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Erschienen in: Die Radiologie 6/2024

23.05.2024 | Hepatozelluläres Karzinom | CME

Ablation von Lebertumoren

Von der prä-interventionellen Bildgebung bis zur post-interventionellen Beurteilung

verfasst von: Dr. med. Timo C. Meine, Prof. Dr. med. Kristina I. Ringe

Erschienen in: Die Radiologie | Ausgabe 6/2024

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Zusammenfassung

Dieser Artikel gibt einen Überblick über die am häufigsten angewendeten bildgesteuerten, perkutanen, lokalablativen Therapieverfahren von primären und sekundären Lebertumoren. Es werden die technischen Verfahren der Radiofrequenzablation (RFA) und der Mikrowellenablation (MWA) vorgestellt. Auch unter Berücksichtigung aktueller nationaler Leitlinien werden präi-nterventionelle Diagnostik, Indikationen und Durchführbarkeit diskutiert. Abschließend folgen eine Präsentation von Therapieergebnissen sowie Empfehlungen zur Bildgebung und post-interventionellen Beurteilung nach lokalablativer Therapie.
Literatur
1.
Zurück zum Zitat Bertolotti L, Bazzocchi MV, Iemma E et al (2023) Radiofrequency Ablation, Cryoablation, and Microwave Ablation for the Treatment of Small Renal Masses: Efficacy and Complications. Diagnostics 13(3):388CrossRefPubMedPubMedCentral Bertolotti L, Bazzocchi MV, Iemma E et al (2023) Radiofrequency Ablation, Cryoablation, and Microwave Ablation for the Treatment of Small Renal Masses: Efficacy and Complications. Diagnostics 13(3):388CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Páez-Carpio A, Gómez FM, Isus OG et al (2021) Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art. Insights Imaging 12(1):57CrossRefPubMedPubMedCentral Páez-Carpio A, Gómez FM, Isus OG et al (2021) Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art. Insights Imaging 12(1):57CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Ringe KI, Panzica M, von Falck C (2016) Thermoablation of Bone Tumors. Rofo 188(6):539–550CrossRefPubMed Ringe KI, Panzica M, von Falck C (2016) Thermoablation of Bone Tumors. Rofo 188(6):539–550CrossRefPubMed
4.
Zurück zum Zitat Goldberg SN, Gazelle GS, Mueller PR (2000) Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 174:323–331CrossRefPubMed Goldberg SN, Gazelle GS, Mueller PR (2000) Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 174:323–331CrossRefPubMed
5.
Zurück zum Zitat Pereira PL, Trübenbach J, Schenk M et al (2004) Radiofrequency ablation: in vivo comparison of four commercially available devices in pig livers. Radiology 232:482–490CrossRefPubMed Pereira PL, Trübenbach J, Schenk M et al (2004) Radiofrequency ablation: in vivo comparison of four commercially available devices in pig livers. Radiology 232:482–490CrossRefPubMed
6.
Zurück zum Zitat Lu DSK, Yu NC, Raman SS et al (2005) Radiofrequency ablation of hepatocellular carcinoma: treatment success as defined by histologic examination of the explanted liver. Radiology 234:954–960CrossRefPubMed Lu DSK, Yu NC, Raman SS et al (2005) Radiofrequency ablation of hepatocellular carcinoma: treatment success as defined by histologic examination of the explanted liver. Radiology 234:954–960CrossRefPubMed
8.
Zurück zum Zitat Ringe KI, Hinrichs JB (2021) State of the art in the diagnostics of hepatocellular carcinoma and current treatment options. Radiologe 61:213–226CrossRefPubMed Ringe KI, Hinrichs JB (2021) State of the art in the diagnostics of hepatocellular carcinoma and current treatment options. Radiologe 61:213–226CrossRefPubMed
11.
Zurück zum Zitat Rinke A, Wiedenmann B, Auernhammer C et al (2918). S2k-Leitlinie Neuroendokrine Tumore. Z Gastroenterol 56:583–681 Rinke A, Wiedenmann B, Auernhammer C et al (2918). S2k-Leitlinie Neuroendokrine Tumore. Z Gastroenterol 56:583–681
