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CT-Guided HDR Brachytherapy: Challenging the Limits of Thermal Ablation

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Percutaneous Tumor Ablation in Medical Radiology

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

The impact of surgical resection on prognosis and patient outcome in certain malignancies in the absence of extrahepatic disease is unchallenged. Percutaneous, image-guided tumor ablation has developed and stands today as a genuine, dedicated and widely used procedure for patients with otherwise non-resectable primary or secondary liver malignancies. Procedures based on thermal tissue effects (e.g., thermal ablation and cryoablation) were initially developed with the intention of treating hepatic malignancies. Visual guidance by computed tomography (CT), magnetic resonance imaging (MRI) or ultrasound is necessary for all percutaneous approaches to the liver.

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References

  • Ahmed M, Liu Z, Afzal KS, Weeks D, Lobo SM, Kruskal JB et al (2004) Radiofrequency ablation: effect of surrounding tissue composition on coagulation necrosis in a canine tumor model. Radiology 230(3):761–767

    Article  PubMed  Google Scholar 

  • Akeboshi M, Yamakado K, Nakatsuka A, Hataji O, Taguchi O, Takao M et al (2004) Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response. J Vasc Interv Radiol 15(5):463–470

    PubMed  Google Scholar 

  • Amthauer H, Denecke T, Hildebrandt B, Ruhl R, Miersch A, Nicolaou A et al (2006) Evaluation of patients with liver metastases from colorectal cancer for locally ablative treatment with laser induced thermotherapy — impact of PET with F-18-fluorodeoxyglucose on therapeutic decisions. Nuklearmedizin 45(4):177–184

    PubMed  CAS  Google Scholar 

  • Antoch G, Kaiser GM, Mueller AB, Metz KA, Zhang H, Kuehl H et al (2004) Intraoperative radiation therapy in liver tissue in a pig model: monitoring with dual-modality PET/CT. Radiology 230(3):753–760

    Article  PubMed  Google Scholar 

  • Bergk A, Wieners G, Weich V, Wiedenmann B, Berg T, Ricke J (2005) CT-guided brachytherapy of hepatocellular carcinoma in liver cirrhosis — a novel therapeutic approach. J Hepatol 42:89

    Google Scholar 

  • de Baere T, Palussiere J, Auperin A, Hakime A, Abdel-Rehim M, Kind M et al (2006) Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: prospective evaluation. Radiology 240(2):587–596

    Article  PubMed  Google Scholar 

  • Diederich S, Hosten N (2004) Percutaneous ablation of pulmonary tumours: state-of-the-art 2004. Radiologe 44(7):658–662

    PubMed  CAS  Google Scholar 

  • Dritschilo A, Grant EG, Harter KW, Holt RW, Rustgi SN, Rodgers JE (1986) Interstitial radiation therapy for hepatic metastases: sonographic guidance for applicator placement. AJR Am J Roentgenol 147(2):275–278

    PubMed  CAS  Google Scholar 

  • Dritschilo A, Harter KW, Thomas D, Nauta R, Holt R, Lee TC et al (1988) Intraoperative radiation therapy of hepatic metastases: technical aspects and report of a pilot study. Int J Radiat Oncol Biol Phys 14(5):1007–1011

    PubMed  CAS  Google Scholar 

  • Eichler K, Mack MG, Straub R, Engelmann K, Zangos S, Woitaschek D et al (2001) Oligonodular hepatocellular carcinoma (HCC): MR-controlled laser-induced thermotherapy. Radiologe 41(10):915–922

    Article  PubMed  CAS  Google Scholar 

  • Folprecht G, Kohne CH (2004) New therapy options in colorectal carcinoma. Ther Umsch 61(6):373–378

    Article  PubMed  CAS  Google Scholar 

  • Hiraki T, Sakurai J, Tsuda T, Gobara H, Sano Y, Mukai T et al (2006a) Risk factors for local progression after percutaneous radiofrequency ablation of lung tumors: evaluation based on a preliminary review of 342 tumors. Cancer 107(12):2873–2880

