159/000448857.

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Objective: Radiofrequency ablation (RFA) induces gas bubbles in ablation zones, and the ablative margin cannot be evaluated accurately on ultrasound (US) during and immediately after RFA. This study assessed the usefulness of US-US fusion imaging to visualize the ablative margin of RFA for liver metastasis. Methods: RFA guided by US-US fusion imaging was performed on 12 targeted tumors in 10 patients. Secondary hepatic malignancies included patients with colorectal cancer (n = 4), breast cancer (n = 2), lung cancer (n = 1), gastrointestinal stromal tumor (n = 1), pancreatic neuroendocrine tumor (n = 1), and adrenocortical carcinoma (n = 1). The maximal diameter of the tumors ranged from 0.8 to 4.0 cm (mean ± SD 1.6 ± 0.9 cm). Results: The mean number of electrode insertions was 1.6 per session (range 1-3). Technically, effective ablation was achieved in a single session in all patients, and safety ablative margins were confirmed on contrast-enhanced CT for early assessment of tumor response. There were no serious adverse events or procedure-related complications. During the follow-up period (median 220 days, range 31-417 days), none of the patients showed local tumor progression. Conclusion: US-US fusion imaging could show the tumor images before ablation and the ablative area on US in real time. The image overlay of US-US fusion imaging made it possible to evaluate the ablative margin three dimensionally according to the US probe action. Therefore, US-US fusion imaging can contribute to RFA therapy with a safety margin, that is, the so-called precise RFA.

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Liapi, Eleni, and Jean-Francois H. Geschwind. "Transcatheter and Ablative Therapeutic Approaches for Solid Malignancies." Journal of Clinical Oncology 25, no. 8 (March 10, 2007): 978–86. http://dx.doi.org/10.1200/jco.2006.09.8657.

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The purpose of this article is to present in a concise manner an overview of the most widely used locoregional transcatheter and ablative therapies for solid malignancies. An extensive MEDLINE search was performed for this review. Therapies used for liver cancer were emphasized because these therapies are used most commonly in the liver. Applications in pulmonary, renal, and bone tumors were also discussed. These approaches were divided into catheter-based therapies (such as transcatheter arterial chemoembolization, bland embolization, and the most recent transcatheter arterial approach with drug-eluting microspheres), ablative therapies (such as chemical [ethanol or acetic acid injection]), and thermal ablative therapies (such as radiofrequency ablation, laser induced thermotherapy, microwave ablation, cryoablation, and extracorporeal high-intensity focused ultrasound ablation). A brief description of each technique and analysis of available data was reported for all therapies. Locoregional transcatheter and ablative therapies continue to be used mostly for palliation, but have also been used with curative intent. A growing body of evidence suggests clear survival benefit, excellent results regarding local tumor control, and improved quality of life. Clinical trials are underway to validate these results. Image-guided transcatheter and ablative approaches currently play an important role in the management of patients with various types of cancer—a role that is likely to grow even more given the technological advances in imaging, image-guidance systems, catheters, ablative tools, and drug delivery systems. As a result, the outcomes of patients with cancer undoubtedly will improve.

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Liu, Lina, Fang Huang, Bin Liu, and Rui Huang. "Detection of distant metastasis at the time of ablation in children with differentiated thyroid cancer: the value of pre-ablation stimulated thyroglobulin." Journal of Pediatric Endocrinology and Metabolism 31, no. 7 (July 26, 2018): 751–56. http://dx.doi.org/10.1515/jpem-2018-0075.

