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Percutaneous Image-Guided Treatment of Pediatric Malignancy

  • William E. ShielsII
  • Mark J. Hogan
Reference work entry

Abstract

Interventional radiologists continue to expand the diagnostic and therapeutic options available for pediatric oncology patients. Percutaneous radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) are performed safely in children, providing new adjuncts in the armamentarium of therapies for childhood cancer. Percutaneous image-guided radiofrequency ablation (RFA) provides a viable and effective therapeutic option in the treatment of benign and malignant solid tumors in a variety of locations to include the skeleton, liver, spleen, kidney, adrenal gland, lung, and pancreas. Primary and metastatic malignancies as large as 8 cm in children are now effectively treated with RFA. The most common indications for RFA in children include hepatoblastoma, hepatocellular carcinoma (HCC), metastatic osteosarcoma, and Wilms tumor. TACE is an additional therapy, safely performed in children, providing effective therapy options for children with multifocal hepatoblastoma, paraganglioma, neuroblastoma, HCC, osteogenic sarcoma, and Wilms tumor. When TACE and surgery are combined, blood loss and operative time are reduced, while providing more efficacious therapy when combined to surgery alone. In conclusion, RFA and TACE provide children with safe and effective options for treatment of pediatric malignancy.

Keywords

Osteogenic Sarcoma Systemic Chemotherapy Orthotopic Liver Transplantation Gelatin Sponge Limb Salvage Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Goldberg SN, Dupuy DE. Image-guided radiofrequency tumor ablation: challenges and opportunities-part I. J Vasc Interv Radiol. 2001;12:1021–32.CrossRefGoogle Scholar
  2. 2.
    Dupuy DE, Goldberg SN. Image-guided radiofrequency tumor ablation: challenges and opportunities-part II. J Vasc Interv Radiol. 2001;12:1135–48.CrossRefPubMedGoogle Scholar
  3. 3.
    Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gephart MC, Mankin HJ. Changes in the management of osteoid osteoma. J Bone Joint Surg. 1998;80:815–21.CrossRefPubMedGoogle Scholar
  4. 4.
    Woertler K, Vestring T, Boettner F, Winkelmann W, Heindel W, Lindner N. Osteoid osteoma: CT-guided percutaneous radiofrequency ablation and follow-up in 47 patients. J Vasc Interv Radiol. 2001;12:717–22.CrossRefPubMedGoogle Scholar
  5. 5.
    Ahmed M, Goldberg SN. Thermal ablation therapy for hepatocellular carcinoma. J Vasc Interv Radiol. 2002;13:S231–43.CrossRefPubMedGoogle Scholar
  6. 6.
    Livraghi T, Solbiati L, Meloni MF, Gazelle GS, Halpern EF, Goldberg SN. Treatment of focal liver tumors with percutaneous radiofrequency ablation: complications encountered in a multicenter study. Radiology. 2003;226:441–51.CrossRefPubMedGoogle Scholar
  7. 7.
    Rocourt DV, Shiels WE, Hammond S, Besner GE. Contemporary management of benign hepatic adenoma using percutaneous radiofrequency ablation. J Pediatr Surg. 2006;41(6):1149–52.CrossRefPubMedGoogle Scholar
  8. 8.
    Shiels WE, Brown SD. Radiofrequency tumor ablation in children. In: van Sonnenberg E, McMullen W, Solbiati L, editors. Tumor ablation: principles and practice. New York: Springer; 2005. p. 488–95.Google Scholar
  9. 9.
    Hoffer FA. Pediatric applications of radiofrequency ablation. Semin Interv Radiol. 2003;20(4):323–31.CrossRefGoogle Scholar
  10. 10.
    Jingjing Y, Qiang S, Minju L, Tian-an J. Percutaneous radiofrequency ablation for treatment of hepatoblastoma recurrence. Pediatr Radiol. 2008;38(9):1021–3.CrossRefGoogle Scholar
  11. 11.
    Nashida Y. Radiofrequency ablation used for the treatment of frequently recurrent rhabdomyosarcoma in the masticator space in a 10-year-old girl. J Pediatr Hematol/Oncol. 2007;29:640–2.CrossRefGoogle Scholar
  12. 12.
    Brown SD, van Sonnenberg E, Morrison PR, Diller L, Shamberger R. CT-guided radiofrequency ablation of pediatric Wilms tumor in a solitary kidney. Pediatr Radiol. 2005;35(9):923–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Sawada M, Watanabe S, Tsuda H, Kano T. An increase in body temperature during radiofrequency ablation of liver tumors. Anesth Analg. 2002;94(6):1416–20.PubMedGoogle Scholar
