O Kosiek1, K Strach, J Ricke, M Pech. 1. Zentrum für Radiologie, Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland. Ortrud.kosiek@med.ovgu.de
Abstract
CLINICAL/METHODICAL ISSUE: Minimally invasive tumor therapies are well established options in multi-modal oncological therapy regimes. So far the methods applied have been of a thermal nature and thus there are inherent limitations, most of all the so-called heat-sink effect. STANDARD RADIOLOGICAL METHODS: Radiofrequency ablation (RFA) and laser-induced thermotherapy (LITT) are well-established techniques. METHODICAL INNOVATIONS: Irreversible electroporation (IRE) could potentially become a novel therapy option with an enlarged spectrum of treatable lesions, i.e. close to blood vessels and potentially a lower rate of complications. PERFORMANCE: The IRE technique is currently the subject of early prospective trials and clinical studies have not yet shown any serious side effects. However, complete tumor ablation was not achieved in all cases (46 out of 69). ACHIEVEMENTS: Preclinical as well as clinical studies seem to show a promising efficiency in tumor ablation as well as a favorable complication profile especially with tumors in thermally critical locations. PRACTICAL RECOMMENDATIONS: Clinical long-term studies are currently under way assessing safety as well as efficiency. The data published so far look promising and considerably enlarge the spectrum of ablation techniques.
CLINICAL/METHODICAL ISSUE: Minimally invasive tumor therapies are well established options in multi-modal oncological therapy regimes. So far the methods applied have been of a thermal nature and thus there are inherent limitations, most of all the so-called heat-sink effect. STANDARD RADIOLOGICAL METHODS: Radiofrequency ablation (RFA) and laser-induced thermotherapy (LITT) are well-established techniques. METHODICAL INNOVATIONS: Irreversible electroporation (IRE) could potentially become a novel therapy option with an enlarged spectrum of treatable lesions, i.e. close to blood vessels and potentially a lower rate of complications. PERFORMANCE: The IRE technique is currently the subject of early prospective trials and clinical studies have not yet shown any serious side effects. However, complete tumor ablation was not achieved in all cases (46 out of 69). ACHIEVEMENTS: Preclinical as well as clinical studies seem to show a promising efficiency in tumor ablation as well as a favorable complication profile especially with tumors in thermally critical locations. PRACTICAL RECOMMENDATIONS: Clinical long-term studies are currently under way assessing safety as well as efficiency. The data published so far look promising and considerably enlarge the spectrum of ablation techniques.
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