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Extracellular matrix collagen I promotes the tumor progression of residual hepatocellular carcinoma after heat treatment. BMC Cancer 2018; 18:901. [PMID: 30227844 PMCID: PMC6145107 DOI: 10.1186/s12885-018-4820-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 09/13/2018] [Indexed: 12/29/2022] Open
Abstract
Background Accelerated malignant behaviors induced by insufficient thermal ablation have been increasingly reported, however, the exact mechanisms are still unclear. Here, we investigated the importance of the extracellular matrix (ECM) in modulating the progression of residual hepatocellular carcinoma (HCC) after heat treatment. Methods Heat-exposed residual HCC cells were cultured in different ECM gels. We used basement membrane gel (Matrigel) to simulate the normal microenvironment and collagen I to model the pathological stromal ECM. The alterations of morphology and parameters of proliferation, epithelial-mesenchymal transition (EMT) and stemness were analyzed in vitro and in vivo. Results Increased collagen I deposition was observed at the periablational zone after incomplete RFA of HCC in a xenograft model. The markers of cell proliferation, EMT, motility and progenitor-like traits of heat-exposed residual HCC cells were significantly induced by collagen I as compared to Matrigel (p values all < 0.05). Importantly, collagen I induced the activation of ERK phosphorylation in heat-exposed residual HCC cells. ERK1/2 inhibitor reversed the collagen I-promoted ERK phosphorylation, cell proliferative, protrusive and spindle-like appearance of heat-treated residual HCC cells in vitro. Moreover, collagen I promoted the in vivo tumor progression of heat-exposed residual HCC cells, and sorafenib markedly reversed the collagen I-mediated protumor effects. Conclusions Our findings demonstrate that collagen I could enhance the aggressive progression of residual HCC cells after suboptimal heat treatment and sorafenib may be a treatment approach to thwart this process. Electronic supplementary material The online version of this article (10.1186/s12885-018-4820-9) contains supplementary material, which is available to authorized users.
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Interventional therapy combined with immune checkpoint inhibitors: Emerging opportunities for cancer treatment in the era of immunotherapy. Cancer Treat Rev 2018; 74:49-60. [PMID: 30831375 DOI: 10.1016/j.ctrv.2018.08.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 08/12/2018] [Accepted: 08/17/2018] [Indexed: 12/16/2022]
Abstract
Immune checkpoint inhibitors-based immunotherapy offers a new effective modality in the treatment of advanced malignancies. Considering the remarkable efficacy of immune checkpoint inhibitors in clinical trials, the FDA has approved a variety of immune checkpoint inhibitors for the treatment of advanced tumors. However, only limited patients with certain cancers can benefit from monotherapy of immune checkpoint inhibitors. Interventional therapy for cancer can not only destroy the primary tumors, but also regulate the immune system through different mechanisms, which provides a potential possibility for the combination of immune checkpoint inhibitors and interventional modalities in cancer treatment. This article reviews the possible synergistic mechanisms of interventional therapy combined with immune checkpoint inhibitors and summarizes the research progress of the combined therapy in cancer treatment.
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Jondal DE, Thompson SM, Butters KA, Knudsen BE, Anderson JL, Carter RE, Roberts LR, Callstrom MR, Woodrum DA. Heat Stress and Hepatic Laser Thermal Ablation Induce Hepatocellular Carcinoma Growth: Role of PI3K/mTOR/AKT Signaling. Radiology 2018; 288:730-738. [PMID: 29737948 DOI: 10.1148/radiol.2018172944] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purpose To determine if heat stress and hepatic laser thermal ablation induce hepatocellular carcinoma (HCC) growth and to identify growth factors induced by heat stress. Materials and Methods Non-heat-stressed HCC cells were cocultured with HCC cells or hepatocytes that were heat stressed at 37°C (physiologic), 45°C (moderate), or 50°C (severe) for 10 minutes and proliferation monitored with bioluminescence imaging for up to 6 days after heat stress (three experiments). Rats bearing orthotopic N1S1 HCC were randomly assigned to undergo immediate sham or laser thermal (3 W for 60 or 90 seconds; hereafter, 3W×60s and 3W×90s, respectively) ablation of the median (local) or left (distant) hepatic lobe, and tumor growth was monitored with magnetic resonance imaging for up to 18 days after ablation (six or more rats per group). Experiments were repeated with rats randomly assigned to receive either the adjuvant phosphoinositide 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) inhibitor (NVP-BEZ235) or the vehicle control. Heat-stressed HCC cells and hepatocytes were analyzed by using microarray or quantitative real-time polymerase chain reaction analysis for growth factor expression (three or more experiments). Groups were compared by using one- or two-way analysis of variance, and post hoc pairwise comparison was performed with the Dunnett test. Results There were more non-heat-stressed HCC cells when cells were cocultured with cells subjected to moderate but not physiologic or severe heat stress (P < .001 for both). Local intrahepatic N1S1 tumors were larger at day 18 in the 3W×60s (mean, 3102 mm3 ± 463 [standard error]; P = .004) and 3W×90s (mean, 3538 mm3 ± 667; P < .001) groups than in the sham group (mean, 1363 mm3 ± 361) but not in distant intrahepatic tumors (P = .31). Adjuvant BEZ235 resulted in smaller N1S1 tumors in the BEZ235 and laser thermal ablation group than in the vehicle control and laser thermal ablation group (mean, 1731 mm3 ± 1457 vs 3844 mm3 ± 2400, P < .001). Moderate heat stress induced expression of growth factors in HCC cells and hepatocytes, including heparin-binding growth factor, fibroblast growth factor 21, and nerve growth factor (range, 2.9-66.9-fold; P < .05). Conclusion Moderate heat stress and laser thermal ablation induce hepatocellular carcinoma growth, which is prevented with adjuvant PI3K/mTOR/protein kinase B inhibition.
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Affiliation(s)
- Danielle E Jondal
- From the Department of Radiology (D.E.J., S.M.T., K.A.B., B.E.K., J.L.A., M.R.C., D.A.W.) and Division of Gastroenterology and Hepatology (L.R.R.), Mayo Clinic School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Health Sciences Research, Mayo Clinic School of Medicine, Jacksonville, Fla (R.E.C.)
| | - Scott M Thompson
- From the Department of Radiology (D.E.J., S.M.T., K.A.B., B.E.K., J.L.A., M.R.C., D.A.W.) and Division of Gastroenterology and Hepatology (L.R.R.), Mayo Clinic School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Health Sciences Research, Mayo Clinic School of Medicine, Jacksonville, Fla (R.E.C.)
| | - Kim A Butters
- From the Department of Radiology (D.E.J., S.M.T., K.A.B., B.E.K., J.L.A., M.R.C., D.A.W.) and Division of Gastroenterology and Hepatology (L.R.R.), Mayo Clinic School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Health Sciences Research, Mayo Clinic School of Medicine, Jacksonville, Fla (R.E.C.)
| | - Bruce E Knudsen
- From the Department of Radiology (D.E.J., S.M.T., K.A.B., B.E.K., J.L.A., M.R.C., D.A.W.) and Division of Gastroenterology and Hepatology (L.R.R.), Mayo Clinic School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Health Sciences Research, Mayo Clinic School of Medicine, Jacksonville, Fla (R.E.C.)
| | - Jill L Anderson
- From the Department of Radiology (D.E.J., S.M.T., K.A.B., B.E.K., J.L.A., M.R.C., D.A.W.) and Division of Gastroenterology and Hepatology (L.R.R.), Mayo Clinic School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Health Sciences Research, Mayo Clinic School of Medicine, Jacksonville, Fla (R.E.C.)