  14. 14.
    Katzenstein HM, Krailo MD, Malogolowkin MH, et al. Hepatocellular carcinoma in children and adolescents: results from the pediatric oncology group and the children’s cancer group intergroup study. J Clin Oncol. 2002;20:2789–97.CrossRefPubMedGoogle Scholar
  15. 15.
    Bellani FF, Massimino M. Liver tumors in childhood: epidemiology and clinics. J Surg Oncol. 1993;53:119–21.CrossRefGoogle Scholar
  16. 16.
    Exelby PR, Filler RM, Grosfeld JL. Liver tumors in children in the particular reference to hepatoblastoma and hepatocellular carcinoma. American Academy of Pediatrics Surgical Section Survey 1974. J Pediatr Surg. 1975;10:329–37.CrossRefPubMedGoogle Scholar
  17. 17.
    Iannitti DA, Dupuy DE, Mayo-Smith WW, Murphy B. Hepatic radiofrequency ablation. Arch Surg. 2002;137:422–6. discussion 427.CrossRefPubMedGoogle Scholar
  18. 18.
    Gervais DA, McGovern FJ, Arellano RS, McDougal WS, Mueller PR. Renal cell carcinoma: clinical experience and technical success with radiofrequency ablation of 42 tumors. Radiology. 2003;226:417–24.CrossRefPubMedGoogle Scholar
  19. 19.
    Gervais DA, McGovern FJ, Wood BJ, et al. Radiofrequency ablation of renal cell carcinoma: early clinical experience. Radiology. 2000;217:665–72.CrossRefPubMedGoogle Scholar
  20. 20.
    Roy-Choudhury SH, Cast JE, Cooksey G, Puri S, Breen DJ. Early experience with radiofrequency ablation of small solid renal masses. AJR Am J Roentgenol. 2003;180:1055–61.CrossRefPubMedGoogle Scholar
  21. 21.
    Goldberg SN, Solbiati L, Halpern EF, Gazelle GS. Variables affecting proper system grounding for radiofrequency ablation in an animal model. J Vasc Interv Radiol. 2000;11:1069–75.CrossRefPubMedGoogle Scholar
  22. 22.
    Ramnath RR, Rosenthal DI, Cates J, Gebhardt M, Quinn RH. Intracortical chondroma simulating osteoid osteoma treated by radiofrequency. Skeletal Radiol. 2002;31(10):597–602.CrossRefPubMedGoogle Scholar
  23. 23.
    Chopra S, Dodd GD, Chanin MP, Chintapalli KN. Radiofrequency ablation of hepatic tumors adjacent to the gallbladder; feasibility and safety. AJR Am J Roentgenol. 2003;180:697–701.CrossRefPubMedGoogle Scholar
  24. 24.
    Livraghi T, Lazzaroni S, Meloni F. Radiofrequency thermal ablation of hepatocellular carcinoma. Eur J Ultrasound. 2001;13:159–66.CrossRefPubMedGoogle Scholar
  25. 25.
    Ahmed M, Lobo SM, Weinstein J, Kruskai JB, Gazelle GS, Halpern EF, Afzal SK, Lenkinski RE, Goldberg SN. Improved coagulation with saline solution pretreatment during radiofrequency tumor ablation in a canine model. J Vasc Interv Radiol. 2002;13:717–24.CrossRefPubMedGoogle Scholar
  26. 26.
    Bloomston M, Binitie O, Fraiji E, et al. Transcatheter arterial chemoembolization with or without radiofrequency ablation in the management of patients with advanced hepatic malignancy. Am Surg. 2002;68:827–31.PubMedGoogle Scholar
  27. 27.
    Shankar S, van Sonnenberg E, Silverman SG, Tuncali KT, Morrison PR. Combined radiofrequency and direct alcohol infusion for percutaneous tumor ablation. Presented at the 88th Scientific Assembly and Annual meeting, RSNA. Chicago; 2002 Dec.Google Scholar
  28. 28.
    Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WM, Kavanagh PV, Safran H. Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol. 2000;174:57–9.CrossRefPubMedGoogle Scholar
  29. 29.
    Simon CJ, Dupuy DE, DiPetrillo TA, et al. Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology. 2007;243:268–75.CrossRefPubMedGoogle Scholar
  30. 30.
    Nakamura T, Matsumine A, Yamakado K, et al. Lung radiofrequency ablation in patients with pulmonary metastases from musculoskeletal sarcomas. Cancer. 2009;115(16):3774–81.CrossRefPubMedGoogle Scholar
  31. 31.
    Kariya Z, Yamakado K, Nakatuka A, Onaoda M, Kobayasi S, Takeda K. Radiofrequency ablation with and without balloon occlusion of the renal artery: an experimental study in porcine kidneys. J Vasc Interv Radiol. 2003;14:241–5.CrossRefPubMedGoogle Scholar
  32. 32.
    Guvnén P. Liver embolizations in oncology; a review. Part I. Arterial (chemo) embolizations. Med Oncol. 2008;25(1):1–11.CrossRefGoogle Scholar
  33. 33.
    Tashjian DB, Moriarty KP, Courtney RA, Bean MS, Steele DA. Preoperative chemoembolization for unresectable hepatoblastoma. Pediatr Surg Int. 2002;18(2–3):187–9.CrossRefPubMedGoogle Scholar
