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Imaging Features of Radiofrequency Ablation with Heat-Deployed Liposomal Doxorubicin in Hepatic Tumors

  • Clinical Investigation
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Abstract

Introduction

The imaging features of unresectable hepatic malignancies in patients who underwent radiofrequency ablation (RFA) in combination with lyso-thermosensitive liposomal doxorubicin (LTLD) were determined.

Materials and Methods

A phase I dose escalation study combining RFA with LTLD was performed with peri- and post- procedural CT and MRI. Imaging features were analyzed and measured in terms of ablative zone size and surrounding penumbra size. The dynamic imaging appearance was described qualitatively immediately following the procedure and at 1-month follow-up. The control group receiving liver RFA without LTLD was compared to the study group in terms of imaging features and post-ablative zone size dynamics at follow-up.

Results

Post-treatment scans of hepatic lesions treated with RFA and LTLD have distinctive imaging characteristics when compared to those treated with RFA alone. The addition of LTLD resulted in a regular or smooth enhancing rim on T1W MRI which often correlated with increased attenuation on CT. The LTLD-treated ablation zones were stable or enlarged at follow-up four weeks later in 69 % of study subjects as opposed to conventional RFA where the ablation zone underwent involution compared to imaging acquired immediately after the procedure.

Conclusion

The imaging features following RFA with LTLD were different from those after standard RFA and can mimic residual or recurrent tumor. Knowledge of the subtle findings between the two groups can help avoid misinterpretation and proper identification of treatment failure in this setting. Increased size of the LTLD-treated ablation zone after RFA suggests the ongoing drug-induced biological effects.

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Acknowledgments

This work was supported by the Center for Interventional Oncology, the National Cancer Institute, and the Intramural Research Program of the National Institutes of Health (NIH). The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. This research was made possible through the NIH Medical Research Scholars Program, a public–private partnership supported jointly by the NIH and generous contributions to the Foundation for the NIH from Pfizer Inc, The Leona M. and Harry B. Helmsley Charitable Trust, and the Howard Hughes Medical Institute, as well as other private donors. For a complete list, please visit the Foundation website at http://www.fnih.org/work/programs-development/medical-research-scholars-program).

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Authors and Affiliations

  1. Center for Interventional Oncology, Clinical Center, National Institutes of Health, 10 Center Drive MSC 1182, Bethesda, MD, 20892, USA

    Cheng William Hong, Lucy Chow & Bradford J. Wood

  2. Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive MSC 1074, Bethesda, MD, 20892, USA

    Cheng William Hong, Lucy Chow, Evrim B. Turkbey & Bradford J. Wood

  3. Division of Diagnostic Imaging and Intervention, Department of Hepatology and Liver Transplantation, Pisa University Hospital, Via Paradisa 2, Building No. 29, 56124, Pisa, Italy

    Riccardo Lencioni

  4. Montefiore-Einstein Center for Cancer Care, Department of Surgery, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA

    Steven K. Libutti

  5. National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, GB 9609 MSC 9760, Bethesda, MD, 20892, USA

    Steven K. Libutti & Bradford J. Wood

Authors
  1. Cheng William Hong
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  2. Lucy Chow
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  6. Bradford J. Wood
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Correspondence to Cheng William Hong.

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Conflict of Interest

National Institutes of Health and Celsion Corp have a cooperative research and development agreement. Dr. Riccardo Lencioni is a consultant for Celsion Corp.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Hong, C.W., Chow, L., Turkbey, E.B. et al. Imaging Features of Radiofrequency Ablation with Heat-Deployed Liposomal Doxorubicin in Hepatic Tumors. Cardiovasc Intervent Radiol 39, 409–416 (2016). https://doi.org/10.1007/s00270-015-1186-0

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  • DOI: https://doi.org/10.1007/s00270-015-1186-0

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