| | - Rickey E Carter
- From the Department of Radiology (D.E.J., S.M.T., K.A.B., B.E.K., J.L.A., M.R.C., D.A.W.) and Division of Gastroenterology and Hepatology (L.R.R.), Mayo Clinic School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Health Sciences Research, Mayo Clinic School of Medicine, Jacksonville, Fla (R.E.C.)
| | - Lewis R Roberts
- From the Department of Radiology (D.E.J., S.M.T., K.A.B., B.E.K., J.L.A., M.R.C., D.A.W.) and Division of Gastroenterology and Hepatology (L.R.R.), Mayo Clinic School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Health Sciences Research, Mayo Clinic School of Medicine, Jacksonville, Fla (R.E.C.)
| | - Matthew R Callstrom
- From the Department of Radiology (D.E.J., S.M.T., K.A.B., B.E.K., J.L.A., M.R.C., D.A.W.) and Division of Gastroenterology and Hepatology (L.R.R.), Mayo Clinic School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Health Sciences Research, Mayo Clinic School of Medicine, Jacksonville, Fla (R.E.C.)
| | - David A Woodrum
- From the Department of Radiology (D.E.J., S.M.T., K.A.B., B.E.K., J.L.A., M.R.C., D.A.W.) and Division of Gastroenterology and Hepatology (L.R.R.), Mayo Clinic School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Health Sciences Research, Mayo Clinic School of Medicine, Jacksonville, Fla (R.E.C.)
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Abstract
OBJECTIVE The purpose of this article is to discuss the use, comparative efficacy, and general technical considerations of percutaneous ablation, alone or in combination with other therapies, for the treatment of hepatocellular carcinoma (HCC). CONCLUSION Percutaneous ablation is a mainstay treatment for early-stage HCC, offering survival comparable to that of surgical resection for small lesions. It can act as a primary curative therapy or bridge therapy for patients waiting to undergo liver transplant. New ablation modalities and combining tumor ablation with other therapies, such as transarterial chemoembolization, can improve clinical outcomes and allow treatment of larger lesions. Combining thermal ablation with systemic chemotherapy, including immunotherapy, is an area of future development.
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Ahmed M, Kumar G, Gourevitch S, Levchenko T, Galun E, Torchilin V, Goldberg SN. Radiofrequency ablation (RFA)-induced systemic tumor growth can be reduced by suppression of resultant heat shock proteins. Int J Hyperthermia 2018; 34:934-942. [PMID: 29631466 DOI: 10.1080/02656736.2018.1462535] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To determine the role of hepatic radiofrequency ablation (RFA) heating parameters and their activation of heat shock proteins (HSPs) in modulating distant tumor growth. METHODS AND MATERIALS First, to study the effects of RFA dose on distant tumor growth, rats with subcutaneous R3230 adenocarcinoma (10 ± 1 mm) were assigned to 3 different hepatic RF doses (60 °C × 10 min, 70 °C × 5 min or 90 °C × 2 min) that induced identical sized ablation or sham (n = 6/arm). Post-RFA tumor growth rates, cellular proliferation (Ki-67) and microvascular density (MVD) were compared at 7d. Next, the effect of low and high power doses on local HSP70 expression and cellular infiltration (α-SMA + myofibroblasts and CD68 + macrophages), cytokine (IL-6) and growth factor (HGF and VEGF) expression was assessed. Finally, 60 °C × 10 min and 90 °C × 2 min RFA were combined with anti-HSP micellar quercetin (MicQ, 2 mg/ml). A total of 150 animals were used. RESULTS Lower RF heating (70 °C × 5 min and 60 °C × 10 min) resulted in larger distant tumors at 7d (19.2 ± 0.8 mm for both) while higher RF heating (90 °C × 2) led to less distant tumor growth (16.7 ± 1.5 mm, p < .01 for both), though increased over sham (13.5 ± 0.5 mm, p < .01). Ki-67 and MVD correlated with tumor growth (p < .01 for all). Additionally, lower dose 60 °C × 10 min hepatic RFA had more periablational HSP70 compared to 90 °C × 2 min (rim: 1.106 ± 163 µm vs. 360 ± 18 µm, p < .001), with similar trends for periablational α-SMA, CD68 and CDC47 (p < .01 for all). Anti-HSP70 MicQ blocked distant tumor growth for lower dose (60 °C × 10: RF/MicQ 14.6 ± 0.4 mm vs. RF alone: 18.1 ± 0.4 mm, p < .01) and higher dose RFA (90 °C × 2 min: RF/MicQ 14.6 ± 0.5 mm vs. RF alone: 16.4 ± 0.7 mm, p < .01). CONCLUSION Hepatic RF heating parameters alter periablational HSP70, which can influence and stimulate distant tumor growth. Modulation of RF heating parameters alone or in combination with adjuvant HSP inhibition can reduce unwanted, off-target systemic tumorigenic effects.
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Affiliation(s)
- Muneeb Ahmed
- a Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology , Beth Israel Deaconess Medical Center/Harvard Medical School , Boston , MA , USA
| | - Gaurav Kumar
- a Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology , Beth Israel Deaconess Medical Center/Harvard Medical School , Boston , MA , USA
| | - Svetlana Gourevitch
- b Division of Image-guided Therapy and Interventional Oncology, Department of Radiology , Hadassah Hebrew University Medical Center , Jerusalem , Israel
| | - Tatyana Levchenko
- c Department of Pharmaceutical Sciences, Center for Pharmaceutical Biotechnology and Nanomedicine , Northeastern University , Boston , MA , USA
| | - Eithan Galun
- d Department of Gene Therapy , Hadassah Hebrew University Medical Center , Jerusalem , Israel
| | - Vladimir Torchilin
- c Department of Pharmaceutical Sciences, Center for Pharmaceutical Biotechnology and Nanomedicine , Northeastern University , Boston , MA , USA
| | - S Nahum Goldberg
- a Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology , Beth Israel Deaconess Medical Center/Harvard Medical School , Boston , MA , USA.,b Division of Image-guided Therapy and Interventional Oncology, Department of Radiology , Hadassah Hebrew University Medical Center , Jerusalem , Israel.,d Department of Gene Therapy , Hadassah Hebrew University Medical Center , Jerusalem , Israel
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Murali N, Laage-Gaupp FM, Chapiro J, Geschwind JF. Science to Practice: Decrypting the Enigma of Ablation-induced Off-Target Effects-Is Network Pathway Analysis the Final Piece of the Puzzle? Radiology 2018; 286:405-408. [PMID: 29356646 DOI: 10.1148/radiol.2017171779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
As part of the ongoing effort to better understand and mitigate pro-oncogenic off-target effects of imaging-guided radiofrequency ablation (RFA), Kumar et al ( 1 ) used gene expression and network pathway analysis to examine the gene activation profiles in the peri-ablational zone after RFA in a breast adenocarcinoma liver metastasis animal model. Their analysis identified STAT3 (signal transducer and activator of transcription 3) as a key transcription factor upregulated in many signaling pathways in the peri-ablational zone after RFA. Consequently, the authors successfully used two STAT3 inhibitors to reduce distant tumor growth after treatment with RFA. By demonstrating that judicious and appropriate adjuvant therapy helped contain distant tumor growth caused by ablation, Kumar et al have managed to pave the road ahead for the definitive success of ablation.
