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Virtual navigation-guided radiofrequency ablation for recurrent hepatocellular carcinoma invisible on ultrasound after hepatic resection

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Hepatobiliary & Pancreatic Diseases International 2020年第6期19卷 532-540页

作者： Qi-Yu Zhao Li-Ting Xie Shuo-Chun Chen Xiao Xu Tian-An Jiang Shu-Sen Zheng Department of Ultrasound First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Division of Hepatobiliary Pancreatic Surgery First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Background:No reports are available on the technical efficiency and therapeutic response of virtual navigation(VN)-guided radiofrequency ablation(RFA)for patients with recurrent hepatocellular carcinoma(HCC)after hepatic *** aim of this study was to investigate the overall technical performance and outcome of VN-guided RFA in recurrent HCC *** addition,a nomogram model was developed to predict the factors influencing the overall survival(OS).Methods:This was a prospective study on 76 recurrent HCC patients who underwent VN-guided RFA between June 2015 and February *** technical feasibility,success,and efficiency,OS,local tumor progression,and complications were evaluated.A multivariate Cox regression analysis was conducted to predict the significant factors,and a nomogram including independent predictive factors was subsequently plotted to predict ***:The technical feasibility,success,and efficiency rates of VN-guided RFA were 86.4%,94.7%,and 97.4%,*** cumulative OS rates at 1-,2-,and 3-year were 88.1%,79.7%,and 71.0%,*** cumulative local tumor progression rates at 1-,2-,and 3-year were 5.5%,8.7%,and 14.0%,*** addition,the minor and major complication rates were 5.3%and 3.9%,*** intervention-related deaths occurred during the follow-up *** C-index of the OS nomogram in this study was ***:VN-guided RFA is an effective therapeutic option in recurrent HCC patients and improves the long-term outcomes especially for the lesions that cannot be detected in the two-dimensional ***,the nomogram may be a useful supporting tool in predicting OS to estimate the individual survival probability,optimize treatment options,and facilitate decision-making.

关键词： Ultrasound Hepatocellular carcinoma ablation techniques Nomogram

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Minimally invasive image-guided therapy of primary and metastatic pancreatic cancer

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World Journal of Gastroenterology 2021年第27期27卷 4322-4341页

作者： Andras Bibok Dae Won Kim Mokenge Malafa Bela Kis Department of Diagnostic Imaging and Interventional Radiology H.Lee Moffitt Cancer CenterTampaFL 33612United States Department of Transplantation&Surgery Radiology UnitSemmelweis UniversityBudapest 1085Hungary Department of Gastrointestinal Oncology H.Lee Moffitt Cancer CenterTampaFL 33612United States

Pancreatic cancer is a challenging malignancy with limited treatment options and poor life *** only curative option is surgical resection,but only 15%-20%of patients are resectable at presentation because more than 50%of patients has distant metastasis at diagnosis and the rest of them has locally advanced pancreatic cancer(LAPC).The standard of care first line treatment for LAPC patients is chemotherapy with or without radiation *** developments in minimally invasive ablative techniques may add to the treatment armamentarium of *** are increasing number of studies evaluating these novel ablative techniques,including radiofrequency ablation,microwave ablation,cryoablation and irreversible *** studies which included pancreatic tumor ablation,demonstrated improved overall survival in LAPC ***,the exact protocols are yet to set up to which stage of the treatment algorithm ablative techniques can be added and in what kind of treatment *** with metastatic pancreatic cancer has dismal prognosis with 5-year survival is only 3%.The most common metastatic site is the liver as 90%of pancreatic cancer patients develop liver *** is the primary treatment option for patients with metastatic pancreatic ***,when the tumor is not responding to chemotherapy or severe drug toxicity develops,locoregional liver-directed therapies can provide an opportunity to control intrahepatic disease progression and improve survival in selected *** the last decade new therapeutic options arose with the advancement of minimally invasive technologies to treat pancreatic cancer *** new therapies have been a topic of increasing interest due to the severe prognostic implications of locally advanced and metastatic pancreatic cancer and the low comorbid risk of these *** review summarizes new ablative options for patients with LAPC and percutaneous liver-directed th

关键词： Pancreatic neoplasms Interventional radiology ablation techniques Electroporation Radiofrequency ablation Therapeutic embolization

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Radiological findings in non-surgical recurrent hepatocellular carcinoma:From locoregional treatments to immunotherapy

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World Journal of Gastroenterology 2023年第11期29卷 1669-1684页

作者： Davide Ippolito Cesare Maino Marco Gatti Paolo Marra Riccardo Faletti Francesco Cortese Riccardo Inchingolo Sandro Sironi Department of Radiology IRCCS San Gerardo dei TintoriMonza 20900Italy School of Medicine and Surgery University of Milano-BicoccaMilano 20121Italy Department of Surgical Sciences University of TurinTurin 10126Italy Department of Diagnostic and Interventional Radiology Papa Giovanni ⅩⅩⅢ HospitalBergamo 24127Italy Interventional Radiology Unit “F.Miulli”Regional General HospitalBari 70121Italy

