Interventional oncology has emerged as an important specialty within cancer care, providing targeted therapy and palliative benefits without the side effects of chemotherapy, surgery and radiation. Covering the principles of current and emerging interventional oncology techniques and detailed diagnosis, staging and treatment algorithms, this book outlines the ways in which these image-guided therapies can inform cancer management strategies. Access to the most current information is vital in this rapidly growing and evolving area of practice. This new edition reflects the most recent clinical data on interventional oncology procedures. Chapters on image guidance and targeting, tumor ablation, embolotherapy, and response assessment have been updated to reflect major technological advances, and new material on microwave ablation and irreversible electroporation has been added. This invaluable resource for interventional radiologists provides essential education and guidance on the full range of minimally invasive image-guided procedures and their integration into comprehensive cancer care.
Author(s): Jean-Francois H. Geschwind, Michael C. Soulen
Edition: 2nd Edition
Publisher: Cambridge University Press
Year: 2016
Language: English
Pages: 350
Tags: Interventional Oncology
Cover......Page 1
Half-title......Page 3
Title page......Page 5
Copyright information......Page 6
Table of contents......Page 7
List of contributors......Page 9
1 Interventional oncology: The fourth pillar of cancer care......Page 13
Introduction......Page 15
Microwave ablation......Page 16
Tissue factors affecting microwave ablation......Page 17
Multiapplicator arrays......Page 18
Perfused electrodes......Page 19
Overlapping techniques......Page 20
Combining RF with chemotherapy......Page 21
References......Page 22
Electric field strength......Page 25
Pulse length......Page 26
Numerical simulations......Page 27
Clinical considerations......Page 28
Clinical experience......Page 29
References......Page 30
Ablation......Page 32
Thermal dose concept......Page 34
MRI guidance......Page 35
Clinical applications......Page 36
Breast......Page 37
Liver......Page 38
Bone......Page 39
Targeted drug delivery......Page 41
Blood–brain barrier disruption......Page 42
References......Page 43
Coils......Page 47
Absolute ethanol......Page 48
Roadmap and superselective arteriography......Page 49
Lipiodol chemoembolization......Page 50
Drug-eluting bead TACE (DEB-TACE)......Page 51
Superselective catheterization and C-arm CT......Page 52
References......Page 53
Mechanism of radioembolization......Page 56
Indications and contraindications......Page 57
Base and follow-up cross-sectional imaging......Page 58
Localization imaging (nuclear medicine imaging)......Page 59
Radiation safety considerations......Page 60
Radiation safety considerations in case of autopsy, burial, or cremation......Page 61
References......Page 62
Regional delivery of the drug leads to increased local concentration......Page 64
Floxuridine (5-fluoro-2’-deoxyuridine)......Page 65
5-Fluorouracil......Page 66
Irinotecan......Page 67
Oxaliplatin......Page 68
Hepatic artery combination chemotherapy administration......Page 69
Therapeutic monoclonal antibodies......Page 70
Combining best systemic chemotherapy with best HAI strategy......Page 71
Regional therapy pharmacology appendix......Page 72
Pharmacology appendix......Page 73
References......Page 75
Imaging for device delivery......Page 77
Contrast agents......Page 78
Image registration and fusion......Page 79
Robotics......Page 80
Intraprocedural monitoring......Page 81
Imaging for therapy assessment......Page 82
References......Page 83
Anatomic biomarkers......Page 89
Functional biomarkers: Diffusion-weighted and contrast-enhanced MRI......Page 90
The volumetric approach......Page 91
Conclusion......Page 92
References......Page 95
Diagnostic criteria......Page 97
Clinical staging......Page 98
Image-guided ablation......Page 99
Systemic treatment......Page 100
References......Page 101
Very-early-stage hepatocellular carcinoma......Page 103
Early-stage hepatocellular carcinoma......Page 104
Conclusion......Page 107
References......Page 109
Celiac stenosis or occlusion......Page 112
Normal hepatic artery anatomy and variations in its origin and anatomic course......Page 116
Intrahepatic variations in branching segmental hepatic arteries......Page 117
Non-hepatic arteries arising from hepatic arteries......Page 118
Right gastric artery......Page 119
Accessory left gastric artery......Page 120
Hepatic falciform artery......Page 121
Pancreaticoduodenal arteries......Page 122
Extrahepatic collateral arteries......Page 123
How to predict: Suggestive findings......Page 125