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Affiliation(s)
- Nikitha Murali
- Department of Radiology and Biomedical Imaging Yale University School of Medicine New Haven, Conn.,PreScience Labs 40 Harbor Rd Westport, CT 06880
| | - Fabian Max Laage-Gaupp
- Department of Radiology and Biomedical Imaging Yale University School of Medicine New Haven, Conn.,PreScience Labs 40 Harbor Rd Westport, CT 06880
| | - Julius Chapiro
- Department of Radiology and Biomedical Imaging Yale University School of Medicine New Haven, Conn.,PreScience Labs 40 Harbor Rd Westport, CT 06880
| | - Jean-François Geschwind
- Department of Radiology and Biomedical Imaging Yale University School of Medicine New Haven, Conn.,PreScience Labs 40 Harbor Rd Westport, CT 06880
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Hickey RM. Reply to: “Re: Immuno-oncology and Its Opportunities for Interventional Radiologists: Immune Checkpoint Inhibition and Potential Synergies with Interventional Oncology Procedures”. J Vasc Interv Radiol 2018; 29:587. [DOI: 10.1016/j.jvir.2017.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022] Open
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Chang W, Lee JM, Lee DH, Yoon JH, Kim YJ, Yoon JH, Han JK. Comparison of switching bipolar ablation with multiple cooled wet electrodes and switching monopolar ablation with separable clustered electrode in treatment of small hepatocellular carcinoma: A randomized controlled trial. PLoS One 2018; 13:e0192173. [PMID: 29420589 PMCID: PMC5805261 DOI: 10.1371/journal.pone.0192173] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 01/16/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE A randomized controlled trial was conducted to prospectively compare the therapeutic effectiveness of switching bipolar (SB) radiofrequency ablation (RFA) using cooled-wet electrodes and switching monopolar (SM) RFA using separable clustered (SC) electrodes in patients with hepatocellular carcinomas (HCCs). MATERIALS AND METHODS This prospective study was approved by our Institutional Review Board. Between April 2014 and January 2015, sixty-nine patients with 74 HCCs were randomly treated with RFA using either internally cooled-wet (ICW) electrodes in SB mode (SB-RFA, n = 36) or SC electrodes in SM mode (SM-RFA, n = 38). Technical parameters including the number of ablations, ablation time, volume, energy delivery, and complications were evaluated. Thereafter, 1-year and 2-year local tumor progression (LTP) free survival rates were compared between the two groups using the Kaplan-Meier method. RESULTS In the SB-RFA group, less number of ablations were required (1.72±0.70 vs. 2.31±1.37, P = 0.039), the ablation time was shorter (10.9±3.9 vs.14.3±5.0 min, p = 0.004), and energy delivery was smaller (13.1±6.3 vs.23.4±12.8 kcal, p<0.001) compared to SM-RFA. Ablation volume was not significantly different between SB-RFA and SM-RFA groups (61.8±24.3 vs.54.9±23.7 cm3, p = 0.229). Technical failure occurred in one patient in the SM-RFA group, and major complications occurred in one patient in each group. The 1-year and 2-year LTP free survival rates were 93.9% and 84.3% in the SB-RFA group and 94.4% and 88.4% in the SM-RFA group (p = 0.687). CONCLUSION Both SB-RFA using ICW electrodes and SM-RFA using SC electrodes provided comparable LTP free survival rates although SB-RFA required less ablations and shorter ablation time.
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Affiliation(s)
- Won Chang
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Korea
- Seoul National University College of Medicine, Jongno-gu, Seou, Korea
- * E-mail:
| | - Dong Ho Lee
- Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Korea
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Korea
| | - Yoon Jun Kim
- Seoul National University College of Medicine, Jongno-gu, Seou, Korea
- Department of Internal Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea
| | - Jung Hwan Yoon
- Seoul National University College of Medicine, Jongno-gu, Seou, Korea
- Department of Internal Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Korea
- Seoul National University College of Medicine, Jongno-gu, Seou, Korea
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Mauri G, Nicosia L, Xu Z, Di Pietro S, Monfardini L, Bonomo G, Varano GM, Prada F, Della Vigna P, Orsi F. Focused ultrasound: tumour ablation and its potential to enhance immunological therapy to cancer. Br J Radiol 2018; 91:20170641. [PMID: 29168922 PMCID: PMC5965486 DOI: 10.1259/bjr.20170641] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/16/2017] [Accepted: 11/16/2017] [Indexed: 12/27/2022] Open
Abstract
Various kinds of image-guided techniques have been successfully applied in the last years for the treatment of tumours, as alternative to surgical resection. High intensity focused ultrasound (HIFU) is a novel, totally non-invasive, image-guided technique that allows for achieving tissue destruction with the application of focused ultrasound at high intensity. This technique has been successfully applied for the treatment of a large variety of diseases, including oncological and non-oncological diseases. One of the most fascinating aspects of image-guided ablations, and particularly of HIFU, is the reported possibility of determining a sort of stimulation of the immune system, with an unexpected "systemic" response to treatments designed to be "local". In the present article the mechanisms of action of HIFU are described, and the main clinical applications of this technique are reported, with a particular focus on the immune-stimulation process that might originate from tumour ablations.
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Affiliation(s)
- Giovanni Mauri
- Deparmtent of interventional radiology, European istitute of oncology, Milan, Italy
| | - Luca Nicosia
- Postgraduate School of Radiology, Università degli Studi di Milano, Milan, Italy
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Salvatore Di Pietro
- Postgraduate School of Radiology, Università degli Studi di Milano, Milan, Italy
| | - Lorenzo Monfardini
- Department of Radiology and diagnotic imaging, Poliambulazna di Brescia, Brescia, Italy
| | - Guido Bonomo
- Deparmtent of interventional radiology, European istitute of oncology, Milan, Italy
| | | | | | - Paolo Della Vigna
- Deparmtent of interventional radiology, European istitute of oncology, Milan, Italy
| | - Franco Orsi
- Deparmtent of interventional radiology, European istitute of oncology, Milan, Italy
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Hickey RM, Kulik LM, Nimeiri H, Kalyan A, Kircher S, Desai K, Riaz A, Lewandowski RJ, Salem R. Immuno-oncology and Its Opportunities for Interventional Radiologists: Immune Checkpoint Inhibition and Potential Synergies with Interventional Oncology Procedures. J Vasc Interv Radiol 2017; 28:1487-1494. [PMID: 28912090 DOI: 10.1016/j.jvir.2017.07.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/14/2017] [Accepted: 07/15/2017] [Indexed: 12/18/2022] Open
Abstract
Immunotherapy, specifically the use of immune checkpoint inhibitors, offers a new approach to fighting cancer. Although the results of treatment with immune checkpoint inhibition alone have been remarkable for certain cancers, these results are not universal. Preclinical and early clinical studies indicate the potential for synergistic effects when immune checkpoint inhibition is combined with immunogenic local therapies such as ablation and embolization. This review offers an overview of immunology as it relates to immune checkpoint inhibition and the possibilities for synergy when combined with interventional radiology treatments.