    Article  PubMed  Google Scholar 

  • Hiraki T, Tajiri N, Mimura H, Yasui K, Gobara H, Mukai T et al (2006b) Pneumothorax, pleural effusion, and chest tube placement after radiofrequency ablation of lung tumors: incidence and risk factors. Radiology 241(1):275–283

    Article  PubMed  Google Scholar 

  • Holt RW, Nauta RJ, Lee TC, Heres EK, Dritschilo A, Harter KW et al (1988) Intraoperative interstitial radiation therapy for hepatic metastases from colorectal carcinomas. Am Surg 54(4):231–233

    PubMed  CAS  Google Scholar 

  • Hosten N, Stier A, Weigel C, Kirsch M, Puls R, Nerger U et al (2003) Laser-induced thermotherapy (LITT) of lung metastases: description of a miniaturized applicator, optimization, and initial treatment of patients. Rofo 175(3):393–400

    PubMed  CAS  Google Scholar 

  • Kishi K, Nakamura H, Kobayashi K, Hashimoto T, Hatao H, Oh-ishi S et al (2006) Percutaneous CT-guided radiofrequency ablation of pulmonary malignant tumors: preliminary report. Intern Med 45(2):65–72

    Article  PubMed  Google Scholar 

  • Knappe V, Mols A (2004) Laser therapy of the lung: biophysical background. Radiologe 44(7):677–683

    Article  PubMed  CAS  Google Scholar 

  • Lencioni R, Crocetti L, Cioni R, Mussi A, Fontanini G, Ambrogi M et al (2004) Radiofrequency ablation of lung malignancies: where do we stand? Cardiovasc Intervent Radiol 27(6):581–590

    Article  PubMed  Google Scholar 

  • Llovet JM, Burroughs A, Bruix J (2003) Hepatocellular carcinoma. Lancet 362(9399):1907–1917

    Article  PubMed  Google Scholar 

  • Mulier S, Ni Y, Jamart J, Ruers T, Marchal G, Michel L (2005) Local recurrence after hepatic radiofrequency coagulation: multivariate meta-analysis and review of contributing factors. Ann Surg 242(2):158–171

    Article  PubMed  Google Scholar 

  • Nauta RJ, Heres EK, Thomas DS, Harter KW, Rodgers JE, Holt RW et al (1987) Intraoperative single-dose radiotherapy. Observations on staging and interstitial treatment of unresectable liver metastases. Arch Surg 122(12):1392–1395

    PubMed  CAS  Google Scholar 

  • Nowak AK, Chow PK, Findlay M (2004) Systemic therapy for advanced hepatocellular carcinoma: a review. Eur J Cancer 40(10):1474–1484

    Article  PubMed  CAS  Google Scholar 

  • Pech M, Spors B, Wieners G, Warschewske G, Beck A, Cho C et al (2004) Comparison of different MRI sequences with and without application of Gd-BOPTA as follow-up after LITT. Rofo 176(4):550–555

    PubMed  CAS  Google Scholar 

  • Pech M, Mohnike K, Wieners G, Bialek E, Lopez HE, Dudek O, Fischbach F, Felix R, Wust P, Ricke J (2006) Irradiation of liver metastases: influence of imaging modality on target volume and dose-volume-histograms. (in press)

    Google Scholar 

  • Punt CJ (2004) New options and old dilemmas in the treatment of patients with advanced colorectal cancer. Ann Oncol 15(10):1453–1459

    Article  PubMed  CAS  Google Scholar 

  • Qian J, Feng GS, Vogl T (2003) Combined interventional therapies of hepatocellular carcinoma. World J Gastroenterol 9(9):1885–1891

    PubMed  Google Scholar 

  • Rhim H (2003) Percutaneous radiofrequency ablation therapy for patients with hepatocellular carcinoma during occlusion of hepatic blood flow: comparison with standard percutaneous radiofrequency ablation therapy. Cancer 98(2):433–434