Since hepatocellular carcinoma(HCC)represents an important cause of mortality and morbidity all over the ***,it is fundamental not only to achieve a curative treatment but also to manage in the best way any possible *** if the latest update of the Barcelona Clinic Liver Cancer guidelines for HCC treatment has introduced new locoregional techniques and confirmed others as well-established clinical practices,there is still no consensus about the treatment of recurrent HCC(RHCC).Locoregional treatments and medical therapy represent two of the most widely accepted approaches for disease control,especially in the advanced stage of liver *** medical treatments are now approved,and others are under *** this basis,radiology plays a central role in the diagnosis of RHCC and the assessment of response to locoregional treatments and medical therapy for *** review summarized the actual clinical practice by underlining the importance of the radiological approach both in the diagnosis and treatment of RHCC.

关键词： Carcinoma Hepatocellular Liver ablation Catheter Radio frequency ablation ablation techniques Medication therapy management RECIST

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Role of gadoxetic acid-enhanced liver magnetic resonance imaging in the evaluation of hepatocellular carcinoma after locoregional treatment

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World Journal of Gastroenterology 2022年第26期28卷 3116-3131页

作者： Marco Gatti Cesare Maino Fatemeh Darvizeh Alessandro Serafini Eleonora Tricarico Alessia Guarneri Riccardo Inchingolo Davide Ippolito Umberto Ricardi Paolo Fonio Riccardo Faletti Department of Surgical Sciences University of TurinTurin 10126Italy Department of Diagnostic Radiology University of Milano-BicoccaMonza 20900Italy Department of Diagnostic Radiology Ospedale San GerardoMonza 20900Italy School of Medicine Vita-Salute San Raffaele UniversityMilan 20121Italy Department of Radiology "F.Perinei"HospitalAltamura(BA)70022Italy Department of Oncology University of TurinTurin 10126Italy Interventional Radiology Unit “F.Miulli”Regional General HospitalAcquaviva delle Fonti(BA)70021Italy

Locoregional treatments,as alternatives to surgery,play a key role in the management of hepatocellular carcinoma(HCC).Liver magnetic resonance imaging(MRI)enables a multiparametric assessment,going beyond the traditional dynamic computed tomography ***,the use of hepatobiliary agents can improve diagnostic accuracy and are becoming important in the diagnosis and follow-up of ***,the main challenge is to quickly identify classical responses to loco-regional treatments in order to determine the most suitable management strategy for each *** aim of this review is to provide a summary of the most common and uncommon liver MRI findings in patients who underwent loco-regional treatments for HCC,with a special focus on ablative therapies(radiofrequency,microwaves and cryoablation),transarterial chemoembolization,trans-arterial radio-embolization and stereotactic ablative radiotherapy techniques,considering the usefulness of gadoxetate disodium(Gd-EOB-DTPA)contrast agent.

关键词： Carcinoma Hepatocellular Magnetic resonance imaging Gd-EOB-DTPA Radiofrequency ablation Catheter ablation ablation techniques

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Application of ablative therapy for intrahepatic recurrent hepatocellular carcinoma following hepatectomy

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World Journal of Gastrointestinal Surgery 2023年第1期15卷 9-18页

作者： Rong Cong Xiao-Hong Ma Shuang Wang Bing Feng Wei Cai Zhao-Wei Chen Xin-Ming Zhao Department of Diagnostic Radiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

The post-hepatectomy recurrence rate of hepatocellular carcinoma(HCC)is persistently high,affecting the prognosis of *** effective therapeutic option is crucial for achieving long-term survival in patients with postoperative *** ablative therapy has been established as a treatment option for resectable and unresectable HCCs,and it is also a feasible approach for recurrent HCC(RHCC)due to less trauma,shorter operation times,fewer complications,and faster *** review focused on ablation techniques,description of potential candidates,and therapeutic and prognostic implications of ablation for guiding its application in treating intrahepatic RHCC.

关键词： Hepatocellular carcinoma Recurrence ablation techniques Radiofrequency ablation Combined therapy Therapeutic index

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Liver-directed therapies for liver metastases from neuroendocrine neoplasms:Can laser ablation play any role?