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Abstract Background The present study was designed to determine the value of pre-ablation stimulated thyroglobulin (s-Tg) in predicting distant metastasis (DM) at the time of ablation in children with differentiated thyroid cancer. Methods From August 2009 to December 2016, consecutive children with differentiated thyroid cancer undergoing remnant ablation were retrospectively analyzed. Serum s-Tg was measured with the high-sensitive electrochemiluminescence immunoassay during hypothyroidism at ablation just before the ablative radioactive iodine (131I) administration. Post-ablation, whole body planar scintigraphy was obtained 5 days after administration of ablation activity of 131I. Single photon emission computed tomography/low-dose computed tomography (SPECT/CT) was added for children whose planar findings were inconclusive. Receiver-operating characteristics (ROC) curve analysis was employed to find a cut-off level of pre-ablation s-Tg as a predictor of DM at the time of ablation. Results Fifty-seven children were included for the analysis. Metastases were noticed on post-ablation scintigraphy in 20 (35%) children: five post-operative residual neck lymph node metastases, four post-operative residual neck lymph node and lung metastases, three mediastinal lymph node and lung metastases and eight lung metastases. A significant difference in pre-ablation s-Tg levels was found in children with DM compared with those without DM, 603.5 vs. 5.7 ng/mL, respectively. A pre-ablation s-Tg level of 156 ng/mL was established as the optimal cut-off point to predict DM. Conclusions This study demonstrated that pre-ablation s-Tg could potentially act as a predictor of DM at the time of ablation in children with differentiated thyroid cancer. We also propose a specific pre-ablation s-Tg cut-off value of 156 ng/mL as an optimal threshold for practical use.

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Corica, Federico A., and Thomas E. Keane. "Bladder Cancer—Resection/Ablation." Surgical Oncology Clinics of North America 14, no. 2 (April 2005): 321–52. http://dx.doi.org/10.1016/j.soc.2004.11.001.

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Vilana Puig, R. "Radiofrequency ablation for cancer." Gastroenterología y Hepatología 27, no. 9 (January 2004): 562. http://dx.doi.org/10.1016/s0210-5705(03)70531-7.

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Klingler, H. Christoph. "Kidney cancer: energy ablation." Current Opinion in Urology 17, no. 5 (September 2007): 322–26. http://dx.doi.org/10.1097/mou.0b013e328277f1c6.

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Coleman, Jonathan A., and Peter T. Scardino. "Targeted prostate cancer ablation." Current Opinion in Urology 23, no. 2 (March 2013): 123–28. http://dx.doi.org/10.1097/mou.0b013e32835d9e94.

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Liu, Yong, Cheng-Song Cao, Yang Yu, and Ya-Meng Si. "Thermal ablation in cancer." Oncology Letters 12, no. 4 (August 11, 2016): 2293–95. http://dx.doi.org/10.3892/ol.2016.4997.

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Gobara, Hideo, Hiroyasu Fujiwara, Hiroaki Ishii, Koji Tomita, Mayu Uka, Satoko Makimoto, Susumu Kanazawa, and Takao Hiraki. "Lung Cancer Ablation: Complications." Seminars in Interventional Radiology 30, no. 02 (May 28, 2013): 169–75. http://dx.doi.org/10.1055/s-0033-1342958.

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Delpla, Alexandre, Thierry de Baere, Eloi Varin, Frederic Deschamps, Charles Roux, and Lambros Tselikas. "Role of Thermal Ablation in Colorectal Cancer Lung Metastases." Cancers 13, no. 4 (February 22, 2021): 908. http://dx.doi.org/10.3390/cancers13040908.

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Background: Consensus guidelines of the European Society for Medical Oncology (ESMO) (2016) provided recommendations for the management of lung metastases. Thermal ablation appears as a tool in the management of these secondary pulmonary lesions, in the same manner as surgical resection or stereotactic ablative radiotherapy (SABR). Methods: Indications, technical considerations, oncological outcomes such as survival (OS) or local control (LC), prognostic factors and complications of thermal ablation in colorectal cancer lung metastases were reviewed and put into perspective with results of surgery and SABR. Results: LC rates varied from 62 to 91%, with size of the metastasis (<2 cm), proximity to the bronchi or vessels, and size of ablation margins (>5 mm) as predictive factors of LC. Median OS varied between 33 and 68 months. Pulmonary free disease interval <12 months, positive carcinoembryonic antigen, absence of neoadjuvant chemotherapy and uncontrolled extra-pulmonary metastases were poor prognostic factors for OS. While chest drainage for less than 48 h was required in 13 to 47% of treatments, major complications were rare. Conclusions: Thermal ablation of a selected subpopulation of patients with colorectal cancer lung metastases is safe and can provide excellent LC and delay systemic chemotherapy.

