Ultrasound-guided percutaneous irreversible electroporation of hepatic and abdominal tumors not eligible for surgery or thermal ablation: a western report on safety and efficacy

Autor: B. Santoro, E. Ingenito, Emanuela Ciracì, Pietro Gatti, P. Matteucci, A. Calvanese, V. Giorgio, A. Giorgio, F. Amendola
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Hepatic tumors
Percutaneous
medicine.medical_treatment
Thermal ablation
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Heart arrhythmia
Irreversible electroporation
Internal Medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
Tomography
Ultrasonography
Interventional
Aged
Ultrasonography
Interventional
business.industry
Abdominal tumors
Liver Neoplasms
Ultrasound
Stent
General Medicine
Middle Aged
medicine.disease
Ablation
Magnetic Resonance Imaging
Tumor Burden
X-Ray Computed
Surgery
Klatskin tumor
Treatment Outcome
Electroporation
Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA
Abdominal Neoplasms
030220 oncology & carcinogenesis
Female
Tomography
X-Ray Computed
business
Follow-Up Studies
Zdroj: Journal of Ultrasound. 22:53-58
ISSN: 1876-7931
Popis: To report our first results on sixteen patients affected by liver and abdominal malignant tumors, unfit for surgery or thermal ablation, treated with US-guided percutaneous irreversible electroporation (IRE). From June 2014 to December 2016, all patients meeting the inclusion criteria (malignant hepatic or abdominal tumors not eligible for resection or thermal ablation) and not meeting the exclusion criteria (heart arrhythmia, pro-hemorrhagic hematological alterations, tumor size > 8 cm, presence of a biliary metallic stent) referred to our institutions were prospectively enrolled to undergo percutaneous US-guided irreversible electroporation (IRE). Sixteen patients (age range 59–68 years, mean 63; 7 females) with 18 tumors (diameter range 1.3–7.5 cm) fulfilled the inclusion criteria and were included in the study. Data concerning efficacy (tested by a 1-week CEUS and a 4-week enhanced CT and/or enhanced MRI) and safety were recorded during a 18-month follow up. All patients completed a 35–50-min procedure without complications. One patient with 6 cm Klatskin tumor also underwent a second session for 1 month. A 1-week CEUS and a 4-week e-CT and/or e-MRI arterial phase contrast enhancement analysis showed an overall reduction of arterial flow with confirmation of unenhanced lesions for seven nodules. After 1–18 months of follow up, no major complications were recorded and no tumor-related death occurred. The lesions of two patients disappeared 3 and 6 months after their treatment, respectively. IRE is a promising ablation modality in the treatment of malignant hepatic and abdominal tumors unsuitable for resection or thermal ablation.
Databáze: OpenAIRE
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