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World Journal of Gastroenterology 2020年第23期26卷 3118-3125页

作者： Sergio Sartori Lara Bianchi Francesca Di Vece Paola Tombesi Department of Internal Medicine Section of Interventional UltrasoundSt.Anna HospitalFerrara 44100Italy

Aggressive cytoreduction can prolong survival in patients with unresectable liver metastases(LM)from neuroendocrine neoplasms(NEN),and minimally invasive,liver-directed therapies are gaining increasing ***-based treatments are used in disseminated disease,whereas ablation techniques are usually indicated when the number of LM is *** radiofrequency ablation(RFA)is by far the most used ablative technique,the goal of this opinion review is to explore the potential role of laser ablation(LA)in the treatment of LM from *** uses thinner needles than RFA,and this is an advantage when the tumors are in at-risk ***,the multi-fiber technique enables the use of one to four laser fibers at once,and each fiber provides an almost spherical thermal lesion of 12-15 mm in *** a characteristic enables to tailor the size of each thermal lesion to the size of each tumor,sparing the liver parenchyma more than any other liver-directed therapy,and allowing for repeated treatments with low risk of liver failure.A recent retrospective study reporting the largest series of LM treated with LA documents both safety and effectiveness of LA,that can play a useful role in the multimodality approach to LM from NEN.

关键词： Neuroendocrine neoplasms Liver metastases Liver-directed therapies ablation techniques Laser ablation Radiofrequency ablation

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Imaging-based prediction of hepatocellular carcinoma recurrence after microwave ablation as bridge therapy: A glimpse into the future

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World Journal of Transplantation 2024年第4期14卷 1-5页

作者： Cristian Lindner Rodrigo San Martín Andrés Concha David Clemo Jorge Valenzuela Department of Radiology Faculty of MedicineUniversity of ConcepciónConcepción 4030000Chile Department of Radiology Hospital Regional Guillermo Grant BenaventeConcepción 4030000BiobíoChile

Liver transplantation(LT)remains the treatment of choice for early-stage hepato-cellular carcinoma(HCC)and offers the best long-term oncological ***,the increasing waiting list for LT has led to a significant dropout rate as patients experience tumor progression beyond the Milan ***,locoregional therapies,such as microwave ablation(MWA),have emerged as promising bridge treatments for patients awaiting *** therapies have shown promising results in preventing tumor progression,thus reducing the dropout rate of LT *** the efficacy of MWA in treating HCC,tumoral recurrence after ablation remains a major challenge and significantly impacts the prognosis of HCC ***,accurately diagnosing tumoral recurrence post-ablation is *** studies have developed novel imaging features based on magnetic resonance imaging of HCC,which could provide essential information for predicting early tumoral recurrence after *** advancements could address this unresolved challenge,improving the clinical outcomes of patients on the LT waiting *** article explored the current landscape of MWA as a bridge therapy for HCC within the Milan criteria,high-lighting the emerging role of novel imaging-based features aimed at improving the prediction of tumor recurrence after MWA.

关键词： Liver transplantation Hepatocellular carcinoma ablation techniques Multiparametric magnetic resonance imaging Interventional oncology Liver disease Microwaves

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Current concepts in hepatic resection for hepatocellular carcinoma in cirrhotic patients

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World Journal of Gastroenterology 2012年第44期18卷 6398-6408页

作者： Alessandro Cucchetti Matteo Cescon Franco Trevisani Antonio Daniele Pinna General Surgery and Transplant Unit Department of General Surgery and Organ TransplantationAlma Mater StudiorumUniversity of Bologna40138 BolognaItaly Department of Clinical Medicine Semeiotica MedicaS.Orsola-Malpighi HospitalAlma Mater StudiorumUniversity of BolognaVia Massarenti 940138 BolognaItaly

Hepatocellular carcinoma(HCC) is one of the most frequent neoplasms worldwide and in most cases it is associated with liver *** resection is considered the most potentially curative therapy for HCC patients when liver transplantation is not an option or is not immediately *** review is aimed at investigating the current concepts that drive the surgical choice in the treatment of HCC in cirrhotic patients;Eastern and Western perspectives are *** extensive literature review of the last two decades was performed,on topics covering various aspects of hepatic *** post-operative and long-term outcome measures adopted were firstly analyzed in an attempt to define an optimal standardization useful for research *** need to avoid the development of post-hepatectomy liver failure represents the "conditio sine qua non" of surgical choice and the role of the current tools available for the assessment of liver function reserve were *** of hepatic resection in relationship with tumor burden were compared with those of available competing strategies,namely,radiofrequency ablation for early stages,and trans-arterial chemoembolization for intermediate and advanced ***,the choice for anatomical versus non-anatomical,as well as the role of laparoscopic approach,was *** literature review suggests that partial hepatectomy for HCC should be considered in the context of multi-disciplinary evaluation of cirrhotic *** research on HCC has moved,in recent years,from surgical therapy toward non-surgical approaches and most of the literature regarding topics debated in the present review is represented by observational studies,whereas very few well-designed randomized controlled trials are currently available;thus,no robust recommendations can be derived.

关键词： Hepatocellular carcinoma Hepatic resec-tion Surgical therapy ablation techniques Transplan-tation Survival Liver failure

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