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Baust, John M., Anthony Robilotto, Kimberly L. Santucci, Kristi K. Snyder, Robert G. Van Buskirk, Aaron Katz, Anthony Corcoran, and John G. Baust. "Evaluation of a Novel Cystoscopic Compatible Cryocatheter for the Treatment of Bladder Cancer." Bladder Cancer 6, no. 3 (September 21, 2020): 303–18. http://dx.doi.org/10.3233/blc-200321.

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BACKGROUND: As the acceptance of cryoablative therapies for the treatment of non-metastatic cancers continues to grow, avenues for novel cryosurgical technologies and approaches have opened. Within the field of genitourinary tumors, cryosurgical treatments of bladder cancers remain largely investigational. Current modalities employ percutaneous needles or transurethral cryoballoons or sprays, and while results have been promising, each technology is limited to specific types and stages of cancers. OBJECTIVE: This study evaluated a new, self-contained transurethral cryocatheter, FrostBite-BC, for its potential to treat bladder cancer. METHODS: Thermal characteristics and ablative capacity were assessed using calorimetry, isothermal analyses, in vitro 3-dimensional tissue engineered models (TEMs), and a pilot in vivo porcine study. RESULTS: Isotherm assessment revealed surface temperatures below – 20°C within 9 sec. In vitro TEMs studies demonstrated attainment of ≤– 20°C at 6.1 mm and 8.2 mm in diameter following single and double 2 min freezes, respectively. Fluorescent imaging 24 hr post-thaw revealed uniform, ablative volumes of 326.2 mm3 and 397.9 mm3 following a single or double 2 min freeze. In vivo results demonstrated the consistent generation of ablative areas. Lesion depth was found to correlate with freeze time wherein 15 sec freezes resulted in ablation confined to the sub-mucosa and ≥30 sec full thickness ablation of the bladder wall. CONCLUSIONS: These studies demonstrate the potential of the FrostBite-BC cryocatheter as a treatment option for bladder cancer. Although preliminary, the outcomes of these studies were encouraging, and support the continued investigation into the potential of the FrostBite-BC cryocatheter as a next generation, minimally invasive cryoablative technology.

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Maria, Tsitskari, and Christos Georgiades. "Percutaneous Cryoablation for Renal Cell Carcinoma." Journal of Kidney Cancer and VHL 2, no. 3 (June 9, 2015): 105–13. http://dx.doi.org/10.15586/jkcvhl.2015.34.

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Renal cell carcinoma (RCC) is the most common type of kidney cancer in adults. Nephron sparing resection (partial nephrectomy) has been the “gold standard” for the treatment of resectable disease. With the widespread use of cross sectional imaging techniques, more cases of renal cell cancers are detected at an early stage, i.e. stage 1A or 1B. This has provided an impetus for expanding the nephron sparing options and especially, percutaneous ablative techniques. Percutaneous ablation for RCC is now performed as a standard therapeutic nephron-sparing option in patients who are poor candidates for resection or when there is a need to preserve renal function due to comorbid conditions, multiple renal cell carcinomas, and/or heritable renal cancer syndromes. During the last few years, percutaneous cryoablation has been gaining acceptance as a curative treatment option for small renal cancers. Clinical studies to date indicate that cryoablation is a safe and effective therapeutic method with acceptable short and long term outcomes and with a low risk, in the appropriate setting. In addition it seems to offer some advantages over radio frequency ablation (RFA) and other thermal ablation techniques for renal masses.

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Giovacchini, Giampiero, and Rossella Leoncini. "Incidence of Second Cancers in Thyroid Cancer Patients Treated with Radioactive Iodine Ablation: How High Is Really the Risk?" Journal of Diagnostic Imaging in Therapy 3, no. 1 (July 12, 2016): 49–51. http://dx.doi.org/10.17229/jdit.2016-0712-022.

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Nomura, Takeo, and Hiromitsu Mimata. "Focal Therapy in the Management of Prostate Cancer: An Emerging Approach for Localized Prostate Cancer." Advances in Urology 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/391437.