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Affiliation(s)
- Ryan M Hickey
- Department of Radiology, Section of Interventional Radiology, New York University, 560 First Ave., New York, NY 10016.
| | - Laura M Kulik
- Department of Medicine, Division of Hepatology, Northwestern University, Chicago, Illinois
| | - Halla Nimeiri
- Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Aparna Kalyan
- Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Sheetal Kircher
- Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Kush Desai
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, Illinois
| | - Ahsun Riaz
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, Illinois
| | - Robert J Lewandowski
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, Illinois
| | - Riad Salem
- Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois; Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, Illinois
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Kumar G, Goldberg SN, Gourevitch S, Levchenko T, Torchilin V, Galun E, Ahmed M. Targeting STAT3 to Suppress Systemic Pro-Oncogenic Effects from Hepatic Radiofrequency Ablation. Radiology 2017; 286:524-536. [PMID: 28880787 DOI: 10.1148/radiol.2017162943] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose To (a) identify key expressed genes in the periablational rim after radiofrequency ablation (RFA) and their role in driving the stimulation of distant tumor growth and (b) use adjuvant drug therapies to block key identified mediator(s) to suppress off-target tumorigenic effects of hepatic RFA. Materials and Methods This institutional animal care and use committee-approved study was performed in C57BL6 mice (n = 20) and F344 rats (n = 124). First, gene expression analysis was performed in mice after hepatic RFA or sham procedure; mice were sacrificed 24 hours to 7 days after treatment. Data were analyzed for differentially expressed genes (greater than twofold change) and their functional annotations. Next, animals were allocated to hepatic RFA or sham treatment with or without STAT3 (signal transducer and activator of transcription 3) inhibitor S3I-201 for periablational phosphorylated STAT3 immunohistochemistry analysis at 24 hours. Finally, animals with subcutaneous R3230 adenocarcinoma tumors were allocated to RFA or sham treatment with or without a STAT3 inhibitor (S3I-201 or micellar curcumin, eight arms). Outcomes included distant tumor growth, proliferation (Ki-67 percentage), and microvascular density. Results At 24 hours, 217 genes had altered expression (107 upregulated and 110 downregulated), decreasing to 55 genes (27 upregulated and 28 downregulated) and 18 genes (four upregulated, 14 downregulated) at 72 hours and 7 days, respectively. At 24 hours, STAT3 occurred in four of seven activated pathways associated with pro-oncogenic genes at network analysis. Immunohistochemistry analysis confirmed elevated periablational phosphorylated STAT3 24 hours after RFA, which was suppressed with S3I-201 (percentage of positive cells per field: 31.7% ± 3.4 vs 3.8% ± 1.7; P < .001). Combined RFA plus S3I-201 reduced systemic distant tumor growth at 7 days (end diameter: 11.8 mm ± 0.5 with RFA plus S3I-201, 19.8 mm ± 0.7 with RFA alone, and 15 mm ± 0.7 with sham procedure; P < .001). STAT3 inhibition with micellar curcumin also suppressed postablation stimulation of distant tumor growth, proliferation, and microvascular density (P < .01). Conclusion Gene expression analysis identified multiple pathways upregulated in the periablational rim after hepatic RFA, of which STAT3 was active in four of seven. Postablation STAT3 activation is linked to increased distant tumor stimulation and can be suppressed with adjuvant STAT3 inhibitors. © RSNA, 2017.
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Affiliation(s)
- Gaurav Kumar
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Rd, WCC 308-B, Boston, MA 02215 (G.K., S.N.G., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G.), and Goldyne Savad Institute of Gene Therapy (S.G., E.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Department of Pharmaceutical Sciences, Northeastern University, Boston, Mass (T.L., V.T.)
| | - S Nahum Goldberg
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Rd, WCC 308-B, Boston, MA 02215 (G.K., S.N.G., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G.), and Goldyne Savad Institute of Gene Therapy (S.G., E.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Department of Pharmaceutical Sciences, Northeastern University, Boston, Mass (T.L., V.T.)
| | - Svetlana Gourevitch
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Rd, WCC 308-B, Boston, MA 02215 (G.K., S.N.G., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G.), and Goldyne Savad Institute of Gene Therapy (S.G., E.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Department of Pharmaceutical Sciences, Northeastern University, Boston, Mass (T.L., V.T.)
| | - Tatyana Levchenko
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Rd, WCC 308-B, Boston, MA 02215 (G.K., S.N.G., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G.), and Goldyne Savad Institute of Gene Therapy (S.G., E.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Department of Pharmaceutical Sciences, Northeastern University, Boston, Mass (T.L., V.T.)
| | - Vladimir Torchilin
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Rd, WCC 308-B, Boston, MA 02215 (G.K., S.N.G., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G.), and Goldyne Savad Institute of Gene Therapy (S.G., E.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Department of Pharmaceutical Sciences, Northeastern University, Boston, Mass (T.L., V.T.)
| | - Eithan Galun
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Rd, WCC 308-B, Boston, MA 02215 (G.K., S.N.G., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G.), and Goldyne Savad Institute of Gene Therapy (S.G., E.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Department of Pharmaceutical Sciences, Northeastern University, Boston, Mass (T.L., V.T.)
| | - Muneeb Ahmed
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Rd, WCC 308-B, Boston, MA 02215 (G.K., S.N.G., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G.), and Goldyne Savad Institute of Gene Therapy (S.G., E.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Department of Pharmaceutical Sciences, Northeastern University, Boston, Mass (T.L., V.T.)
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Zhang R, Ma M, Dong G, Yao RR, Li JH, Zheng QD, Dong YY, Ma H, Gao DM, Cui JF, Ren ZG, Chen RX. Increased matrix stiffness promotes tumor progression of residual hepatocellular carcinoma after insufficient heat treatment. Cancer Sci 2017; 108:1778-1786. [PMID: 28699238 PMCID: PMC5581508 DOI: 10.1111/cas.13322] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/02/2017] [Accepted: 07/08/2017] [Indexed: 12/13/2022] Open
Abstract
Aggravated behaviors of hepatocellular carcinoma (HCC) will occur after inadequate thermal ablation. However, its underlying mechanisms are not fully understood. Here, we assessed whether the increased matrix stiffness after thermal ablation could promote the progression of residual HCC. Heat‐treated residual HCC cells were cultured on tailorable 3D gel with different matrix stiffness, simulating the changed physical environment after thermal ablation, and then the mechanical alterations of matrix stiffness on cell phenotypes were explored. Increased stiffness was found to significantly promote the proliferation of the heat‐treated residual HCC cells when the cells were cultured on stiffer versus soft supports, which was associated with stiffness‐dependent regulation of ERK phosphorylation. Heat‐exposed HCC cells cultured on stiffer supports showed enhanced motility. More importantly, vitamin K1 reduced stiffness‐dependent residual HCC cell proliferation by inhibiting ERK phosphorylation and suppressed the in vivo tumor growth, which was further enhanced by combining with sorafenib. Increased matrix stiffness promotes the progression of heat‐treated residual HCC cells, proposing a new mechanism of an altered biomechanical environment after thermal ablation accelerates HCC development. Vitamin K1 plus sorafenib can reverse this protumor effect.
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Affiliation(s)
- Rui Zhang
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Min Ma
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Gang Dong
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rong-Rong Yao
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing-Huan Li
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qiong-Dan Zheng
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yin-Ying Dong
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hui Ma
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dong-Mei Gao
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jie-Feng Cui
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zheng-Gang Ren
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rong-Xin Chen
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
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Abstract
The clinical management of hepatocellular carcinoma has evolved greatly in the last decade mostly through recent technical innovations. In particular, the application of cutting-edge image guidance has led to minimally invasive solutions for complex clinical problems and rapid advances in the field of interventional oncology. Many image-guided therapies, such as transarterial chemoembolization and radiofrequency ablation, have meanwhile been fully integrated into interdisciplinary clinical practice, whereas others are currently being investigated. This review summarizes and evaluates the most relevant completed and ongoing clinical trials, provides a synopsis of recent innovations in the field of intraprocedural imaging and tumor response assessment, and offers an outlook on new technologies, such as radiopaque embolic materials. In addition, combination therapies consisting of locoregional therapies and systemic molecular targeted agents (e.g., sorafenib) remain of major interest to the field and are also discussed. Finally, we address the many substantial advances in immune response pathways that have been related to the systemic effects of locoregional therapies. Knowledge of these new developments is crucial as they continue to shape the future of cancer treatment, further establishing interventional oncology along with surgical, medical, and radiation oncology as the fourth pillar of cancer care.