    Article  PubMed  Google Scholar 

  • Ricke J (2004) Interventional therapy for liver metastases. Z Gastroenterol 42(11):1321–1328

    Article  PubMed  CAS  Google Scholar 

  • Ricke J, Wust PG, Werk M, Pech M, Beck AN, Stohlmann A (2002) CT-guided brachytherapy of liver metastasis alone or in combination with laser induced thermo therapy (LITT): Safety and efficacy. Radiology 225:447

    Google Scholar 

  • Ricke J, Sehouli J, Hach C, Hanninen EL, Lichtenegger W, Felix R (2003) Prospective evaluation of contrast-enhanced MRI in the depiction of peritoneal spread in primary or recurrent ovarian cancer. Eur Radiol 13(5):943–949

    PubMed  Google Scholar 

  • Ricke J, Wust P, Stohlmann A, Beck A, Cho CH, Pech M et al (2004a) CT-guided brachytherapy. A novel percutaneous technique for interstitial ablation of liver malignancies. Strahlenther Onkol 180(5):274–280

    Article  PubMed  Google Scholar 

  • Ricke J, Wust P, Stohlmann A, Beck A, Cho CH, Pech M et al (2004b) CT-guided interstitial brachytherapy of liver malignancies alone or in combination with thermal ablation: phase I-II results of a novel technique. Int J Radiat Oncol Biol Phys 58(5):1496–1505

    Article  PubMed  Google Scholar 

  • Ricke J, Wust P, Wieners G, Beck A, Cho CH, Seidensticker M et al (2004c) Liver malignancies: CT-guided interstitial brachytherapy in patients with unfavorable lesions for thermal ablation. J Vasc Interv Radiol 15(11):1279–1286

    PubMed  Google Scholar 

  • Ricke J, Wust P, Hengst S, Wieners G, Pech M, Herzog H et al (2004d) CT-guided interstitial brachytherapy of lung malignancies. Technique and first results. Radiologe 44(7):684–686

    Article  PubMed  CAS  Google Scholar 

  • Ricke J, Wust P, Stohlmann A, Beck A, Cho CH, Pech M et al (2004e) CT-guided brachytherapy. A novel percutaneous technique for interstitial ablation of liver metastases. Strahlenther Onkol 180(5):274–280

    Article  PubMed  Google Scholar 

  • Ricke J, Seidensticker M, Ludemann L, Pech M, Wieners G, Hengst S et al (2005a) In vivo assessment of the tolerance dose of small liver volumes after single-fraction HDR irradiation. Int J Radiat Oncol Biol Phys 62(3):776–784

    Article  PubMed  Google Scholar 

  • Ricke J, Wust P, Wieners G, Hengst S, Pech M, Lopez HE et al (2005b) CT-guided interstitial single-fraction brachytherapy of lung tumors: phase I results of a novel technique. Chest 127(6):2237–2242

    Article  PubMed  Google Scholar 

  • Rose SC, Fotoohi M, Levin DL, Harrell JH (2002) Cerebral microembolization during radiofrequency ablation of lung malignancies. J Vasc Interv Radiol 13(10):1051–1054

    Article  PubMed  Google Scholar 

  • Ruhl R, Ricke J (2006) Image-guided micro-therapy for tumor ablation: from thermal coagulation to advanced irradiation techniques. Onkologie 29(5):219–224

    Article  PubMed  Google Scholar 

  • Sakr AA, Saleh AA, Moeaty AA, Moeaty AA (2005) The combined effect of radiofrequency and ethanol ablation in the management of large hepatocellular carcinoma. Eur J Radiol 54(3):418–425

    Article  PubMed  Google Scholar 

  • Strehl R (2006) Finanzierungsprobleme der modernen Krebsmedizin in Deutschland. Studium Generale Vorlesung an der Eberhard-Karls-Universität Tübingen am 220.06.06