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A widespread screening with prostate-specific antigen (PSA) has led increased diagnosis of localized prostate cancer along with a reduction in the proportion of advanced-stage disease at diagnosis. Over the past decade, interest in focal therapy as a less morbid option for the treatment of localized low-risk prostate cancer has recently been renewed due to downward stage migration. Focal therapy stands midway between active surveillance and radical treatments, combining minimal morbidity with cancer control. Several techniques of focal therapy have potential for isolated ablation of a tumor focus with sparing of uninvolved surround tissue demonstrating excellent short-term cancer control and a favorable patient’s quality of life. However, to date, tissue ablation has mostly used for near-whole prostate gland ablation without taking advantage of accompanying the technological capabilities. The available ablative technologies include cryotherapy, high-intensity focused ultrasound (HIFU), and vascular-targeted photodynamic therapy (VTP). Despite the interest in focal therapy, this technology has not yet been a well-established procedure nor provided sufficient data, because of the lack of randomized trial comparing the efficacy and morbidity of the standard treatment options. In this paper we briefly summarize the recent data regarding focal therapy for prostate cancer and these new therapeutic modalities.

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Jing, Xiang, Jianmin Ding, Jibin Liu, Yandong Wang, Fengmei Wang, Yijun Wang, and Zhi Du. "Complications of thermal ablation of hepatic tumors: Comparison of radiofrequency and microwave techniques." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e15040-e15040. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e15040.

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e15040 Background: The efficacy and safety of radiofrequency ablation (RFA) have been reported in the literatures, which are considered as frontline choice for treatment of liver cancer. Recently, microwave ablation (MWA) has emerged and gained great attention over RFA. However, in comparison to RFA, the safety of MWA for treatment of liver cancer has not been fully reported in the literatures. Studies with large clinical data sets are still needed to understand the technique and avoid the complications. The objective of this study was to retrospectively investigate the common complications of thermal ablations of liver tumors using both RFA and MWA techniques, and compare the safety between these two procedures. Methods: This retrospective study protocol was approved by our institutional ethics committee to allow investigators to review the existing patient’s medical records. A total of 879 patients with hepatic tumors underwent thermal ablation. There were 323 cases having the RFA procedures and 556 cases having MWA procedures. The complications of thermal ablations of liver tumors were compared using both RFA and MWA techniques. Results: A total of 1,030 thermal ablation sessions was performed in 879 patients with a total of 1,652 tumors. There were 323 patients with 562 tumors received a total of 376 RFA with averaged 1.16±0.48 sessions per patient. The other 556 patients with 1,090 tumors received a total of 654 MWA with averaged1.18±0.51 sessions per patient. The mortality rates were 0.31% (1/323) and 0.36% (2/556) in RFA and MWA group. In RFA and MWA group, the major complication rates were 3.5% (13/376) and 3.1% (20/654) (Table 1), meanwhile the minor complication rates were 5.9% (22/376) and 5.7% (37/654). There was no statistical significant difference for the mortality rates, the major complications, the minor complications between the RFA and MWA groups (P>0.05). Conclusions: Thermal ablation therapy in the treatment of liver cancers is relatively safe with low mortality and low incidence of serious complications. The types and incidences of complications caused by RFA and MWA are similar and comparable for safety consideration in clinical settings.

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Miller, Liron, Jonathan Leor, and Boris Rubinsky. "Cancer Cells Ablation with Irreversible Electroporation." Technology in Cancer Research & Treatment 4, no. 6 (December 2005): 699–705. http://dx.doi.org/10.1177/153303460500400615.

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In this study we perform in vitro irreversible electroporation (IRE) experiments with human hepatocarcinoma cells (HepG2) to investigate IRE as a new technique for undesirable tissue ablation. Irreversible electroporation (IRE) is the irreversible permeabilization of the cell membrane through the application of microsecond through millisecond electrical pulses. Until now IRE was studied only as an undesirable condition during the use of reversible electroporation in gene therapy and electrochemotherapy. There was a possibility that the IRE ablation domain is mostly superimposed on the electrical pulses induced Joule heating thermal ablation domain. This study demonstrates that there is a real and substantial domain of electrical parameters for IRE ablation of cancer that is distinct from the thermal domain and which results in complete cancer cell ablation. Experiments show that the application of 1500 V/cm in three sets of ten pulses of 300 microseconds each can produce complete cancer cell ablation. We also find that the use of multiple pulses appears to be more effective for cancer cell ablation than the application of the same energy in one single pulse.