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Song KD, Rhim H, Lee MW, Kim YS, Kang TW. Intrahepatic distant recurrence after radiofrequency ablation for hepatocellular carcinoma: precursor nodules on pre-procedural gadoxetic acid-enhanced liver magnetic resonance imaging. Acta Radiol 2017; 58:778-785. [PMID: 27903759 DOI: 10.1177/0284185116673122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Intrahepatic distant recurrence (IDR) after radiofrequency (RF) ablation for hepatocellular carcinoma (HCC) is associated with poor overall survival outcome. Purpose To evaluate the incidence and findings on pre-procedural gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) of precursor nodules for IDR after RF ablation for HCC. Material and Methods This study was approved by our institutional review board. Among 343 patients treated with RF ablation for HCC between 2009 and 2011, 141 patients who underwent pre-procedural gadoxetic acid-enhanced liver MRI and experienced IDR were enrolled. The presence of precursor nodules for IDR on pre-procedural imaging was assessed. Nodules were categorized based on hypervascularity in the arterial phase and signal intensity on hepatobiliary phase images. Time to recurrence was compared between patients with and without precursor nodules. Results In 46 (32.7%) of 141 patients (50 HCCs), there were precursor nodules on pre-procedural MRIs (median follow-up period, 4.39 years; range, 0.08-6.08). In three patients, HCCs were missed on imaging. In the remaining 43 patients, the 47 precursor nodules identified were non-hypervascular hypointense (n = 26), non-hypervascular isointense (n = 6), non-hypervascular hyperintense (n = 2), hypervascular hypointense (n = 10), and hypervascular isointense (n = 3). The mean time-to-recurrence was significantly shorter for patients with precursor nodules than for those without (16.6 versus 24.0 months, P = 0.011). Conclusion About one-third of patients with IDR after RF ablation for HCC had precursor nodules on pre-procedural gadoxetic acid-enhanced MRI, most commonly non-hypervascular hypointense nodules in the hepatobiliary phase.
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Affiliation(s)
- Kyoung Doo Song
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyunchul Rhim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Min Woo Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young-sun Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Wook Kang
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Guo H, Tsung K. Tumor reductive therapies and antitumor immunity. Oncotarget 2017; 8:55736-55749. [PMID: 28903456 PMCID: PMC5589695 DOI: 10.18632/oncotarget.18469] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 05/03/2017] [Indexed: 12/29/2022] Open
Abstract
Tumor reductive therapy is to reduce tumor burden through direct killing of tumor cells. So far, there is no report on the connection between antitumor immunity and tumor reductive therapies. In the last few years, a new category of cancer treatment, immunotherapy, emerged and they are categorized separately from classic cytotoxic treatments (chemo and radiation therapy). The most prominent examples include cellular therapies (LAK and CAR-T) and immune checkpoint inhibitors (anti-PD-1 and CTLA-4). Recent advances in clinical immunotherapy and our understanding of the mechanism behind them revealed that these therapies have a closer relationship with classic cancer treatments than we thought. In many cases, the effectiveness of classic therapies is heavily influenced by the status of the underlying antitumor-immunity. On the other hand, immunotherapies have shown better outcome when combined with tumor reductive therapies, not only due to the combined effects of tumor killing by each therapy but also because of a synergy between the two. Many clinical observations can be explained once we start to look at these classic therapies from an immunity standpoint. We have seen their direct effect on tumor antigen in vivo that they impact antitumor immunity more than we have realized. In turn, antitumor immunity contributes to tumor control and destruction as well. This review will take the immunological view of the classic therapies and summarize historical as well as recent findings in animal and clinical studies to make the argument that most of the cancer treatments exert their ultimate efficacy through antitumor immunity.
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Affiliation(s)
- Huiqin Guo
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Kangla Tsung
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
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Pacella CM, Mauri G, Cesareo R, Paqualini V, Cianni R, De Feo P, Gambelunghe G, Raggiunti B, Tina D, Deandrea M, Limone PP, Mormile A, Giusti M, Oddo S, Achille G, Di Stasio E, Misischi I, Papini E. A comparison of laser with radiofrequency ablation for the treatment of benign thyroid nodules: a propensity score matching analysis. Int J Hyperthermia 2017; 33:911-919. [PMID: 28605944 DOI: 10.1080/02656736.2017.1332395] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To compare technique efficacy and safety of laser ablation (LA) and radiofrequency ablation (RFA) in treatment of benign thyroid nodules. MATERIALS AND METHODS Institutional review board approval was obtained, and patients' consent was waived. 601 nodules were treated from May 2009 to December 2014 at eight centres, 449 (309 females, age 57 ± 14 years) with LA and 152 (107 females, age 57 ± 14 years) with RFA. A matched cohort composed of 138 patients from each group was selected after adjustment with propensity score matching. Factors influencing volume reduction at 6 and 12 months and complications were evaluated. RESULTS No significant differences were observed in the baseline characteristics between groups after propensity score matching adjustment. Mean nodule reduction at 6 and 12 months was -67 ± 19% vs. -57 ± 21% (p < 0.001) - 70 ± 19% vs. -62 ± 22% (p = 0.001) in LA group and in RFA group, respectively. Nodules with volume >30 mL had significantly higher percentage volume reduction at 6 and 12 months (-69 ± 19 vs. -50 ± 21, p = 0.001) and (-73 ± 18 vs. -54 ± 23 8, p = 0.001) in the LA group than in the RFA group, respectively. In both groups, operator's skills affected the results. Major complications occurred in 4 cases in each group (p = 0.116) Conclusions: LA and RFA showed nearly similar outcome but LA was slightly more effective than RFA in large nodules. Operator's skills could be crucial in determining the extent of nodule volume reduction regardless of the used technique.
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Affiliation(s)
| | - Giovanni Mauri
- b Department of Interventional Radiology , European Institute of Oncology , Milan , Italy
| | - Roberto Cesareo
- c Thyroid Disease Center "S.M. Goretti" Hospital , Latina , Italy
| | | | - Roberto Cianni
- c Thyroid Disease Center "S.M. Goretti" Hospital , Latina , Italy
| | - Pierpaolo De Feo
- d Department of Internal Medicine , University of Perugia , Perugia , Italy
| | | | | | - Doris Tina
- e Endocrinology Unit, Atri Hospital , Atri , Italy
| | - Maurilio Deandrea
- f Thyroid Disease Center "A. Costa" Mauriziano Hospital , Turin , Italy
| | - Pier Paolo Limone
- f Thyroid Disease Center "A. Costa" Mauriziano Hospital , Turin , Italy
| | - Alberto Mormile
- f Thyroid Disease Center "A. Costa" Mauriziano Hospital , Turin , Italy
| | - Massimo Giusti
- g Endocrinology Department , AOU-IST IRCSS San Martino University of Genoa , Genoa , Italy
| | - Silvia Oddo
- g Endocrinology Department , AOU-IST IRCSS San Martino University of Genoa , Genoa , Italy
| | - Gaetano Achille
- h Cervico-Facial Ultrasound Diagnostic and Interventional Unit , Institute of Oncology of Bari , Bari , Italy
| | - Enrico Di Stasio
- i Institute of Biochemistry and Clinical Biochemistry , Rome Catholic University "Sacro Cuore" , Rome , Italy
| | - Irene Misischi
- j Department of Endocrinology , "Regina Apostolorum" Hospital , Albano Laziale , Italy
| | - Enrico Papini
- j Department of Endocrinology , "Regina Apostolorum" Hospital , Albano Laziale , Italy
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Sui WF, Li JY, Fu JH. Percutaneous laser ablation for benign thyroid nodules: a meta-analysis. Oncotarget 2017; 8:83225-83236. [PMID: 29137336 PMCID: PMC5669962 DOI: 10.18632/oncotarget.17928] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 05/03/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate percutaneous laser ablation in treating benign thyroid nodules, we conducted a meta-analysis based on summarizing existing researches. Materials and Methods A literature search for clinical trial was performed in PubMed, Cochrane Library and Excerpt Medica Database. The qualities of included studies were evaluated. We calculated the indexes with mean difference. Heterogeneity and publication bias were tested and explored. We performed subgroup analyses and sensitivity analysis further. Results A total of 19 researches and 2137 patients were included in this meta-analysis. The pooled estimates of nodule volume were statistically significant after percutaneous laser ablation for 1 month, 3 month, 6month, 12month, 24month and 36month(P < 0.05). The pooled estimate of thyroid-stimulating hormone was statistically significant after percutaneous laser ablation for 1 and 12 month (P = 0.008 and P = 0.03). The pooled estimate of free triiodothyronine was no statistically significant after percutaneous laser ablation for all follow-up intervals. The pooled estimate of free tetraiodothyronin was statistically significant after percutaneous laser ablation1 month (P = 0.004). The pooled estimate of thyroglobulin was statistically significant after percutaneous laser ablation 24 month (P = 0.04). The heterogeneity was found and the source of heterogeneity was explored in nodule volume for 6 and 12 month. No publication bias was found. Conclusions This meta-analysis demonstrated that percutaneous laser ablation was safe and useful in shrinking benign thyroid nodules volume, improving thyroid function, relieving symptoms of pressure and esthetic, especial for hyper-vascular benign thyroid nodules. Larger number of high-quality prospective studies still needs to be performed.
