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Geevarghese R, Bodard S, Razakamanantsoa L, Marcelin C, Petre EN, Dohan A, Kastler A, Frandon J, Barral M, Soyer P, Cornelis FH. Interventional Oncology: 2024 Update. Can Assoc Radiol J 2024:8465371241236152. [PMID: 38444144 DOI: 10.1177/08465371241236152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
Interventional Oncology (IO) stands at the forefront of transformative cancer care, leveraging advanced imaging technologies and innovative interventions. This narrative review explores recent developments within IO, highlighting its potential impact facilitated by artificial intelligence (AI), personalized medicine and imaging innovations. The integration of AI in IO holds promise for accelerating tumour detection and characterization, guiding treatment strategies and refining predictive models. Imaging modalities, including functional MRI, PET and cone beam CT are reshaping imaging and precision. Navigation, fusion imaging, augmented reality and robotics have the potential to revolutionize procedural guidance and offer unparalleled accuracy. New developments are observed in embolization and ablative therapies. The pivotal role of genomics in treatment planning, targeted therapies and biomarkers for treatment response prediction underscore the personalization of IO. Quality of life assessment, minimizing side effects and long-term survivorship care emphasize patient-centred outcomes after IO treatment. The evolving landscape of IO training programs, simulation technologies and workforce competence ensures the field's adaptability. Despite barriers to adoption, synergy between interventional radiologists' proficiency and technological advancements hold promise in cancer care.
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Affiliation(s)
- Ruben Geevarghese
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sylvain Bodard
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Clement Marcelin
- Department of Radiology, Bordeaux University, Hopital Pellegrin, Bordeaux, France
| | - Elena N Petre
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anthony Dohan
- Department of Radiology, Hopital Cochin, AP-HP, Paris, France
- Faculté de Médecine, Université Paris Cité, Paris, France
| | - Adrian Kastler
- Department of Radiology, Grenoble University Hospital, Grenoble, France
| | - Julien Frandon
- Department of Radiology, Nimes University Hospital, Nimes, France
| | - Matthias Barral
- Department of Radiology, Sorbonne University, Hopital Tenon, Paris, France
| | - Philippe Soyer
- Department of Radiology, Hopital Cochin, AP-HP, Paris, France
- Faculté de Médecine, Université Paris Cité, Paris, France
| | - Francois H Cornelis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiology, Sorbonne University, Hopital Tenon, Paris, France
- Weill Cornell Medical College, New York, NY, USA
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Granata V, Fusco R, D’Alessio V, Simonetti I, Grassi F, Silvestro L, Palaia R, Belli A, Patrone R, Piccirillo M, Izzo F. Percutanous Electrochemotherapy (ECT) in Primary and Secondary Liver Malignancies: A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13020209. [PMID: 36673019 PMCID: PMC9858594 DOI: 10.3390/diagnostics13020209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/09/2023] Open
Abstract
The aim of the study was to analyse papers describing the use of Electrochemotherapy (ECT) in local treatment of primary and secondary liver tumours located at different sites and with different histologies. Other Local Ablative Therapies (LAT) are also discussed. Analyses of these papers demonstrate that ECT use is safe and effective in lesions of large size, independently of the histology of the treated lesions. ECT performed better than other thermal ablation techniques in lesions > 6 cm in size and can be safely used to treat lesions distant, close, or adjacent to vital structures. ECT spares vessel and bile ducts, is repeatable, and can be performed between chemotherapeutic cycles. ECT can fill the gap in local ablative therapies due to being lesions too large or localized in highly challenging anatomical sites.
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Affiliation(s)
- Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Roberta Fusco
- Oncology Medical and Research & Development Division, Casalnuovo di Napoli, 80013 Naples, Italy
| | - Valeria D’Alessio
- Oncology Medical and Research & Development Division, Casalnuovo di Napoli, 80013 Naples, Italy
- Correspondence:
| | - Igino Simonetti
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Francesca Grassi
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80127 Naples, Italy
| | - Lucrezia Silvestro
- Division of Clinical Experimental Oncology Abdomen, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Raffaele Palaia
- Division of Epatobiliary Surgical Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Andrea Belli
- Division of Epatobiliary Surgical Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Renato Patrone
- Division of Epatobiliary Surgical Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Mauro Piccirillo
- Division of Epatobiliary Surgical Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Francesco Izzo
- Division of Epatobiliary Surgical Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
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Ridouani F, Ghosn M, Doustaly R, Gonzalez-Aguirre AJ, Ziv E, Solomon SB, Edward Boas F, Yarmohammadi H. Accuracy of a CBCT-based virtual injection software for vessel detection during hepatic arterial embolization. Eur J Radiol 2022; 150:110273. [PMID: 35338952 DOI: 10.1016/j.ejrad.2022.110273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/23/2022] [Accepted: 03/17/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the accuracy, sensitivity, positive predictive value (PPV) and interobserver agreement of a virtual injection (VI) software that simulates selective arterial injection from nonselective cone-beam CT (CBCT) arteriography. METHODS From March 2019 to May 2020, 20 consecutive patients in whom a nonselective injected CBCT and a selective CT angiography (CTA) were completed in the same procedure, were retrospectively included. The position of the microcatheter tip used for selective CTA injection was identified. The VI was simulated from the exact same point on the nonselective CBCT and the two volumes were merged. VI was compared to the real injection on the selective CTA. Three interventional radiologists evaluated the accuracy using a 6-point scale (Perfect; Good; Fair; Incorrect Origin; False Negative; Non existing). Sensitivity, PPV, and Fleiss' kappa were calculated. Numerical variables were presented as means ± standard deviations. RESULTS Twenty procedures and 195 vessel segments were analyzed. Most vessels were 4th order (57/195; 29%) and 5th order (96/195; 49%). VI was classified as perfect to good in 96.8% ± 1.4 of 1st-3rd order arteries and in 83.4% ± 0.4 of 4th-5th order arteries. Interobserver agreement was substantial (Fleiss' kappa = 0.79; 95% confidence interval = 0.73-0.84, P < 0.01). False negatives were reported with a mean of 9.4% ± 0.3. Average sensitivity was 90.6% ± 0.3 and average PPV was 92.7% ± 0.02. Fourteen false positives were noted. CONCLUSION CBCT-based VI software accurately simulated distal injections in the liver with high sensitivity and a substantial interobserver agreement.