    Google Scholar 

  • Streitparth F, Pech M, Bohmig M, Ruehl R, Peters N, Wieners G et al (2006) In vivo assessment of the gastric mucosal tolerance dose after single fraction, small volume irradiation of liver malignancies by computed tomographyguided, high-dose-rate brachytherapy. Int J Radiat Oncol Biol Phys 65(5):1479–1486

    Article  PubMed  Google Scholar 

  • Suh RD, Wallace AB, Sheehan RE, Heinze SB, Goldin JG (2003) Unresectable pulmonary malignancies: CT-guided percutaneous radiofrequency ablation — preliminary results. Radiology 229(3):821–829

    Article  PubMed  Google Scholar 

  • Thomas DS, Nauta RJ, Rodgers JE, Popescu GF, Nguyen H, Lee TC et al (1993) Intraoperative high-dose rate interstitial irradiation of hepatic metastases from colorectal carcinoma. Results of a phase I–II trial. Cancer 71(6):1977–1981

    Article  PubMed  CAS  Google Scholar 

  • Vogl TJ, Straub R, Eichler K, Sollner O, Mack MG (2004a) Colorectal carcinoma metastases in liver: laser-induced interstitial thermotherapy-local tumor control rate and survival data. Radiology 230(2):450–458

    Article  PubMed  Google Scholar 

  • Vogl TJ, Straub R, Lehnert T, Eichler K, Luder-Luhr T, Peters J et al (2004b) Percutaneous thermoablation of pulmonary metastases. Experience with the application of laser-induced thermotherapy (LITT) and radiofrequency ablation (RFA), and a literature review. Rofo 176(11):1658–1666

    PubMed  CAS  Google Scholar 

  • Vogl TJ, Fieguth HG, Eichler K, Straub R, Lehnert T, Zangos S et al (2004c) Laser-induced thermotherapy of lung metastases and primary lung tumors. Radiologe 44(7):693–699

    Article  PubMed  CAS  Google Scholar 

  • Wieners G, Pech M, Rudzinska M, Lehmkuhl L, Wlodarczyk W, Miersch A et al (2006) CT-guided interstitial brachytherapy in the local treatment of extrahepatic, extrapulmonary secondary malignancies. Eur Radiol 16(11):2586–2593

    Article  PubMed  Google Scholar 

  • Zangos S, Eichler K, Balzer JO, Straub R, Hammerstingl R, Herzog C et al (2007) Large-sized hepatocellular carcinoma (HCC): a neoadjuvant treatment protocol with repetitive transarterial chemoembolization (TACE) before percutaneous MR-guided laser-induced thermotherapy (LITT). Eur Radiol 17(2):553–563

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg AöR, Leipziger Strasse 44, 39120, Magdeburg, Germany

    Konrad Mohnike MD & Jens Ricke MD (Professor)

Authors
  1. Konrad Mohnike MD
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  2. Jens Ricke MD
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Editors and Affiliations

  1. Institute for Diagnostic and Interventional Radiology University Hospital, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany

    Thomas J. Vogl MD (Professor) & Martin G. Mack MD (PD) (Professor) &  (PD)

  2. Department of Diagnostic and Interventional Radiology and Nuclear Medicine Klinikum Bogenhausen, Academic Teaching, Hospital of the Technical University Munich, Engelschalkingerstrasse 77, 81925, Munich, Germany

    Thomas K. Helmberger MD (Professor) (Professor)

  3. Department of Clinical Radiology University Hospitals — Grosshadern and Innenstadt, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany

    Maximilian F. Reiser MD (Professor and Chairman) (Professor and Chairman)

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© 2008 Springer-Verlag Berlin Heidelberg

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Mohnike, K., Ricke, J. (2008). CT-Guided HDR Brachytherapy: Challenging the Limits of Thermal Ablation. In: Vogl, T.J., Helmberger, T.K., Mack, M.G., Reiser, M.F. (eds) Percutaneous Tumor Ablation in Medical Radiology. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68250-9_7

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  • DOI: https://doi.org/10.1007/978-3-540-68250-9_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-22518-8

  • Online ISBN: 978-3-540-68250-9

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