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Affiliation(s)
- Wei Fan Sui
- Department of Interventional Radiology, The Affiliated Renmin Hospital of Jiangsu University, Zhenjiang, 212002, China
| | - Jian Yun Li
- Department of Interventional Radiology, The Affiliated Renmin Hospital of Jiangsu University, Zhenjiang, 212002, China
| | - Jian Hua Fu
- Department of Interventional Radiology, The Affiliated Renmin Hospital of Jiangsu University, Zhenjiang, 212002, China
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Chapiro J, Geschwind JF. Science to Practice: Systemic Implications of Ablative Tumor Therapies-Reality Uncovered and Myths Exposed? Radiology 2017; 280:329-31. [PMID: 27429140 DOI: 10.1148/radiol.2016160505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In their effort to characterize the systemic "off-target" effects of radiofrequency (RF) ablation and irreversible electroporation (IRE), Bulvik et al demonstrated substantial differences in physiologic, tumorigenic, and immunologic responses between the two ablative modalities. By establishing that IRE may in fact stimulate more robust inflammatory and systemic reactions than RF at liver ablation, the authors conclude that the selection of a given ablation energy source may alter the clinical outcome depending on the circumstance-both favorably and unfavorably.
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Affiliation(s)
- Julius Chapiro
- Department of Diagnostic and Interventional Radiology Charité Universitätsmedizin Berlin Berlin, Germany.,Department of Radiology and Biomedical Imaging Yale University School of Medicine 333 Cedar St New Haven, CT 06520
| | - Jean-François Geschwind
- Department of Diagnostic and Interventional Radiology Charité Universitätsmedizin Berlin Berlin, Germany.,Department of Radiology and Biomedical Imaging Yale University School of Medicine 333 Cedar St New Haven, CT 06520
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Mauri G, Cova L, Monaco CG, Sconfienza LM, Corbetta S, Benedini S, Ambrogi F, Milani V, Baroli A, Ierace T, Solbiati L. Benign thyroid nodules treatment using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA). Int J Hyperthermia 2016; 33:295-299. [PMID: 27701923 DOI: 10.1080/02656736.2016.1244707] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To evaluate the reduction over time of benign thyroid nodules treated using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA) by the same equipe. MATERIALS AND METHODS Ninety patients (age 55.6 ± 14.1 years) underwent ablation for benign thyroid nodule causing compression/aesthetic dissatisfaction from 2011. Fifty-nine (age 55.8 ± 14.1 years) underwent RFA and 31 (age 55.2 ± 14.2 years) PLA, ultrasound guided. Technical success, complications, duration of ablation and treatment, energy deployed, volumetric percentage reduction at 1, 6 and 12 months were derived. A regression model for longitudinal measurements was used with random intercept and random slope. Values are expressed as mean ± standard deviation or N (%). RESULTS Technical success was always obtained. No major complications occurred. Mean ablation time was 30.1 ± 13.8 vs. 13.9 ± 5.9 min (p < .0001) and mean energy deployment was 5422.3 ± 2484.5 J vs. 34 662.7 ± 15 812.3 J in PLA vs. RFA group. Mean volume reduced from 20.3 ± 16.4 ml to 13.17 ± 10.74 ml (42% ± 17% reduction) at 1st month, 8.7 ± 7.4 ml (60% ± 15% reduction) at 6th month and 7.1 ± 7.7 ml (70%% ± 16% reduction) at 12th month, in PLA group, and from 32.7 ± 19.5 ml to 17.2 ± 12.9 ml (51%±15% reduction) at 1st month, 12.8 ± 9.6 ml (64 ± 14% reduction) at 6th month and 9.9 ± 9.2 ml (74% ± 14% reduction) at 12th month in RFA group. No difference in time course of the relative volume reduction between the two techniques was found. CONCLUSIONS RFA and PLA are similarly feasible, safe and effective in treating benign thyroid nodules when performed by the same equipe. RFA is faster than PLA but require significantly higher energy.
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Affiliation(s)
- Giovanni Mauri
- a Division of Interventional Oncology , European Institute of Oncology , Milan , Italy.,b Radiology Service, IRCCS Policlinico San Donato , Milan , Italy
| | - Luca Cova
- c Interventional Oncology Service, Azienda Socio-Sanitario Territoriale (ASST) della Valle Olona , Varese , Italy
| | | | - Luca Maria Sconfienza
- b Radiology Service, IRCCS Policlinico San Donato , Milan , Italy.,e Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - Sabrina Corbetta
- e Department of Biomedical Sciences for Health , University of Milan , Milan , Italy.,f Endocrinology Unit, IRCCS Policlinico San Donato , Milano , Italy
| | - Stefano Benedini
- f Endocrinology Unit, IRCCS Policlinico San Donato , Milano , Italy
| | - Federico Ambrogi
- g Department of Clinical Sciences and Community Health, University of Milan, IRCCS Policlinico San Donato , Milan , Italy
| | - Valentina Milani
- g Department of Clinical Sciences and Community Health, University of Milan, IRCCS Policlinico San Donato , Milan , Italy
| | - Alberto Baroli
- h Department of Nuclear Medicine, Azienda Socio-Sanitario Territoriale (ASST) della Valle Olona , Varese , Italy
| | - Tiziana Ierace
- i Unit of Interventional Radiology, Istituto Clinico Humanitas , Milano , Italy
| | - Luigi Solbiati
- i Unit of Interventional Radiology, Istituto Clinico Humanitas , Milano , Italy.,j Humanitas University, Istituto Clinico Humanitas , Milano , Italy
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Ma Y, Wallace AN, Madaelil TP, Jennings JW. Treatment of osseous metastases using the Spinal Tumor Ablation with Radiofrequency (STAR) system. Expert Rev Med Devices 2016; 13:1137-1145. [PMID: 27807994 DOI: 10.1080/17434440.2016.1256772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Percutaneous ablation is an emerging, minimally invasive therapy for patients with osseous metastases who have not responded or have contraindications to radiation therapy. Goals of therapy are pain relief, and in some cases, prevention of local tumor progression. Areas covered: The epidemiology, pathophysiology, natural history, and traditional management of metastatic bone disease are reviewed. Novel features of the Spinal Tumor Ablation with Radiofrequency (STAR) System (DFINE, San Jose, CA) that facilitate treatment of osseous metastases are described, including the bipolar electrode, extensible distal tip that can be curved up to 90°, and inclusion of thermocouples that enable real-time monitoring of the ablation zone volume. Lastly, research evaluating the safety and efficacy of using this device to treat musculoskeletal metastases is summarized. Expert commentary: Although evidence supporting the efficacy of RFA for the treatment of bone metastases is limited to case series, it is a reasonable therapy when other options have been exhausted, especially given the safety and minimal morbidity of the procedure. The STAR Tumor Ablation System has expanded the anatomic scope of bone metastases that can be safely and effectively treated with percutaneous ablation.
