1000 consecutive ablation sessions in the era of computer assisted image guidance – Lessons learned
| Autor: | Piotr Harbut, Jacob Freedman, Henrik Nilsson, J. Engstrand, Silja Karlgren, Johan Lindeberg, David Stillström, Karolina Galmén, Marie Beermann |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty Jet ventilation Hepatocellular carcinoma medicine.medical_treatment HIFU high intensity focused ultrasound lcsh:R895-920 TAE TACE trans-arterial embolization or chemo-embolization SBRT stereotactic body radiation therapy Ablation IRE irreversible electroporation Kidney Article Renal cell carcinoma Ultrasound Medicine Radiology Nuclear Medicine and imaging TIVA total intravenous anaesthesia RFA radio-frequency ablation Pancreas Lung Computer-assisted surgery HFJV high frequency jet ventilation Stereotactic navigation Modalities business.industry CAS computer assisted surgery Microwave ablation Irreversible electroporation medicine.disease High-intensity focused ultrasound Colorectal liver metastases MWA microwave ablation Fused ultrasound Liver IRE RF Radiology business Microwave |
| Zdroj: | European Journal of Radiology Open, Vol 6, Iss, Pp 1-8 (2019) European Journal of Radiology Open |
| ISSN: | 2352-0477 |
| Popis: | Highlights • Computer assisted targeting techniques are simple to use and improve results in ablative tumour treatments. • The indications for ablative soft tissue tumour ablation are increasing. • Treatments are superior to resective surgery in terms of complications and hospitalization, oncological non-inferiority remains to be proven. • An incomplete ablation can be retreated without negative effects on survival. • Jet ventilation is an effective technique to minimize organ displacement during percutaneous or laparoscopic ablation. Background Ablation therapies for tumours are becoming more used as ablation modalities evolve and targeting solutions are getting better. There is an increasing body of long-term results challenging resection and proving lower morbidities and costs. The aim of this paper is to share the experiences from a high-volume centre in introducing computer assisted targeting solutions and efficient ablation modalities like microwave generators and irreversible electroporation. Material and methods One thousand consecutive treatments in one high-volume centre were evaluated retrospectively from prospectively collected data. Results The purpose of this paper is to present the benefits of going into computer assisted targeting techniques and microwave technology; pitfalls and overview of outcomes. The main target organ was the liver and the main indications were ablation of hepatocellular carcinomas and colorectal liver metastases. With the assistance of computer assisted targeting the local recurrence rate within 6 months has dropped from 30 to near 10%. The survival of patients with hepatocellular carcinoma and colorectal liver metastases is not worse if the tumour can be retreated after a local recurrence. Multiple colorectal liver metastases can be treated successfully. Discussion The incorporation of computer assisted targeting technologies for ultrasound-, ct guided- and laparoscopic tumour ablation has been very successful and without a noticeable learning curve. The same is true for switching from radiofrequency energies to microwave generators and irreversible electroporation. Conclusion It is well worthwhile upgrading ablation and targeting technologies to achieve excellent and reproducible results and minimizing operator dependency. |
| Databáze: | OpenAIRE |
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