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Krokidis, Miltiadis, and Adam Hatzidakis. "Ablative Techniques for Image-Guided Thermal Ablation." Digestive Disease Interventions 03, no. 02 (May 10, 2019): 093–97. http://dx.doi.org/10.1055/s-0039-1688686.

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AbstractPercutaneous image-guided thermal ablation is an established form of treatment of small volume hepato-pancreatico-biliary (HPB) tumors with very satisfactory results over the last three decades. Purpose of this article is to offer a brief overview of the history of thermal ablation and the currently available technology that interventional radiologists have in their armamentarium to offer minimally invasive thermally for HPB cancer.

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Vogel, Jantien A., Eran van Veldhuisen, Lindy K. Alles, Olivier R. Busch, Frederike Dijk, Thomas M. van Gulik, Goos M. Huijzer, Marc G. Besselink, Krijn P. van Lienden, and Joanne Verheij. "Time-Dependent Impact of Irreversible Electroporation on Pathology and Ablation Size in the Porcine Liver: A 24-Hour Experimental Study." Technology in Cancer Research & Treatment 18 (January 1, 2019): 153303381987689. http://dx.doi.org/10.1177/1533033819876899.

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Irreversible electroporation causes cell death through low frequency, high voltage electrical pulses and is increasingly used to treat non-resectable cancers. A recent systematic review revealed that tissue damage through irreversible electroporation is time-dependent, but the impact of time on the ablation zone size remains unknown. Irreversible electroporation ablations were performed hourly during 24 consecutive hours in the peripheral liver of 2 anaesthetized domestic pigs using clinical treatment settings. Immediately after the 24th ablation, the livers were harvested and examined for tissue response in time based on macroscopic and microscopic pathology. The impact of time on these outcomes was assessed with Spearman rank correlation test. Ablation zones were sharply demarcated as early as 1 hour after treatment. During 24 hours, the ablation zones showed a significant increase in diameter (rs = 0.493, P = .014) and total surface (rs = 0.499, P = .013), whereas the impact of time on the homogeneous ablated area was not significant (rs = 0.172, P = .421). Therefore, the increase in size could mainly be attributed to an increase in the transition zone. Microscopically, the ablation zones showed progression in cell death and inflammation. This study assessed the dynamics of irreversible electroporation on the porcine liver during 24 consecutive hours and found that the pathological response (ie, cell death/inflammation), and ablation size continue to develop for at least 24 hours. Consequently, future studies on irreversible electroporation should prolong their observation period.

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Crocetti, Laura, Paola Scalise, Elena Bozzi, Daniela Campani, Piercarlo Rossi, Rosa Cervelli, Irene Bargellini, Davide Ghinolfi, Paolo De Simone, and Roberto Cioni. "Microwave Ablation of Very-Early- and Early-Stage HCC: Efficacy Evaluation by Correlation with Histology after Liver Transplantation." Cancers 13, no. 14 (July 8, 2021): 3420. http://dx.doi.org/10.3390/cancers13143420.

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Microwave (MW) ablation is a worldwide-diffused technique for the percutaneous ablation of hepatocellular carcinoma (HCC). Nevertheless, the efficacy of this technique still needs to be confirmed in pathological specimens. The purpose of this study was to evaluate the efficacy of MW ablation by correlation with histology in excised liver samples at the time of liver transplantation (LT). All patients with MW-ablated HCC who subsequently underwent LT between 2012 and 2020 were retrospectively evaluated. In the explanted livers, the treated lesions were evaluated at pathology, and the necrosis was classified as complete or partial. Thirty-six HCCs were ablated in 30 patients (20.9 ± 6.1 mm, a range of 10–30 mm). Ablations were performed with a single insertion of a MW antenna under ultrasound or CT guidance. A complete radiological response was demonstrated in 30/36 nodules (83.3%) in 24/30 patients (80%) at imaging performed one-month after MW ablation. At pathology, of the 36 treated nodules, 28 (77.8%) showed a complete necrosis, and 8 (22.2%) showed a pathological partial necrosis. Good agreement was found between the imaging performed one-month after treatment and the complete pathological response (Cohen’s k = 0.65). The imaging accuracy in detecting a complete response to treatment was 88.9%. All lesions with complete necrosis did not show recurrence at follow-up imaging until transplantation. The rad-path correlation in the explanted livers showed that MW ablation achieved a high rate of complete necrosis if a macroscopical complete ablation was obtained.