15.
Zurück zum Zitat European Association for the Study of the Liver (2023) EASL-ILCA clinical practice guidelines in the management of intrahepatic cholangiocarcinoma. J Hepatol 79:181–209 European Association for the Study of the Liver (2023) EASL-ILCA clinical practice guidelines in the management of intrahepatic cholangiocarcinoma. J Hepatol 79:181–209
16.
Zurück zum Zitat Cervantes A, Adam R, Roselló S et al (2023) Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 34(1):10–32CrossRefPubMed Cervantes A, Adam R, Roselló S et al (2023) Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 34(1):10–32CrossRefPubMed
17.
Zurück zum Zitat Malloy PC, Grassi CJ, Kundu S et al (2009) Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 20:S240–249CrossRefPubMed Malloy PC, Grassi CJ, Kundu S et al (2009) Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 20:S240–249CrossRefPubMed
18.
Zurück zum Zitat McGlynn KA, Petrick JL, El-Serag HB (2021) Epidemiology of Hepatocellular Carcinoma. Hepatology 73 (Suppl 1):4–13 McGlynn KA, Petrick JL, El-Serag HB (2021) Epidemiology of Hepatocellular Carcinoma. Hepatology 73 (Suppl 1):4–13
19.
Zurück zum Zitat Nishikawa H, Inuzuka T, Takeda H et al (2011) Comparison of percutaneous radiofrequency thermal ablation and surgical resection for small hepatocellular carcinoma. BMC Gastroenterol 111:143CrossRef Nishikawa H, Inuzuka T, Takeda H et al (2011) Comparison of percutaneous radiofrequency thermal ablation and surgical resection for small hepatocellular carcinoma. BMC Gastroenterol 111:143CrossRef
20.
Zurück zum Zitat Morimoto M, Numata K, Kondou M et al (2010) Midterm outcomes in patients with intermediate-sized hepatocellular carcinoma: a randomized controlled trial for determining the efficacy of radiofrequency ablation combined with transcatheter arterial chemoembolization. Cancer 116:5452–5460CrossRefPubMed Morimoto M, Numata K, Kondou M et al (2010) Midterm outcomes in patients with intermediate-sized hepatocellular carcinoma: a randomized controlled trial for determining the efficacy of radiofrequency ablation combined with transcatheter arterial chemoembolization. Cancer 116:5452–5460CrossRefPubMed
21.
Zurück zum Zitat Peng Z‑W, Zhang Y‑J, Chen M‑S et al (2013) Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma: a prospective randomized trial. J Clin Oncol 31(4):426–432CrossRefPubMed Peng Z‑W, Zhang Y‑J, Chen M‑S et al (2013) Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma: a prospective randomized trial. J Clin Oncol 31(4):426–432CrossRefPubMed
22.
Zurück zum Zitat Wang L, Ke Q, Lin N et al (2019) The efficacy of transarterial chemoembolization combined with microwave ablation for unresectable hepatocellular carcinoma: a systematic review and meta-analysis. Int J Hyperthermia 36:1288–1296CrossRefPubMed Wang L, Ke Q, Lin N et al (2019) The efficacy of transarterial chemoembolization combined with microwave ablation for unresectable hepatocellular carcinoma: a systematic review and meta-analysis. Int J Hyperthermia 36:1288–1296CrossRefPubMed
23.
Zurück zum Zitat Chu HH, Kim JH, Shin YM, Won HJ, Kim P‑N (2021) Percutaneous radiofrequency ablation for recurrent intrahepatic cholangiocarcinoma after curative resection: multivariable analysis of factors predicting survival outcomes. AJR Am J Roentgenol 217:426–432CrossRefPubMed Chu HH, Kim JH, Shin YM, Won HJ, Kim P‑N (2021) Percutaneous radiofrequency ablation for recurrent intrahepatic cholangiocarcinoma after curative resection: multivariable analysis of factors predicting survival outcomes. AJR Am J Roentgenol 217:426–432CrossRefPubMed