  34. 34.
    Mutabagani KH, Klopfenstein KJ, Hogan MJ, Caniano DA. Metastatic paraganglioma and paraneoplastic-induced anemia in an adolescent: treatment with hepatic arterial chemoembolization. J Pediatr Hematol Oncol. 1999;21(6):544–7.CrossRefPubMedGoogle Scholar
  35. 35.
    Malogolowkin MH, Stanley P, Steele DA, Ortega JA. Feasibility and toxicity of chemoembolization for children with liver tumors. J Clin Oncol. 2000;18(6):1279–84.CrossRefPubMedGoogle Scholar
  36. 36.
    Arcement CM, Towbin RB, Meza MP, Gerber DA, Kaye RD, Mazariegos GV, Carr BI, Reyes J. Intrahepatic chemoembolization in unresectable pediatric liver malignancies. Pediatr Radiol. 2000;30(11):779–85.CrossRefPubMedGoogle Scholar
  37. 37.
    Li JP, Chu JP, Yang JY, Chen W, Wang Y, Huang YH. Preoperative transcatheter selective arterial chemoembolization in treatment of unresectable hepatoblastoma in infants and children. Cardiovasc Intervent Radiol. 2008;31(6):1117–23.CrossRefPubMedGoogle Scholar
  38. 38.
    Xuewu J, Jianhong L, Xianliang H, Zhongxian C. Combined treatment of hepatoblastoma with transcatheter arterial chemoembolization and surgery. Pediatr Hematol Oncol. 2006;23(1):1–9.CrossRefPubMedGoogle Scholar
  39. 39.
    Czauderna P, Zbrzezniak G, Narozanski W, Korzon M, Wyszomirska M, Stoba C. Preliminary experience with arterial chemoembolization for hepatoblastoma and hepatocellular carcinoma in children. Pediatr Blood Cancer. 2006;46(7):825–8.CrossRefPubMedGoogle Scholar
  40. 40.
    Ohtsuka Y, Matsunaga T, Yoshida H, Kouchi K, Okada T, Ohnuma N. Optimal strategy of preoperative transcatheter arterial chemoembolization for hepatoblastoma. Surg Today. 2004;34(2):127–33.CrossRefPubMedGoogle Scholar
  41. 41.
    Xianliang H, Jianhong L, Xuewu J, Zhongxian C. Cure of hepatoblastoma with transcatheter arterial chemoembolization. J Pediatr Hematol Oncol. 2004;26(1):60–3.CrossRefPubMedGoogle Scholar
  42. 42.
    Oue T, Fukuzawa M, Kusafuka T, Kohmoto Y, Okada A, Imura K. Transcatheter arterial chemoembolization in the treatment of hepatoblastoma. J Pediatr Surg. 1998;33(12):1771–5.CrossRefPubMedGoogle Scholar
  43. 43.
    Weintraub M, Bloom AI, Gross E, Revel-Vilk S, Shahroor S, Koplewitz BZ, Freeman AI. Successful treatment of progressive state 4s hepatic neuroblastoma in a neonate with intra-arterial chemoembolization. Pediatr Blood Cancer. 2004;43(2):148–51.CrossRefPubMedGoogle Scholar
  44. 44.
    Uemura S, Todani T, Watanabe Y, Toki A, Sato Y, Morotomi Y, Ohkawa M, Kojima K, Seo H. Successful left hepatectomy for hepatocellular carcinoma in a child after transcatheter arterial chemoembolization; report of a survival. Eur J Pediatr Surg. 1993;3(1):54–6.CrossRefPubMedGoogle Scholar
  45. 45.
    Wang MQ, Dake MD, Wang ZP, et al. Isolated lower extremity chemotherapeutic infusion for treatment of osteogenic sarcoma; experimental study and preliminary clinical report. J Vasc Interv Radiol. 2001;12:731–7.CrossRefPubMedGoogle Scholar
  46. 46.
    Zhang HJ, Yang JJ, Lu JP, Lai CJ, Sheng J, Li YX, Hao Q, Zhang SM, Gupta S. Use of intra-arterial chemotherapy and embolization before limb salvage surgery for osteosarcoma of the lower extremity. Cardiovasc Intervent Radiol. 2009;32(4):672–8.CrossRefPubMedGoogle Scholar
  47. 47.
    Chu JP, Chen W, Li JP, Zhuang WQ, Huang YH, Huang ZM, Yang JY. Clinicopathologic features and results of transcatheter arterial chemoembolization for osteosarcoma. Cardiovasc Intervent Radiol. 2007;30(2):201–6.CrossRefPubMedGoogle Scholar
  48. 48.
    Liu WG, Gu WZ, Zhou YB, Tang HF, Li MJ, Ma WX. The prognostic relevance of preoperative transcatheter arterial chemoembolizaton (TACE) and PCNA/VEGF expression in patients with Wilms’ tumour. Eur J Clin Invest. 2008;38(12):931–8.CrossRefPubMedGoogle Scholar
  49. 49.
    Li JP, Chu JP, Oh P, Li Z, Chen W, Huang YH, Yang JY. Characterizing clinicopathological findings of transarterial chemoembolization for Wilms tumor. J Urol. 2010;183(3):1138–44.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Radiology, School of MedicineThe University of Toledo Medical CenterColumbusUSA

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