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Mancia, Lauren, Eli Vlaisavljevich, Nyousha Yousefi, Adam Maxwell, Geoffrey W. Siegel, Zhen Xu, and Eric Johnsen. "Focused ultrasound ablation of solid tumors: Feasibility of planning tissue-selective treatments." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e15600-e15600. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e15600.

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e15600 Background: Focused ultrasound (FUS) is a noninvasive, nonionizing, repeatable local ablative therapy that induces mechanical fractionation or thermal necrosis of a variety of solid tumors including hepatocellular carcinoma, prostate cancer, and desmoid fibromatosis. Recent feasibility studies in animal models have demonstrated the possibility of designing focused ultrasound treatments that are selective (e.g. spare healthy tissue, nerves, and blood vessels) due to differences in tissue and tumor mechanical properties. Given wide variation in individual tumor and patient characteristics, mechanics-based predictions of ablation zone features in different tissues under a range of FUS device settings are needed to permit personalized treatment planning. Methods: A finite difference computational method is used to simulate FUS ablation of tissues with variable mechanical properties (shear moduli of 0.6 – 200 kPa) under different FUS sonication parameters (frequency and peak pressure). The model calculates strain fields contributing to tissue ablation in FUS treatments which are used to predict ablation zone radii and boundary characteristics. Simulation predictions in model tissues are then compared to histology obtained from FUS-treated porcine tissue samples with similar mechanical properties. Results: The mechanical properties of model tissues and FUS treatment parameters have distinct effects on predicted minimum ablation zone radii. For example, smaller ablation zone radii are achieved in stiffer vessel wall than liver under given FUS sonication parameters. In each tissue, lower frequency and higher peak pressure FUS sonication predict a larger ablation zone. Combined variation of sonication frequency and peak pressure are found to achieve wider variation in ablation zone radius than previously achieved with frequency variation alone. Predicted ablation zone radii and boundary characteristics are consistent with the observed histology of FUS-treated tissues. Conclusions: Results show that simulations accounting for tissue mechanical properties and device settings can predict tissue selectivity and ablation zone characteristics observed in FUS procedures. This study demonstrates the potential of using noninvasive measurements of tissue and tumor properties obtained, for example, via shear wave elastography, in combination with micromechanical tissue ablation simulations to develop personalized, selective focused ultrasound treatments for solid tumors.

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van den Bos, W., D. M. de Bruin, B. G. Muller, I. M. Varkarakis, A. A. Karagiannis, P. J. Zondervan, M. P. Laguna Pes, et al. "The safety and efficacy of irreversible electroporation for the ablation of prostate cancer: a multicentre prospective human in vivo pilot study protocol." BMJ Open 4, no. 10 (October 2014): e006382. http://dx.doi.org/10.1136/bmjopen-2014-006382.

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IntroductionCurrent surgical and ablative treatment options for prostate cancer have a relatively high incidence of side effects, which may diminish the quality of life. The side effects are a consequence of procedure-related damage of the blood vessels, bowel, urethra or neurovascular bundle. Ablation with irreversible electroporation (IRE) has shown to be effective in destroying tumour cells and harbours the advantage of sparing surrounding tissue and vital structures. The aim of the study is to evaluate the safety and efficacy and to acquire data on patient experience of minimally invasive, transperineally image-guided IRE for the focal ablation of prostate cancer.Methods and analysisIn this multicentre pilot study, 16 patients with prostate cancer who are scheduled for a radical prostatectomy will undergo an IRE procedure, approximately 30 days prior to the radical prostatectomy. Data as adverse events, side effects, functional outcomes, pain and quality of life will be collected and patients will be controlled at 1 and 2 weeks post-IRE, 1 day preprostatectomy and postprostatectomy. Prior to the IRE procedure and the radical prostatectomy, all patients will undergo a multiparametric MRI and contrast-enhanced ultrasound of the prostate. The efficacy of ablation will be determined by whole mount histopathological examination, which will be correlated with the imaging of the ablation zone.Ethics and disseminationThe protocol is approved by the ethics committee at the coordinating centre (Academic Medical Center (AMC) Amsterdam) and by the local Institutional Review Board at the participating centres. Data will be presented at international conferences and published in peer-reviewed journals.ConclusionsThis pilot study will determine the safety and efficacy of IRE in the prostate. It will show the radiological and histopathological effects of IRE ablations and it will provide data to construct an accurate treatment planning tool for IRE in prostate tissue.Trial registration numberClinicaltrials.gov database: NCT01790451.