24.
Zurück zum Zitat Díaz-González Á, Vilana R, Bianchi L et al (2020) Thermal ablation for intrahepatic cholangiocarcinoma in cirrhosis: safety and efficacy in non-surgical patients. J Vasc Interv Radiol 31:710–719CrossRefPubMed Díaz-González Á, Vilana R, Bianchi L et al (2020) Thermal ablation for intrahepatic cholangiocarcinoma in cirrhosis: safety and efficacy in non-surgical patients. J Vasc Interv Radiol 31:710–719CrossRefPubMed
25.
Zurück zum Zitat Leporrier J, Maurel J, Chiche L et al (2006) A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer. Br J Surg 93:465–474CrossRefPubMed Leporrier J, Maurel J, Chiche L et al (2006) A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer. Br J Surg 93:465–474CrossRefPubMed
26.
Zurück zum Zitat Gillams AR, Lees WR (2009) Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation. Eur Radiol 19(5):1206–1213CrossRefPubMed Gillams AR, Lees WR (2009) Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation. Eur Radiol 19(5):1206–1213CrossRefPubMed
27.
Zurück zum Zitat Gillams A, Goldberg N, Ahmed M et al (2015) Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, The Interventional Oncology Sans Frontieres meeting 2013. Eur Radiol 25(12):3438–3454CrossRefPubMedPubMedCentral Gillams A, Goldberg N, Ahmed M et al (2015) Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, The Interventional Oncology Sans Frontieres meeting 2013. Eur Radiol 25(12):3438–3454CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat van Amerongen MJ, van der Stok EP, Fütterer JJ et al (2016) Short term and long term results of patients with colorectal liver metastases undergoing surgery with or without radiofrequency ablation. Eur J Surg Oncol 42:523–530CrossRefPubMed van Amerongen MJ, van der Stok EP, Fütterer JJ et al (2016) Short term and long term results of patients with colorectal liver metastases undergoing surgery with or without radiofrequency ablation. Eur J Surg Oncol 42:523–530CrossRefPubMed
29.
Zurück zum Zitat Ruers T, Punt C, Van Coevorden F et al (2012) Radiofrequency ablation combined with systemic treatment versus systemic treatment alone in patients with non-resectable colorectal liver metastases: a randomized EORTC Intergroup phase II study (EORTC 40004). Ann Oncol 23:2619–2626CrossRefPubMedPubMedCentral Ruers T, Punt C, Van Coevorden F et al (2012) Radiofrequency ablation combined with systemic treatment versus systemic treatment alone in patients with non-resectable colorectal liver metastases: a randomized EORTC Intergroup phase II study (EORTC 40004). Ann Oncol 23:2619–2626CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Yang DP, Zhuang BW, Wang YZ et al (2020) Thermal ablation versus hepatic resection for the treatment of liver metastases from gastrointestinal stromal tumors: a retrospective study. Int J Hyperthemia 37(1):591–599 Yang DP, Zhuang BW, Wang YZ et al (2020) Thermal ablation versus hepatic resection for the treatment of liver metastases from gastrointestinal stromal tumors: a retrospective study. Int J Hyperthemia 37(1):591–599
31.
Zurück zum Zitat Filippiadis DK, Binkert C, Pellerin O et al (2017) CIRSE Quality Assurance Document and Standards for Classification of Complications: The CIRSE Classification System. Cardiovasc Intervent Radiol 40:1141–1146CrossRefPubMed Filippiadis DK, Binkert C, Pellerin O et al (2017) CIRSE Quality Assurance Document and Standards for Classification of Complications: The CIRSE Classification System. Cardiovasc Intervent Radiol 40:1141–1146CrossRefPubMed
32.
