Interventional Oncology/Stereotaxy and Robotics, Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
Siemens Healthineers, Erlangen, Germany.
J Med Imaging Radiat Oncol. 2023 Dec;67(8):886-894. doi: 10.1111/1754-9485.13555. Epub 2023 Jul 3.
For both primary and metastatic liver cancer, thermal ablation represents an interesting alternative to surgery. However, except for a small fraction of patients, conventional ultrasound- and CT-guided single-probe approaches have not achieved oncologic outcomes comparable with surgery. In this overview, we describe our stereotactic ablation workflow and discuss the short- and long-term results of stereotactic radiofrequency ablation (SRFA) and stereotactic microwave ablation (SMWA) for the treatment of primary and secondary liver tumours. The advantages of this method are discussed together with a summary of the existing stereotactic techniques for thermal ablation and the clinical data that support them. Stereotactic ablation is based on an optical navigation system and a specialized aiming tool. The workflow includes advanced three-dimensional planning, precise needle/probe placements according to the plan and intraoperative image fusion to check the needle positions and the ablation margins. Stereotactic ablation offers all the advantages of a minimally invasive procedure while producing oncological results comparable with surgery. The number of locally treatable liver cancers may be significantly expanded with these cutting-edge instruments and methods. We firmly believe that it can become a cornerstone in the treatment of liver cancers.
对于原发性和转移性肝癌，热消融术代表了一种有前途的手术替代疗法。然而，除了一小部分患者外，传统的超声和 CT 引导的单探针方法尚未达到与手术可比的肿瘤学结果。在本篇综述中，我们描述了立体定向消融工作流程，并讨论了立体定向射频消融（SRFA）和立体定向微波消融（SMWA）治疗原发性和继发性肝肿瘤的短期和长期结果。本文还讨论了该方法的优势，并总结了现有的立体定向热消融技术及其支持的临床数据。立体定向消融基于光学导航系统和专门的瞄准工具。工作流程包括先进的三维规划、根据计划进行精确的针/探头放置以及术中图像融合，以检查针的位置和消融边界。立体定向消融术具有微创程序的所有优势，同时产生与手术相当的肿瘤学结果。使用这些先进的仪器和方法，可能会显著增加可局部治疗的肝癌数量。我们坚信，它可以成为治疗肝癌的基石。