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Affiliation(s)
- Fourat Ridouani
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Avenue, New York, NY 10065, United States
| | - Mario Ghosn
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Avenue, New York, NY 10065, United States
| | | | - Adrian J Gonzalez-Aguirre
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Avenue, New York, NY 10065, United States
| | - Etay Ziv
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Avenue, New York, NY 10065, United States
| | - Stephen B Solomon
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Avenue, New York, NY 10065, United States
| | - F Edward Boas
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Avenue, New York, NY 10065, United States
| | - Hooman Yarmohammadi
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Avenue, New York, NY 10065, United States.
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Bogoni M, Cerci JJ, Cornelis FH, Nanni C, Tabacchi E, SchÖder H, Shyn PB, Sofocleous CT, Solomon SB, Kirov AS. Practice and prospects for PET/CT guided interventions. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF... 2021; 65:20-31. [PMID: 33494585 PMCID: PMC10446123 DOI: 10.23736/s1824-4785.21.03291-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
During the past 10 years, performing real-time molecular imaging with positron emission tomography (PET) in combination with computed tomography (CT) during interventional procedures has undergone rapid development. Keeping in mind the interest of the nuclear medicine readers, an update is provided of the current workflows using real-time PET/CT in percutaneous biopsies and tumor ablations. The clinical utility of PET/CT guided biopsies in cancer patients with lung, liver, lymphoma, and bone tumors are reviewed. Several technological developments, including the introduction of new PET tracers and robotic arms as well as opportunities provided through acquiring radioactive biopsy specimens are briefly reviewed.
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Affiliation(s)
| | | | | | - Cristina Nanni
- Unit of Nuclear Medicine, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Elena Tabacchi
- Unit of Nuclear Medicine, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Heiko SchÖder
- Unit of Nuclear Medicine, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paul B Shyn
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Constantinos T Sofocleous
- Unit of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stephen B Solomon
- Unit of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Assen S Kirov
- Unit of Molecular Imaging and Therapy Physics, Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA -
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Modern therapeutic approaches for the treatment of malignant liver tumours. Nat Rev Gastroenterol Hepatol 2020; 17:755-772. [PMID: 32681074 DOI: 10.1038/s41575-020-0314-8] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2020] [Indexed: 02/06/2023]
Abstract
Malignant liver tumours include a wide range of primary and secondary tumours. Although surgery remains the mainstay of curative treatment, modern therapies integrate a variety of neoadjuvant and adjuvant strategies and have achieved dramatic improvements in survival. Extensive tumour loads, which have traditionally been considered unresectable, are now amenable to curative treatment through systemic conversion chemotherapies followed by a variety of interventions such as augmentation of the healthy liver through portal vein occlusion, staged surgeries or ablation modalities. Liver transplantation is established in selected patients with hepatocellular carcinoma but is now emerging as a promising option in many other types of tumour such as perihilar cholangiocarcinomas, neuroendocrine or colorectal liver metastases. In this Review, we summarize the available therapies for the treatment of malignant liver tumours, with an emphasis on surgical and ablative approaches and how they align with other therapies such as modern anticancer drugs or radiotherapy. In addition, we describe three complex case studies of patients with malignant liver tumours. Finally, we discuss the outlook for future treatment, including personalized approaches based on molecular tumour subtyping, response to targeted drugs, novel biomarkers and precision surgery adapted to the specific tumour.
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Percutaneous image-guided therapies of primary liver tumors: Techniques and outcomes. Presse Med 2019; 48:e245-e250. [PMID: 31445698 DOI: 10.1016/j.lpm.2019.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 06/11/2019] [Accepted: 07/04/2019] [Indexed: 02/08/2023] Open
Abstract
Embolization and percutaneous ablations became well-established therapeutic options for hepatocellular carcinomas (HCC). All are performed under minimally invasive conditions using imaging guidance. Selection of a technique over another follows guidelines but also patient's status and availability of the techniques. The aim of this review is to present these techniques performed in routine to treat HCC and to report the outcomes.
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