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Publications

Journal Article Review Epublish 10 citations

PubMed: 35628893 DOI: 10.3390/jcm11102766

Complications Risk Assessment and Imaging Findings of Thermal Ablation Treatment in Liver Cancers: What the Radiologist Should Expect.

J Clin Med 11(10)

Authors: Vincenza Granata, Roberta Fusco, Federica De Muzio, Carmen Cutolo, Sergio Venanzio Setola, Igino Simonetti, Federica Dell'Aversana, Francesca Grassi, Federico Bruno, Andrea Belli, Renato Patrone, Vincenzo Pilone, Antonella Petrillo, Francesco Izzo

Affiliations

  • Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131 Naples, Italy.
  • Medical Oncology Division, Igea SpA, 80013 Naples, Italy.
  • Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy.
  • Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy.
  • Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy.
  • Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy.
  • Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, 67100 L'Aquila, Italy.
  • Hepatobiliary Surgical Oncology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131 Naples, Italy.

Abstract

One of the major fields of application of ablation treatment is liver tumors. With respect to HCC, ablation treatments are considered as upfront treatments in patients with early-stage disease, while in colorectal liver metastases (CLM), they can be employed as an upfront treatment or in association with surgical resection. The main prognostic feature of ablation is the tumor size, since the goal of the treatment is the necrosis of all viable tumor tissue with an adequate tumor-free margin. Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most employed ablation techniques. Ablation therapies in HCC and liver metastases have presented a challenge to radiologists, who need to assess response to determine complication-related treatment. Complications, defined as any unexpected variation from a procedural course, and adverse events, defined as any actual or potential injury related to the treatment, could occur either during the procedure or afterwards. To date, RFA and MWA have shown no statistically significant differences in mortality rates or major or minor complications. To reduce the rate of major complications, patient selection and risk assessment are essential. To determine the right cost-benefit ratio for the ablation method to be used, it is necessary to identify patients at high risk of infections, coagulation disorders and previous abdominal surgery interventions. Based on risk assessment, during the procedure as part of surveillance, the radiologists should pay attention to several complications, such as vascular, biliary, mechanical and infectious. Multiphase CT is an imaging tool chosen in emergency settings. The radiologist should report technical success, treatment efficacy, and complications. The complications should be assessed according to well-defined classification systems, and these complications should be categorized consistently according to severity and time of occurrence.

MeSH

Neoplasm Metastasis, Therapeutics, Neoplasms, Liver, Risk Assessment, Radiologists

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