Zurück zum Zitat Crocetti L, de Baère T, Pereira L, Tarantino FP (2020) CIRSE standards of practice on thermal ablation of liver tumours. Cardiovasc Intervent Radiol 43:951–962CrossRefPubMed Crocetti L, de Baère T, Pereira L, Tarantino FP (2020) CIRSE standards of practice on thermal ablation of liver tumours. Cardiovasc Intervent Radiol 43:951–962CrossRefPubMed
33.
34.
Zurück zum Zitat Langenhoff BS, Oyen WJG, Jager GJ et al (2002) Efficacy of fluorine-18-deoxyglucose positron emission tomography in detecting tumor recurrence after local ablative therapy for liver metastases: a prospective study. J Clin Oncol 20:4453–4458CrossRefPubMed Langenhoff BS, Oyen WJG, Jager GJ et al (2002) Efficacy of fluorine-18-deoxyglucose positron emission tomography in detecting tumor recurrence after local ablative therapy for liver metastases: a prospective study. J Clin Oncol 20:4453–4458CrossRefPubMed
35.
Zurück zum Zitat Purandare NC, Rangarajan V, Shah SA et al (2011) Therapeutic response to radiofrequency ablation of neoplastic lesions: FDG PET/CT findings. Radiographics 31:201–213CrossRefPubMed Purandare NC, Rangarajan V, Shah SA et al (2011) Therapeutic response to radiofrequency ablation of neoplastic lesions: FDG PET/CT findings. Radiographics 31:201–213CrossRefPubMed
36.
Zurück zum Zitat Choi H, Loyer EM, DuBrow RA et al (2001) Radio-frequency ablation of liver tumors: assessment of therapeutic response and complications. Radiographics: S41–54 Choi H, Loyer EM, DuBrow RA et al (2001) Radio-frequency ablation of liver tumors: assessment of therapeutic response and complications. Radiographics: S41–54
37.
Zurück zum Zitat Hoffmann R, Rempp H, Schraml C et al (2015) Diffusion-weighted imaging during MR-guided radiofrequency ablation of hepatic malignancies: analysis of immediate pre- and post-ablative diffusion characteristics. Acta Radiol 56:908–916CrossRefPubMed Hoffmann R, Rempp H, Schraml C et al (2015) Diffusion-weighted imaging during MR-guided radiofrequency ablation of hepatic malignancies: analysis of immediate pre- and post-ablative diffusion characteristics. Acta Radiol 56:908–916CrossRefPubMed
38.
Zurück zum Zitat Lu T‑L, Becce F, Bize P et al (2012) Assessment of liver tumor response by high-field (3T) MRI after radiofrequency ablation: short- and mid-term evolution of diffusion parameters within the ablation zone. Eur J Radiol 81:e944–950CrossRefPubMed Lu T‑L, Becce F, Bize P et al (2012) Assessment of liver tumor response by high-field (3T) MRI after radiofrequency ablation: short- and mid-term evolution of diffusion parameters within the ablation zone. Eur J Radiol 81:e944–950CrossRefPubMed
39.
Zurück zum Zitat Schraml C, Schwenzer NF, Clasen S et al (2009) Navigator respiratory-triggered diffusion-weighted imaging in the follow-up after hepatic radiofrequency ablation-initial results. J Magn Reson Imaging 29:1308–1316CrossRefPubMed Schraml C, Schwenzer NF, Clasen S et al (2009) Navigator respiratory-triggered diffusion-weighted imaging in the follow-up after hepatic radiofrequency ablation-initial results. J Magn Reson Imaging 29:1308–1316CrossRefPubMed
40.
Zurück zum Zitat Choi YS, Lee SM, Song BY et al (2002) Dynamic sonography of external snapping hip syndrome. J Ultrasound Med 21:753–758CrossRefPubMed Choi YS, Lee SM, Song BY et al (2002) Dynamic sonography of external snapping hip syndrome. J Ultrasound Med 21:753–758CrossRefPubMed
Metadaten
Titel
Ablation von Lebertumoren
Von der prä-interventionellen Bildgebung bis zur post-interventionellen Beurteilung
verfasst von
Dr. med. Timo C. Meine
Prof. Dr. med. Kristina I. Ringe
Publikationsdatum
23.05.2024
Verlag
Springer Medizin
Erschienen in
Die Radiologie / Ausgabe 6/2024
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI
https://doi.org/10.1007/s00117-024-01308-x

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