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Affiliation(s)
- Yuntong Ma
- a Washington University School of Medicine , St. Louis , MO , USA
| | - Adam N Wallace
- b Mallinckrodt Institute of Radiology , Washington University School of Medicine , St. Louis , MO , USA
| | - Thomas P Madaelil
- b Mallinckrodt Institute of Radiology , Washington University School of Medicine , St. Louis , MO , USA
| | - Jack W Jennings
- b Mallinckrodt Institute of Radiology , Washington University School of Medicine , St. Louis , MO , USA
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Velez E, Goldberg SN, Kumar G, Wang Y, Gourevitch S, Sosna J, Moon T, Brace CL, Ahmed M. Hepatic Thermal Ablation: Effect of Device and Heating Parameters on Local Tissue Reactions and Distant Tumor Growth. Radiology 2016; 281:782-792. [PMID: 27409564 DOI: 10.1148/radiol.2016152241] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Purpose To determine whether variable hepatic microwave ablation (MWA) can induce local inflammation and distant pro-oncogenic effects compared with hepatic radiofrequency ablation (RFA) in an animal model. Materials and Methods In this institutional Animal Care and Use Committee-approved study, F344 rats (150 gm, n = 96) with subcutaneous R3230 breast adenocarcinoma tumors had normal non-tumor-bearing liver treated with RFA (70°C × 5 minutes), rapid higher-power MWA (20 W × 15 seconds), slower lower-power MWA (5 W × 2 minutes), or a sham procedure (needle placement without energy) and were sacrificed at 6 hours to 7 days (four time points; six animals per arm per time point). Ablation settings produced 11.4 mm ± 0.8 of coagulation for all groups. Distant tumor growth rates were determined to 7 days after treatment. Liver heat shock protein (HSP) 70 levels (at 72 hours) and macrophages (CD68 at 7 days), tumor proliferative indexes (Ki-67 and CD34 at 7 days), and serum and tissue levels of interleukin 6 (IL-6) at 6 hours, hepatocyte growth factor (HGF) at 72 hours, and vascular endothelial growth factor (VEGF) at 72 hours after ablation were assessed. All data were expressed as means ± standard deviations and were compared by using two-tailed t tests and analysis of variance for selected group comparisons. Linear regression analysis of tumor growth curves was used to determine pre- and posttreatment growth curves on a per-tumor basis. Results At 7 days, hepatic ablations with 5-W MWA and RFA increased distant tumor size compared with 20-W MWA and the sham procedure (5-W MWA: 16.3 mm ± 1.1 and RFA: 16.3 mm ± 0.9 vs sham: 13.6 mm ± 1.3, P < .01, and 20-W MWA: 14.6 mm ± 0.9, P < .05). RFA and 5-W MWA increased postablation tumor growth rates compared with the 20-W MWA and sham arms (preablation growth rates range for all arms: 0.60-0.64 mm/d; postablation: RFA: 0.91 mm/d ± 0.11, 5-W MWA: 0.91 mm/d ± 0.14, P < .01 vs pretreatment; 20-W MWA: 0.69 mm/d ± 0.07, sham: 0.56 mm/d ± 1.15; P = .48 and .65, respectively). Tumor proliferation (Ki-67 percentage) was increased for 5-W MWA (82% ± 5) and RFA (79% ± 5), followed by 20-W MWA (65% ± 2), compared with sham (49% ± 5, P < .01). Likewise, distant tumor microvascular density was greater for 5-W MWA and RFA (P < .01 vs 20-W MWA and sham). Lower-energy MWA and RFA also resulted in increased HSP 70 expression and macrophages in the periablational rim (P < .05). Last, IL-6, HGF, and VEGF elevations were seen in 5-W MWA and RFA compared with 20-W MWA and sham (P < .05). Conclusion Although hepatic MWA can incite periablational inflammation and increased distant tumor growth similar to RFA in an animal tumor model, higher-power, faster heating protocols may potentially mitigate such undesired effects. © RSNA, 2016.
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Affiliation(s)
- Erik Velez
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 1 Deaconess Rd, Boston, MA 02215 (E.V., S.N.G., G.K., Y.W., J.S., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G., J.S.), and Goldyne Savad Institute of Gene Therapy (S.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Departments of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, Wis (T.M., C.B.)
| | - S Nahum Goldberg
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 1 Deaconess Rd, Boston, MA 02215 (E.V., S.N.G., G.K., Y.W., J.S., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G., J.S.), and Goldyne Savad Institute of Gene Therapy (S.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Departments of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, Wis (T.M., C.B.)
| | - Gaurav Kumar
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 1 Deaconess Rd, Boston, MA 02215 (E.V., S.N.G., G.K., Y.W., J.S., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G., J.S.), and Goldyne Savad Institute of Gene Therapy (S.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Departments of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, Wis (T.M., C.B.)
| | - Yuanguo Wang
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 1 Deaconess Rd, Boston, MA 02215 (E.V., S.N.G., G.K., Y.W., J.S., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G., J.S.), and Goldyne Savad Institute of Gene Therapy (S.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Departments of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, Wis (T.M., C.B.)
| | - Svetlana Gourevitch
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 1 Deaconess Rd, Boston, MA 02215 (E.V., S.N.G., G.K., Y.W., J.S., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G., J.S.), and Goldyne Savad Institute of Gene Therapy (S.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Departments of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, Wis (T.M., C.B.)
| | - Jacob Sosna
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 1 Deaconess Rd, Boston, MA 02215 (E.V., S.N.G., G.K., Y.W., J.S., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G., J.S.), and Goldyne Savad Institute of Gene Therapy (S.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Departments of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, Wis (T.M., C.B.)
| | - Tyler Moon
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 1 Deaconess Rd, Boston, MA 02215 (E.V., S.N.G., G.K., Y.W., J.S., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G., J.S.), and Goldyne Savad Institute of Gene Therapy (S.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Departments of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, Wis (T.M., C.B.)
| | - Christopher L Brace
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 1 Deaconess Rd, Boston, MA 02215 (E.V., S.N.G., G.K., Y.W., J.S., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G., J.S.), and Goldyne Savad Institute of Gene Therapy (S.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Departments of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, Wis (T.M., C.B.)
| | - Muneeb Ahmed
- From the Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 1 Deaconess Rd, Boston, MA 02215 (E.V., S.N.G., G.K., Y.W., J.S., M.A.); Division of Image-guided Therapy and Interventional Oncology, Department of Radiology (S.N.G., J.S.), and Goldyne Savad Institute of Gene Therapy (S.G.), Hadassah Hebrew University Hospital, Jerusalem, Israel; and Departments of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, Wis (T.M., C.B.)
