Interventional Oncology Principles and Practice of Image Guided Cancer Therapy 2nd Edition by Jean Francois Geschwind , Michael Soulen ISBN 1107043476 978-1107043473

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ISBN 10: 1107043476 
ISBN 13: 978-1107043473
Author: Jean-Francois H. Geschwind , Michael C. Soulen 

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.

Interventional Oncology Principles and Practice of Image Guided Cancer Therapy 2nd Table of contents:

Section I Principles of oncology

1 Interventional oncology: The fourth pillar of cancer care

Section II Principles of image-guided therapies

2 Principles of radiofrequency and microwave tumor ablation

Key points

Introduction

Biology of heating

Radiofrequency ablation

Microwave ablation

Tissue factors affecting RF ablation

Tissue factors affecting microwave ablation

Radiofrequency ablation vs. microwave ablation – benefits and trade-offs

Energy-deposited technology

Multiapplicator arrays

Multitine applicators

Bipolar arrays

Internally cooled electrodes

Perfused electrodes

Cooling in microwave ablation

Cluster RF

Pulsed RF application

Switching RF applicator energy

Operator and technique

Ablative margin

Choice of applicator

Overlapping techniques

Ancillary procedures

Combination therapies

Combining RF with transarterial chemoembolization

Combining RF with chemotherapy

Combining RF ablation with radiation

Patient selection

Conclusion

References

3 Principles of irreversible electroporation

Introduction

Pulse parameters and impact on IRE

Electric field strength

Pulse length

Number of pulses

Numerical simulations

Equipment and ablation probes

Clinical considerations

Clinical experience

Conclusion

References

4 Principles of high-intensity focused ultrasound

Introduction

HIFU principles and bioeffects

History

Thermal effects

Ablation

Hyperthermia

Ultrasound field generation and transducer design

Thermal dose concept

Mechanical effects

Cavitation

Histotripsy

Microstreaming

Radiation forces

HIFU system technology

Ultrasound guidance

MRI guidance

HIFU devices

Clinical applications

Prostate

Breast

Liver

Bone

Emerging applications

Targeted drug delivery

Blood–brain barrier disruption

Conclusion

References

5 Principles of tumor embolotherapy and chemoembolization

Tumor embolotherapy

General indications

Embolic materials

Gelfoam

Polyvinyl alcohol foam

Coils

Absolute ethanol

Microspheres

Embolization: Technical considerations

Pre-embolization evaluation

Roadmap and superselective arteriography

Chemoembolization

Basic principle

Chemotherapeutic agents used for chemoembolization

Lipiodol chemoembolization

Subsegmental chemoembolization

Drug-eluting bead TACE (DEB-TACE)

Superselective catheterization and C-arm CT

References

6 Principles of radioembolization

Introduction

Mechanism of radioembolization

Radioembolic material

Indications and contraindications

Imaging considerations

Base and follow-up cross-sectional imaging

Localization imaging (nuclear medicine imaging)

Determining treatment dosage (activity)

(Y-90) SIR-Sphere

(Y-90) TheraSphere

Radioembolization: technical considerations

Microcatheters

(Y-90) SIR-Sphere

(Y-90) TheraSphere

Radiation safety considerations

Patient release

Radiation safety considerations for cases involving surgery

Radiation safety considerations in case of autopsy, burial, or cremation

References

7 Principles of intra-arterial infusional chemotherapy in the treatment of liver metastases from colorectal cancer

Background

Pharmacologic concepts useful in understanding and evaluating potential advantages of regional delivery for specific drugs

Regional delivery of the drug leads to increased local concentration

Increased local concentration leads to increased therapeutic response

Regional delivery of a drug leads to decreased systemic exposure

Pharmacological suitability for hepatic arterial infusion of different active drugs in colorectal cancer

Floxuridine (5-fluoro-2’-deoxyuridine)

5-Fluorouracil

Irinotecan

Oxaliplatin

Hepatic artery combination chemotherapy administration

Hepatic intra-arterial infusion of irinotecan-loaded drug-eluting beads (DEBIRI)

