Interventional Oncology: Principles and Practice of Image-Guided Cancer Therapy

Description

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. 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