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Hepatic radiofrequency ablation: markedly reduced systemic effects by modulating periablational inflammation via cyclooxygenase-2 inhibition. Eur Radiol 2016; 27:1238-1247. [DOI: 10.1007/s00330-016-4405-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 05/03/2016] [Accepted: 05/12/2016] [Indexed: 12/16/2022]
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Mauri G, Orsi F, Sconfienza LM. Systemic Effects of Local Tumor Ablation: Oncogenesis and Antitumor Induced Immunity. Radiology 2016; 279:322-323. [DOI: 10.1148/radiol.2016151739] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Thermal Ablative Therapies and Immune Checkpoint Modulation: Can Locoregional Approaches Effect a Systemic Response? Gastroenterol Res Pract 2016; 2016:9251375. [PMID: 27051417 PMCID: PMC4802022 DOI: 10.1155/2016/9251375] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 02/16/2016] [Indexed: 02/08/2023] Open
Abstract
Percutaneous image-guided ablation is an increasingly common treatment for a multitude of solid organ malignancies. While historically these techniques have been restricted to the management of small, unresectable tumors, there is an expanding appreciation for the systemic effects these locoregional interventions can cause. In this review, we summarize the mechanisms of action for the most common thermal ablation modalities and highlight the key advances in knowledge regarding the interactions between thermal ablation and the immune system.
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Bulvik BE, Rozenblum N, Gourevich S, Ahmed M, Andriyanov AV, Galun E, Goldberg SN. Irreversible Electroporation versus Radiofrequency Ablation: A Comparison of Local and Systemic Effects in a Small-Animal Model. Radiology 2016; 280:413-24. [PMID: 27429143 DOI: 10.1148/radiol.2015151166] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Purpose To compare both periablational and systemic effects of two mechanistically different types of ablation: thermal radiofrequency (RF) ablation and electroporative ablation with irreversible electroporation (IRE) in appropriately selected animal models. Materials and Methods Animal experiments were performed according to a protocol approved by the Animal Care Committee of Hebrew University. Female C57BL/6 mice (n = 165) were randomized to undergo either RF or IRE ablation of noncancerous normal liver. The inflammatory response, cell proliferation, interleukin 6 (IL-6) levels, and intactness of vessels in the liver were assessed at 6, 12, and 24 hours and at 3, 7, and 14 days after ablation (n = 122 for mechanistic experiments). Systemic effects were then assessed by comparing tumor formation in an Mdr2-knockout (KO) mouse model (n = 15) and tumor growth in a remote BNL 1ME hepatoma xenograft tumor (n = 28). Results were averaged and evaluated by using two-tailed t tests. Results Although RF ablation was associated with a well-defined periablational inflammatory rim, for IRE, the infiltrate penetrated the ablation zone, largely along persistently patent vessels. Peak IL-6 levels (6 hours after ablation) were 10 and three times higher than at baseline for IRE and RF, respectively (P < .03). Mdr2-KO mice that were treated with IRE ablation had more tumors that were 3 mm or larger than mice treated with RF ablation or sham operation (mean, 3.6 ± 1.3 [standard deviation] vs 2.4 ± 1.1 and 2.2 ± 0.8, respectively; P < .05 for IRE vs both RF ablation and sham operation). For BNL 1ME tumors, both RF and IRE liver ablation reduced tumor growth, with a greater effect noted for IRE (1329 mm(3) ± 586 and 819 mm(3) ± 327 vs 2241 mm(3) ± 548 for sham operation; P < .05) that was accompanied by more infiltrating lymphocytes compared with sham operation (7.6 cells per frame ± 1.9 vs 11.2 ± 2.1 vs 0.3 ± 0.1; P < .05). Conclusion Persistent patency of vasculature within the coagulated zone from IRE increases the area and accumulation of infiltrative cells that is associated with a higher serum IL-6 level than RF ablation. These local changes of IRE induce more robust systemic effects, including both tumorigenic and immunogenic effects. (©) RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Baruch E Bulvik
- From the Goldyne Savad Institute of Gene Therapy (B.E.B., N.R., S.G., E.G., S.N.G.), Laboratory of Membrane and Liposome Research, Department of Biochemistry, Institute for Medical Research Israel-Canada (A.V.A.), and Department of Radiology (S.N.G.), Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A., S.N.G.)
| | - Nir Rozenblum
- From the Goldyne Savad Institute of Gene Therapy (B.E.B., N.R., S.G., E.G., S.N.G.), Laboratory of Membrane and Liposome Research, Department of Biochemistry, Institute for Medical Research Israel-Canada (A.V.A.), and Department of Radiology (S.N.G.), Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A., S.N.G.)
| | - Svetlana Gourevich
- From the Goldyne Savad Institute of Gene Therapy (B.E.B., N.R., S.G., E.G., S.N.G.), Laboratory of Membrane and Liposome Research, Department of Biochemistry, Institute for Medical Research Israel-Canada (A.V.A.), and Department of Radiology (S.N.G.), Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A., S.N.G.)
| | - Muneeb Ahmed
- From the Goldyne Savad Institute of Gene Therapy (B.E.B., N.R., S.G., E.G., S.N.G.), Laboratory of Membrane and Liposome Research, Department of Biochemistry, Institute for Medical Research Israel-Canada (A.V.A.), and Department of Radiology (S.N.G.), Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A., S.N.G.)
| | - Alexander V Andriyanov
- From the Goldyne Savad Institute of Gene Therapy (B.E.B., N.R., S.G., E.G., S.N.G.), Laboratory of Membrane and Liposome Research, Department of Biochemistry, Institute for Medical Research Israel-Canada (A.V.A.), and Department of Radiology (S.N.G.), Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A., S.N.G.)
| | - Eithan Galun
- From the Goldyne Savad Institute of Gene Therapy (B.E.B., N.R., S.G., E.G., S.N.G.), Laboratory of Membrane and Liposome Research, Department of Biochemistry, Institute for Medical Research Israel-Canada (A.V.A.), and Department of Radiology (S.N.G.), Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A., S.N.G.)
| | - S Nahum Goldberg
- From the Goldyne Savad Institute of Gene Therapy (B.E.B., N.R., S.G., E.G., S.N.G.), Laboratory of Membrane and Liposome Research, Department of Biochemistry, Institute for Medical Research Israel-Canada (A.V.A.), and Department of Radiology (S.N.G.), Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A., S.N.G.)
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Chapiro J, Geschwind JF. Science to Practice: The Changing Face of Local Tumor Therapies-Do We Have to Think Systemically When Treating Cancer Locally? Radiology 2015. [PMID: 26203703 DOI: 10.1148/radiol.2015150451] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In this issue, Rozenblum et al ( 1 ) were able to demonstrate that radiofrequency (RF) ablation-induced liver regeneration promotes "off-target" tumorigenesis in a MDR2 knock-out mouse model of hepatocellular carcinoma (HCC) in the setting of chronic liver inflammation. In addition, the authors demonstrated that blocking liver regeneration with a c-met inhibitor might attenuate or eliminate potential tumorigenic effects. These results provide the rationale for combined therapeutic approaches of RF ablation followed by a systemic application of immunomodulatory drugs.
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Affiliation(s)
- Julius Chapiro
- Department of Diagnostic and Interventional Radiology Charité Universitätsmedizin Berlin Berlin, Germany.,Department of Diagnostic Radiology and Imaging Sciences Yale University School of Medicine 421 Temple St New Haven, CT 06520-8224
| | - Jean-François Geschwind
- Department of Diagnostic and Interventional Radiology Charité Universitätsmedizin Berlin Berlin, Germany.,Department of Diagnostic Radiology and Imaging Sciences Yale University School of Medicine 421 Temple St New Haven, CT 06520-8224
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