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Image-Guided Transarterial and Percutaneous Interventional Oncology Therapies

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A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Radiobiology and Nuclear Medicine".

Deadline for manuscript submissions: closed (17 March 2023) | Viewed by 8835

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Special Issue Editors

Dr. Nariman Nezami

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Guest Editor

Vascular and Interventional Radiology, Department of Radiology, Georgetwon University School of Medicine, Washington, DC, USA
Interests: interventional oncology; interventional immunology; tumor microenvironment; tumor immune cells; tumor microenvironment manipulation
Special Issues, Collections and Topics in MDPI journals

Dr. Peiman Habibollahi

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Guest Editor

Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Interests: radiology; interventional radiology; ultrasound radiomics; embolization; liver tumors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

For years, surgical resection and systemic therapy ± radiation therapy were the mainstay of treatments for primary and metastatic tumors. However, development and advancement of the imaging modalities and improvement of availability of the advanced imaging techniques have resulted in increased precision and popularity of image guided locoregional therapies which are divided into transarterial or percutaneous therapies.

Transarterial embolization was initially the most widely used locoregional therapeutic approach, used to be the mainstay of treatment for cases with unresectable cancer entities. However, transarterial is not the only image guided locoregional therapies and has its own limitation. For those patients with hypovascular tumors or uncertain arterial blood supply, embolization is a suboptimal treatment option, resulting in incomplete coverage of tumor, recurrent tumor, or residual tumor, which could turn into hypoxia or chemotherapy resistance tumor. Also, for patients with limited hepatic function reserve, transarterial are associated with higher risk of liver failure.

Image guided percutaneous locoregional therapies have evolved as chemical, thermal, nonthermal, or percutaneous energy delivery techniques. Percutaneous ethanol injection (PEI), radiofrequency ablation (RFA), microwave ablation (MWA), cryoablation (CA), laser-induced thermotherapy (LITT), irreversible electroporation (IRE), high-intensity focused ultrasound (HIFU), or histotripsy are only a few of image guided percutaneous locoregional therapies have been increasingly utilized for treatment of primary and metastatic tumors.

This special issue of Life Journal will present the current status of imaging-guided transarterial and percutaneous locoregional treatments for different organs tumors.

Dr. Nariman Nezami
Dr. Peiman Habibollahi
Guest Editors

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Keywords

tumor
locoregional therapy
transarterial
embolization
ablation

Published Papers (4 papers)

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Research

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12 pages, 1511 KiB

Open AccessArticle

Single-Compartment Dose Prescriptions for Ablative ⁹⁰Y-Radioembolization Segmentectomy

by Srinivas Cheenu Kappadath and Benjamin P. Lopez

Life 2023, 13(6), 1238; https://doi.org/10.3390/life13061238 - 24 May 2023

Cited by 2 | Viewed by 1121

Abstract

Background: Yttrium-90 (⁹⁰Y) radioembolization is increasingly being utilized with curative intent. While single-compartment doses with respect to the perfused volume for the complete pathologic necrosis (CPN) of tumors have been reported, the actual doses delivered to the tumor and at-risk margins that leads to CPN have hitherto not been estimated. We present an ablative dosimetry model that calculates the dose distribution for tumors and at-risk margins based on numerical mm-scale dose modeling and the available clinical CPN evidence and report on the necessary dose metrics needed to achieve CPN following ⁹⁰Y-radioembolization. Methods: Three-dimensional (3D) activity distributions (MBq/voxel) simulating spherical tumors were modeled with a 121 × 121 × 121 mm³ soft tissue volume (1 mm³ voxels). Then, 3D dose distributions (Gy/voxel) were estimated by convolving 3D activity distributions with a ⁹⁰Y 3D dose kernel (Gy/MBq) sized 61 × 61 × 61 mm³ (1 mm³ voxels). Based on the published data on single-compartment segmental doses for the resected liver samples of HCC tumors showing CPN after radiation segmentectomy, the nominal voxel-based mean tumor dose (

D_{m e a n}^{C P N}

), point dose at tumor rim (

D_{r i m}^{C P N}

), and point dose 2 mm beyond the tumor boundary (

D_{2 m m}^{C P N}

), which are necessary to achieve CPN, were calculated. The single-compartment dose prescriptions to required achieve CPN were then analytically modeled for more general cases of tumors with diameters

d_{t}

= 2, 3, 4, 5, 6, and 7 cm and with tumor-to-normal-liver uptake ratios

T : N

= 1:1, 2:1, 3:1, 4:1, and 5:1. Results: The nominal case defined to estimate the doses needed for CPN, based on the previously published clinical data, was a single hyperperfused tumor with a diameter of 2.5 cm and

T : N

= 3:1, treated with a single-compartment segmental dose of 400 Gy. The voxel-level doses necessary to achieve CPN were 1053 Gy for the mean tumor dose, 860 Gy for the point dose at the tumor boundary, and 561 Gy for the point dose at 2 mm beyond the tumor edge. The single-compartment segmental doses necessary to satisfy the criteria for CPN in terms of the mean tumor dose, point dose at the tumor boundary, and the point dose at 2 mm beyond the tumor edge were tabulated for a range of tumor diameters and tumor-to-normal-liver uptake ratios. Conclusions: The analytical functions that describe the relevant dose metrics for CPN and, more importantly, the single-compartment dose prescriptions for the perfused volume needed to achieve CPN are reported for a large range of conditions in terms of tumor diameters (1–7 cm) and