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Chen, Angela, Nadine Abi-Jaoudeh, Min-Jung Lee, Jane B. Trepel, Udayan Guha, Elliot B. Levy, Venkatesh P. Krishnasamy, Bradford J. Wood, and Arun Rajan. "Thermal ablation for treatment of hepatic metastasis from thymic epithelial tumors (TETs)." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e20000-e20000. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e20000.

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e20000 Background: Thermal ablation [radiofrequency ablation (RFA), cryoablation, microwave ablation (MWA)] has been used effectively for control of hepatic metastases from various solid tumors. However, these interventions have not been systematically evaluated in patients (pts) with TETs. We present our experience of the safety and clinical efficacy of thermal ablation in pts with advanced TETs and limited sites of disease progression. Methods: Pts with metastatic TETs followed at the National Cancer Institute were considered for thermal ablation if extrathoracic disease progression was limited to 3 or fewer anatomic sites amenable to percutaneous thermal ablative techniques. Appropriate imaging studies were used to evaluate for recurrence, and recurrence-free survival (RFS) was calculated. Biopsies were performed prior to ablation to study mutational and signaling events that may predispose to benefit. Results: From November 2012 to June 2016, 11 metastases (9 liver, 2 chest wall) in 4 pts (3 male, 1 female; median age 59.5 (range, 59-67); 3 thymic carcinoma, 1 WHO B2 thymoma; all Masaoka stage IVB) were treated with thermal ablation (6 MWA, 3 RFA, 2 cryoablation). Median size of metastasis was 1.5 cm (range, 1-4 cm). Local recurrence occurred at 2 (18%) of 11 treated sites, 11.5 months and 10 months after thermal ablation. All pts experienced distant recurrence (1 mesenteric/pelvic mass, 1 lung, 1 malignant pleural effusion, 1 liver) with a median RFS of 7 months (range, 2.5-14). Treatment was well tolerated with no serious adverse events. One pt died due to disease progression 9 months after thermal ablation; 3 pts are alive at the time of reporting (23.5, 37.5 and 38 months after treatment). Conclusions: Thermal ablation is well tolerated and largely successful in achieving local control in pts with advanced, unresectable TETs. Further studies are needed to assess the clinical benefit of thermal ablation compared with systemic therapy and surgery in specific pts with recurrent, oligometastatic TETs. The exact role of thermal ablation tools remains to be defined in this population. The potential for local thermally-induced cell death to induce or augment immunogenic tumor cell death will be assessed and reported.

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Dumolard, Lucile, Julien Ghelfi, Gael Roth, Thomas Decaens, and Zuzana Macek Jilkova. "Percutaneous Ablation-Induced Immunomodulation in Hepatocellular Carcinoma." International Journal of Molecular Sciences 21, no. 12 (June 20, 2020): 4398. http://dx.doi.org/10.3390/ijms21124398.

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Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide and its incidence is rising. Percutaneous locoregional therapies, such as radiofrequency ablation and microwave ablation, are widely used as curative treatment options for patients with small HCC, but their effectiveness remains restricted because of the associated high rate of recurrence, occurring in about 70% of patients at five years. These thermal ablation techniques have the particularity to induce immunomodulation by destroying tumours, although this is not sufficient to raise an effective antitumour immune response. Ablative therapies combined with immunotherapies could act synergistically to enhance antitumour immunity. This review aims to understand the different immune changes triggered by radiofrequency ablation and microwave ablation as well as the interest in using immunotherapies in combination with thermal ablation techniques as a tool for complementary immunomodulation.

