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实体肿瘤图像引导消融治疗的进展

Advances in Image-Guided Ablation Therapies for Solid Tumors.

作者信息

Campbell Warren A, Makary Mina S

机构信息

Division of Vascular and Interventional Radiology, Department of Radiology, University of Virginia, Charlottesville, VA 22903, USA.

Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.

出版信息

Cancers (Basel). 2024 Jul 17;16(14):2560. doi: 10.3390/cancers16142560.

Abstract

Image-guided solid tumor ablation methods have significantly advanced in their capability to target primary and metastatic tumors. These techniques involve noninvasive or percutaneous insertion of applicators to induce thermal, electrochemical, or mechanical stress on malignant tissue to cause tissue destruction and apoptosis of the tumor margins. Ablation offers substantially lower risks compared to traditional methods. Benefits include shorter recovery periods, reduced bleeding, and greater preservation of organ parenchyma compared to surgical intervention. Due to the reduced morbidity and mortality, image-guided tumor ablation offers new opportunities for treatment in cancer patients who are not candidates for resection. Currently, image-guided ablation techniques are utilized for treating primary and metastatic tumors in various organs with both curative and palliative intent, including the liver, pancreas, kidneys, thyroid, parathyroid, prostate, lung, breast, bone, and soft tissue. The invention of new equipment and techniques is expanding the criteria of eligible patients for therapy, as now larger and more high-risk tumors near critical structures can be ablated. This article provides an overview of the different imaging modalities, noninvasive, and percutaneous ablation techniques available and discusses their applications and associated complications across various organs.

摘要

图像引导下的实体肿瘤消融方法在靶向原发性和转移性肿瘤的能力方面取得了显著进展。这些技术包括无创或经皮插入施源器,以对恶性组织施加热、电化学或机械应力,从而导致组织破坏和肿瘤边缘细胞凋亡。与传统方法相比,消融的风险要低得多。其优点包括恢复期更短、出血减少,与手术干预相比,能更好地保留器官实质。由于发病率和死亡率降低,图像引导下的肿瘤消融术为那些不适合进行切除术的癌症患者提供了新的治疗机会。目前,图像引导下的消融技术被用于以治愈和姑息为目的治疗各种器官的原发性和转移性肿瘤,包括肝脏、胰腺、肾脏、甲状腺、甲状旁腺、前列腺、肺、乳腺、骨骼和软组织。新设备和技术的发明正在扩大符合治疗条件的患者标准,因为现在可以消融靠近关键结构的更大且风险更高的肿瘤。本文概述了现有的不同成像方式、无创和经皮消融技术,并讨论了它们在各个器官中的应用及相关并发症。

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