T : N

uptake ratios (2:1–5:1). Full article

(This article belongs to the Special Issue Image-Guided Transarterial and Percutaneous Interventional Oncology Therapies)

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Review

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12 pages, 1142 KiB

Open AccessReview

Transarterial Embolization and Percutaneous Ablation of Primary and Metastatic Soft Tissue Tumors

by Chang Shu, Maria Lim and Adam Fang

Life 2023, 13(7), 1485; https://doi.org/10.3390/life13071485 - 30 Jun 2023

Cited by 3 | Viewed by 1666

Abstract

Soft tissue tumors (STTs) include a range of benign and malignant tumors originating from soft tissues. Transarterial and percutaneous therapies are image-guided and minimally invasive approaches for managing primary and metastatic STTs. The objective of this review is to discuss transarterial and percutaneous therapies by examining the current literature, including indications, patient selection, safety, and effectiveness. Transarterial therapies (e.g., transarterial bland embolization and transarterial chemoembolization) involve the delivery of either embolic or chemotherapeutic particles using a catheter into arteries feeding the tumor, resulting in localized tumor destruction. Percutaneous therapies (e.g., radiofrequency ablation, cryoablation, irreversible electroporation, laser ablation, and magnetic resonance-guided high-intensity focused ultrasound) involve the delivery of either hot or cold temperatures, electrical current, laser, or ultrasound to specifically target tumor cells. Both therapies have been shown to be safe and effective for reducing morbidity and local control of STTs, specifically in patients who are surgically inoperable or who are unresponsive to conventional therapies. Accurate diagnosis, staging, and histological subtype identification are crucial for treatment selection. A multidisciplinary approach, a thorough understanding of tissue anatomy and surrounding structures, as well as individualized strategies based on assessment are essential for optimal patient care. Full article

(This article belongs to the Special Issue Image-Guided Transarterial and Percutaneous Interventional Oncology Therapies)

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Figure 1

12 pages, 4205 KiB

Open AccessReview

Role of the Interventional Radiologist in the Treatment of Desmoid Tumors

by Daniel Goldberg, Gregory Woodhead, Jack Hannallah and Shamar Young

Life 2023, 13(3), 645; https://doi.org/10.3390/life13030645 - 26 Feb 2023

Cited by 3 | Viewed by 2027

Abstract

Desmoid tumors are locally aggressive soft tissue tumors with variable clinical presentation. As is the case with most relatively rare tumors, a multidisciplinary team approach is required to best manage these patients. Surgical resection, systemic therapy, and radiation therapy have classically been mainstays of treatment for desmoid tumors; however, a more conservative “wait-and-see” approach has been adopted given their high recurrence rates and significant morbidity associated with the aforementioned therapies. Given the challenges of classical treatment methods, interventional radiologists have begun to play a significant role in minimally invasive interventions for desmoid tumors. Herein, the authors review imaging characteristics of desmoid tumors, current management recommendations, and minimally invasive therapeutic intervention options. Full article

(This article belongs to the Special Issue Image-Guided Transarterial and Percutaneous Interventional Oncology Therapies)

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17 pages, 1015 KiB

Open AccessReview

Portal Vein Embolization: Rationale, Techniques, and Outcomes to Maximize Remnant Liver Hypertrophy with a Focus on Contemporary Strategies

by Jonathan Charles, Nariman Nezami, Mohammad Loya, Samuel Shube, Cliff Davis, Glenn Hoots and Jamil Shaikh

Life 2023, 13(2), 279; https://doi.org/10.3390/life13020279 - 19 Jan 2023

Cited by 1 | Viewed by 3520

Abstract

Hepatectomy remains the gold standard for curative therapy for patients with limited primary or metastatic hepatic tumors as it offers the best survival rates. In recent years, the indication for partial hepatectomy has evolved away from what will be removed from the patient to the volume and function of the future liver remnant (FLR), i.e., what will remain. With this regard, liver regeneration strategies have become paramount in transforming patients who previously had poor prognoses into ones who, after major hepatic resection with negative margins, have had their risk of post-hepatectomy liver failure minimized. Preoperative portal vein embolization (PVE) via the purposeful occlusion of select portal vein branches to promote contralateral hepatic lobar hypertrophy has become the accepted standard for liver regeneration. Advances in embolic materials, selection of treatment approaches, and PVE with hepatic venous deprivation or concurrent transcatheter arterial embolization/radioembolization are all active areas of research. To date, the optimal combination of embolic material to maximize FLR growth is not yet known. Knowledge of hepatic segmentation and portal venous anatomy is essential before performing PVE. In addition, the indications for PVE, the methods for assessing hepatic lobar hypertrophy, and the possible complications of PVE need to be fully understood before undertaking the procedure. The goal of this article is to discuss the rationale, indications, techniques, and outcomes of PVE before major hepatectomy. Full article

(This article belongs to the Special Issue Image-Guided Transarterial and Percutaneous Interventional Oncology Therapies)

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