Therapeutic monoclonal antibodies

Combining best systemic chemotherapy with best HAI strategy

Future research

Regional therapy pharmacology appendix1,7

Pharmacology appendix49–52

References

8 Imaging in interventional oncology: Role of image guidance

Introduction

Imaging for procedure planning

Imaging for device delivery

Advances in real-time imaging

Three-dimensionality

Contrast agents

Image registration and fusion

Navigation

Robotics

Open access to the patient

Radiation exposure

Intraprocedural monitoring

Imaging for therapy assessment

Summary

References

9 Novel developments in MR assessment of treatment response after locoregional therapy

Introduction: Multiparametric MRI

Anatomic biomarkers

Functional biomarkers: Diffusion-weighted and contrast-enhanced MRI

The volumetric approach

Conclusion

References

Section III Organ-specific cancers – primary liver cancers

10 Assessment and triage of hepatocellular carcinoma

Summary

Introduction

Assessment of hepatocellular carcinoma

Diagnostic criteria

Clinical staging

Triage of hepatocellular carcinoma

Early stage

Liver transplantation

Surgical resection

Image-guided ablation

Intermediate–advanced stage

Transarterial treatment

Systemic treatment

Conclusion

References

11 Image-guided ablation of hepatocellular carcinoma

Introduction

Very-early-stage hepatocellular carcinoma

Early-stage hepatocellular carcinoma

Image-guided ablation: Evolving methods and techniques

Conclusion

References

12 Embolization of liver tumors: Anatomy

Celiac trunk anatomy

Normal celiac trunk anatomy and variations

Celiac stenosis or occlusion

Hepatic artery anatomy

Normal hepatic artery anatomy and variations in its origin and anatomic course

Intrahepatic variations in branching segmental hepatic arteries

Segmental localization of liver tumors

Non-hepatic arteries arising from hepatic arteries

Right gastric artery

Accessory left gastric artery

Hepatic falciform artery

Left inferior phrenic artery

Pancreaticoduodenal arteries

Cystic artery and biliary plexus

Extrahepatic collateral arteries

How to predict: Suggestive findings

Anatomy of extrahepatic collateral arteries

Inferior phrenic arteries

Internal mammary arteries

Intercostal and lumbar arteries

Omental arteries

Adrenal arteries

Renal and renal capsular arteries

Gastric arteries

Colic branches

Transcatheter management of extrahepatic collateral arteries

References

13 Conventional chemoembolization and chemoembolization with drug-eluting beads: Technique and future potential

Background

Concept and materials used during TACE

Patient selection and contraindications for TACE and DEB-TACE

Technique

Follow-up and evaluation of response to treatment

Complications and side effects

Clinical outcome

Combination therapies

Conclusion and outlook

References

14 90Yttrium radioembolization for hepatocellular carcinoma

Patient selection

Technique

Dosimetry

Adverse events and toxicities

Clinical outcomes

References

15 Image-guided therapy of intrahepatic cholangiocarcinoma

Assessment and triage

Curative therapies

Percutaneous ablation

Non-curative therapies

Chemoembolization

Radioembolization

Multidisciplinary approach

References

Section IV Organ-specific cancers – liver metastases

16 Colorectal masses: Ablation

Introduction

Indications

Contraindications

Ablation modalities

Radiofrequency ablation

Cryoablation

Microwave ablation

Irreversible electroporation

Laser-induced interstitial thermotherapy

Discussion

References

17 Assessment, triage, and chemoembolization for colorectal liver metastases

Assessment of the patient with liver metastases

Triage of patients with liver metastases

Resection

Ablation

Intra-arterial chemoinfusion

Systemic therapy

Chemoembolization

Patient selection for chemoembolization

Chemoembolization regimens

“Conventional” cocktails

Drug-eluting microsphere platforms

Preclinical animal studies with drug-eluting microspheres

Technical aspects of chemoembolization

Technical aspects for drug-eluting microspheres, particle size, drug loading, delivery endpoints, peri- and intraprocedural management

Loading

Technique for drug-eluting microsphere embolization

Delivery endpoints

Peri- and intraprocedural management for drug-eluting microspheres

Outcomes of conventional chemoembolization for colorectal metastases

Outcomes with drug-eluting microspheres

Summary

References

18 Radioembolization for colorectal liver metastases

Introduction

Patient identification and selection

Patient presentation

Preimplantation workup procedure

Treatment process

Dosimetry and dose calculation25

TheraSphere

SIR-Spheres

Calculation of lung dose25

Postprocedural care and follow-up

Postprocedure considerations

Side effects and toxicities

Postembolization syndrome (20–30%)

