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Tips for Preparing and Practicing Thermal Ablation Therapy of Hepatocellular Carcinoma

SIMPLE SUMMARY: Thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), for hepatocellular carcinomas (HCCs) is accepted as a curative treatment option in many HCC treatment guidelines because of the better clinical outcomes performed in a more minimally invasive mann...

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Autores principales: Minami, Yasunori, Aoki, Tomoko, Hagiwara, Satoru, Kudo, Masatoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10571938/
https://www.ncbi.nlm.nih.gov/pubmed/37835456
http://dx.doi.org/10.3390/cancers15194763
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author Minami, Yasunori
Aoki, Tomoko
Hagiwara, Satoru
Kudo, Masatoshi
author_facet Minami, Yasunori
Aoki, Tomoko
Hagiwara, Satoru
Kudo, Masatoshi
author_sort Minami, Yasunori
collection PubMed
description SIMPLE SUMMARY: Thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), for hepatocellular carcinomas (HCCs) is accepted as a curative treatment option in many HCC treatment guidelines because of the better clinical outcomes performed in a more minimally invasive manner. Essential management tips to successful ablation therapy can be organized into five categories: understanding the principles of ablation therapies and the characteristics of ablation devices, assessing the benefits and risks of ablation, practicing ultrasound-guided needle tip control and visualization, taking advantage of imaging guidance techniques, and evaluating therapeutic response to ensure adequate ablation. We herein provide an overview of the basic principles and characteristics of tissue heating, highlight the safety management of ablation therapy, and provide the technical skills of sophisticated planning and image guidance technologies to improve short- and long-term outcome of HCC patients. These essentials will contribute to the expansion of thermal ablation applications in clinical settings. ABSTRACT: Thermal ablation therapy, including radiofrequency ablation (RFA) and microwave ablation (MWA), is considered the optimal locoregional treatment for unresectable early-stage hepatocellular carcinomas (HCCs). Percutaneous image-guided ablation is a minimally invasive treatment that is being increasingly performed because it achieves good clinical outcomes with a lower risk of complications. However, the physics and principles of RFA and MWA markedly differ. Although percutaneous thermal ablation under image guidance may be challenging in HCC cases with limited access or a risk of thermal injury, a number of ablative techniques, each of which may be advantageous and disadvantageous for individual cases, are available. Furthermore, even when a HCC is eligible for ablation based on tumor selection and technical factors, additional patient factors may have an impact on whether it is the appropriate treatment choice. Therefore, a basic understanding of the advantages and limitations of each ablation device and imaging guidance technique, respectively, is important. We herein provide an overview of the basic principles of tissue heating in thermal ablation, clinical and laboratory parameters for ablation therapy, preprocedural management, imaging assessments of responses, and early adverse events. We also discuss associated challenges and how they may be overcome using optimized imaging techniques.
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spelling pubmed-105719382023-10-14 Tips for Preparing and Practicing Thermal Ablation Therapy of Hepatocellular Carcinoma Minami, Yasunori Aoki, Tomoko Hagiwara, Satoru Kudo, Masatoshi Cancers (Basel) Review SIMPLE SUMMARY: Thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), for hepatocellular carcinomas (HCCs) is accepted as a curative treatment option in many HCC treatment guidelines because of the better clinical outcomes performed in a more minimally invasive manner. Essential management tips to successful ablation therapy can be organized into five categories: understanding the principles of ablation therapies and the characteristics of ablation devices, assessing the benefits and risks of ablation, practicing ultrasound-guided needle tip control and visualization, taking advantage of imaging guidance techniques, and evaluating therapeutic response to ensure adequate ablation. We herein provide an overview of the basic principles and characteristics of tissue heating, highlight the safety management of ablation therapy, and provide the technical skills of sophisticated planning and image guidance technologies to improve short- and long-term outcome of HCC patients. These essentials will contribute to the expansion of thermal ablation applications in clinical settings. ABSTRACT: Thermal ablation therapy, including radiofrequency ablation (RFA) and microwave ablation (MWA), is considered the optimal locoregional treatment for unresectable early-stage hepatocellular carcinomas (HCCs). Percutaneous image-guided ablation is a minimally invasive treatment that is being increasingly performed because it achieves good clinical outcomes with a lower risk of complications. However, the physics and principles of RFA and MWA markedly differ. Although percutaneous thermal ablation under image guidance may be challenging in HCC cases with limited access or a risk of thermal injury, a number of ablative techniques, each of which may be advantageous and disadvantageous for individual cases, are available. Furthermore, even when a HCC is eligible for ablation based on tumor selection and technical factors, additional patient factors may have an impact on whether it is the appropriate treatment choice. Therefore, a basic understanding of the advantages and limitations of each ablation device and imaging guidance technique, respectively, is important. We herein provide an overview of the basic principles of tissue heating in thermal ablation, clinical and laboratory parameters for ablation therapy, preprocedural management, imaging assessments of responses, and early adverse events. We also discuss associated challenges and how they may be overcome using optimized imaging techniques. MDPI 2023-09-28 /pmc/articles/PMC10571938/ /pubmed/37835456 http://dx.doi.org/10.3390/cancers15194763 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Minami, Yasunori
Aoki, Tomoko
Hagiwara, Satoru
Kudo, Masatoshi
Tips for Preparing and Practicing Thermal Ablation Therapy of Hepatocellular Carcinoma
title Tips for Preparing and Practicing Thermal Ablation Therapy of Hepatocellular Carcinoma
title_full Tips for Preparing and Practicing Thermal Ablation Therapy of Hepatocellular Carcinoma
title_fullStr Tips for Preparing and Practicing Thermal Ablation Therapy of Hepatocellular Carcinoma
title_full_unstemmed Tips for Preparing and Practicing Thermal Ablation Therapy of Hepatocellular Carcinoma
title_short Tips for Preparing and Practicing Thermal Ablation Therapy of Hepatocellular Carcinoma
title_sort tips for preparing and practicing thermal ablation therapy of hepatocellular carcinoma
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10571938/
https://www.ncbi.nlm.nih.gov/pubmed/37835456
http://dx.doi.org/10.3390/cancers15194763
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