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Schatzl, Georg. "Focal ablation of prostate cancer." Hamdan Medical Journal 6, no. 2 (2013): 129. http://dx.doi.org/10.7707/hmj.v6i2.280.

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Sabel, Michael S. "Nonsurgical Ablation of Breast Cancer." Surgical Oncology Clinics of North America 23, no. 3 (July 2014): 593–608. http://dx.doi.org/10.1016/j.soc.2014.03.009.

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D’Onofrio, Mirko, Valentina Ciaravino, Riccardo De Robertis, Emilio Barbi, Roberto Salvia, Roberto Girelli, Salvatore Paiella, Camilla Gasparini, Nicolò Cardobi, and Claudio Bassi. "Percutaneous ablation of pancreatic cancer." World Journal of Gastroenterology 22, no. 44 (2016): 9661. http://dx.doi.org/10.3748/wjg.v22.i44.9661.

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Sarangi, S., S. K. Laughlin-Tommaso, M. Al Hilli, A. Mariani, and A. O. Famuyide. "Endometrial Cancer Following Endometrial Ablation." Journal of Minimally Invasive Gynecology 19, no. 6 (November 2012): S101. http://dx.doi.org/10.1016/j.jmig.2012.08.669.

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Tsafrir, Z., L. Schiff, R. Sangha, E. Theoharis, C. Mangat, F. Siddiqui, M. Elshiakh, and D. Eisenstein. "Endometrial Cancer Following Endometrial Ablation." Journal of Minimally Invasive Gynecology 21, no. 6 (November 2014): S148. http://dx.doi.org/10.1016/j.jmig.2014.08.507.

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Clark, Timothy W. I. "Chemical Ablation of Liver Cancer." Techniques in Vascular and Interventional Radiology 10, no. 1 (March 2007): 58–63. http://dx.doi.org/10.1053/j.tvir.2007.08.004.

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Lencioni, Riccardo, and Laura Crocetti. "Radiofrequency Ablation of Liver Cancer." Techniques in Vascular and Interventional Radiology 10, no. 1 (March 2007): 38–46. http://dx.doi.org/10.1053/j.tvir.2007.08.006.

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Leylek, Ann M., Gary J. Whitman, Vanessa S. Vilar, Nestor Kisilevzky, and Salomao Faintuch. "Radiofrequency Ablation for Breast Cancer." Techniques in Vascular and Interventional Radiology 16, no. 4 (December 2013): 269–76. http://dx.doi.org/10.1053/j.tvir.2013.08.009.

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Hlavsa, J., V. Procházka, Z. Kala, T. Andrašina, B. Hemmelová, T. Pavlík, I. Penka, et al. "Radiofrequency ablation of pancreatic cancer." Pancreatology 12, no. 6 (November 2012): 586. http://dx.doi.org/10.1016/j.pan.2012.11.287.

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Sarno, Alessandro, Alessandro Beleù, Riccardo De Robertis, Gabriele Giannotti, Giorgia Tedesco, Salvatore Paiella, and Mirko D'Onofrio. "Radiofrequency Ablation of Pancreatic Cancer." Digestive Disease Interventions 03, no. 02 (May 10, 2019): 133–37. http://dx.doi.org/10.1055/s-0039-1688437.

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AbstractRadiofrequency ablation (RFA) is emerging as a safe and feasible technique to treat various pancreatic lesions. In particular, pancreatic ductal adenocarcinoma (PDAC) is the most frequent treated lesion. Nowadays, PDAC treatment by means of RFA is limited to locally advanced, non-resectable, but non-metastatic lesions. The aim of this article is to describe the RFA technique, its results and possible complications.

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Merckel, Laura G., and Maurice A. A. J. van den Bosch. "Imaging-guided Breast Cancer Ablation." Radiology 265, no. 1 (October 2012): 322–23. http://dx.doi.org/10.1148/radiol.12121033.

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Journal articles on the topic 'Cancer ablation'

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