Inferior phrenic arteries......Page 128
Omental arteries......Page 129
References......Page 130
Concept and materials used during TACE......Page 132
Technique......Page 133
Follow-up and evaluation of response to treatment......Page 135
Clinical outcome......Page 136
References......Page 137
Technique......Page 140
Adverse events and toxicities......Page 141
Clinical outcomes......Page 142
References......Page 144
Curative therapies......Page 146
Chemoembolization......Page 148
References......Page 149
Radiofrequency ablation......Page 151
Microwave ablation......Page 153
Discussion......Page 154
References......Page 156
Resection......Page 160
Chemoembolization......Page 161
Drug-eluting microsphere platforms......Page 162
Technical aspects of chemoembolization......Page 163
Technique for drug-eluting microsphere embolization......Page 164
Outcomes of conventional chemoembolization for colorectal metastases......Page 165
Outcomes with drug-eluting microspheres......Page 166
References......Page 167
Patient presentation......Page 170
TheraSphere......Page 171
Radiation gastritis/gastrointestinal ulceration/pancreatitis (= 5%)......Page 172
Radioembolization combined with first-line chemotherapy......Page 173
TheraSphere – results......Page 174
References......Page 175
Diagnosis......Page 177
Multidisciplinary triage of neuroendocrine neoplasms......Page 179
Surgical management......Page 180
Tumor ablation......Page 181
Hepatic arterial therapy......Page 182
References......Page 185
Mechanisms of liver regeneration......Page 188
Pathophysiology of preoperative PVE......Page 189
FLR volume measurement and predicting function after PVE......Page 190
Standard approaches......Page 191
PVE in conjunction with transarterial therapies......Page 192
Extent of embolization......Page 194
Complications......Page 195
General indications......Page 196
Normal underlying liver......Page 197
High-dose chemotherapy......Page 198
Conclusion......Page 199
References......Page 200
21 Extrahepatic biliary cancer: Stenting, brachytherapy, and photodynamic therapy......Page 205
Photodynamic therapy......Page 208
Radiotherapy......Page 209
References......Page 211
Diagnosis......Page 215
Percutaneous techniques......Page 216
Histology of cryoablation......Page 217
Radiofrequency ablation......Page 218
Microwave ablation......Page 219
Complications......Page 220
Surgical and RFA options......Page 221
References......Page 223
Basic concepts......Page 226
Partial nephrectomy......Page 227
Palliative embolization......Page 230
Complications......Page 231
References......Page 232
Microwave ablation......Page 235
Procedure......Page 236
Cryoablation......Page 237
Radiofrequency ablation......Page 239
Comparison of thermal ablation techniques......Page 240
Applications and outcomes for thoracic ablation......Page 241
Palliation......Page 249
References......Page 250
Indications for treatment......Page 255
RFA technique......Page 256
RFA pain palliation outcomes......Page 257
Cryoablation technique......Page 260
Cryoablation pain palliation outcomes......Page 262
References......Page 264
Contraindications......Page 267
Technique......Page 268
Efficacy and complications......Page 270
Percutaneous sacroplasty, osteoplasty, and advance hybrid stabilization techniques......Page 271
References......Page 274
Cancer detection and treatment guidance......Page 277
Targeting strategies......Page 278
Ultrasound guidance......Page 279
High-intensity focused ultrasound......Page 280
Cryoablation......Page 281
Other techniques......Page 282
Complications and outcomes......Page 283
Local control......Page 286
References......Page 289
Rationale......Page 295
Catheter positioning......Page 296
Contraindications......Page 297
Chemotherapy......Page 299
Description......Page 300
Access route......Page 301
Catheter tip location......Page 302
Catheter-related infection......Page 303
References......Page 304
Overview of hospice care......Page 306
Prognostication......Page 307
Breaking bad news......Page 308
Pain......Page 310
Opioid analgesics......Page 311
Adjuvant analgesics......Page 313
Nausea and vomiting......Page 314
Constipation......Page 316
Constitutional symptoms......Page 318
Depression......Page 319
Anxiety......Page 321
References......Page 322
Anatomy......Page 327
Positioning and approach......Page 328
Antecrural......Page 329
Complications......Page 330
Superior hypogastric neurolysis......Page 331
Positioning and approach......Page 332
References......Page 333
Diuretics and sodium restriction......Page 335
Permanent indwelling catheters......Page 336
Tenckhoff catheter......Page 337
Peritoneovenous shunts......Page 338
Thoracentesis......Page 340
References......Page 341
Index......Page 345