Radiation gastritis/gastrointestinal ulceration/pancreatitis (≤ 5%)

Radiation pneumonitis (≤ 1%)

Radiation hepatitis (≤ 1%)

Lymphopenia (40%)

Biliary injury (≤ 10%)

Radiation cholecystitis (≤ 2%)

CT/PET evaluation of tumor response

Literature review

SIR-Spheres – results

Radioembolization combined with first-line chemotherapy

Radioembolization combined with second- or third-line chemotherapy

Radioembolization as salvage therapy in chemorefractory metastatic colorectal cancer

TheraSphere – results

Conclusion

References

19 Assessment, triage, and liver-directed therapies for neuroendocrine tumor metastases

Defining neuroendocrine disease

Terminology

Demographics and epidemiology

Diagnosis

Prognosis

Multidisciplinary triage of neuroendocrine neoplasms

Systemic therapies

Surgical management

Image-guided therapy

Tumor ablation

Hepatic arterial therapy

Conclusion

References

20 Preoperative portal vein embolization

Mechanisms of liver regeneration

Rate of liver regeneration

Pathophysiology of preoperative PVE

FLR volume measurement and predicting function after PVE

Technical considerations for PVE

Standard approaches

Additional approaches

PVE in conjunction with transarterial therapies

Extent of embolization

Embolic materials

Complications

Indications and outcomes for PVE

General indications

General contraindications

Normal underlying liver

Underlying liver disease

High-dose chemotherapy

Conclusion

References

Section V Organ-specific cancers – extrahepatic biliary cancer

21 Extrahepatic biliary cancer: Stenting, brachytherapy, and photodynamic therapy

Photodynamic therapy

Radiotherapy

References

Section VI Organ-specific cancers – renal cell carcinoma

22 Management of small renal masses

Clinical overview

Staging

Diagnosis

Treatment options

Surgery

Percutaneous techniques

Radiofrequency ablation

Background

Histology of RFA

Microwave ablation

Background

Histology

Cryoablation

Background

Histology of cryoablation

Indications for percutaneous ablation

Patient factors

Tumor-specific factors

Preablation imaging

Adjunctive procedures

Technique

Anesthesia

Modality for guidance

Radiofrequency ablation

Microwave ablation

Cryoablation

Adjacent structures

Postprocedure follow-up

Clinical efficacy

Complications

Treatment of metastatic disease

Surgical and RFA options

Medical therapies

Conclusion

References

23 Embolotherapy in the management of renal cell carcinoma

Introduction

Basic concepts

Embolization technique

Preoperative embolization

Radical nephrectomy

Partial nephrectomy

Postoperative embolization

Palliative embolization

Complications

Conclusion

References

Section VII Organ-specific cancers – chest

24 Image-guided ablation in the thorax

Physics of ablation therapy

Radiofrequency ablation

Microwave ablation

Cryoablation

Irreversible electroporation

Performing ablation therapy

Patient selection

Procedure

Radiofrequency ablation

Microwave ablation

Cryoablation

Irreversible electroporation

Imaging follow-up

Radiofrequency ablation

Microwave ablation

Cryoablation

Irreversible electroporation

Comparison of thermal ablation techniques

Applications and outcomes for thoracic ablation

Ablation of primary and metastatic thoracic tumors

Palliation

Conclusion

References

Section VIII Organ-specific cancers – musculoskeletal

25 Percutaneous ablation of painful metastases involving bone

Introduction

Indications for treatment

Preprocedural imaging

Contraindications to ablation treatment

RFA technique

RFA pain palliation outcomes

Cryoablation technique

Cryoablation pain palliation outcomes

Emerging technologies

Summary

References

26 Cementoplasty and musculoskeletal interventions

Introduction

Indications

Contraindications

Preprocedural care

Technique

Efficacy and complications

Postprocedural care and follow-up

Current bone cement properties and future directions

Percutaneous sacroplasty, osteoplasty, and advance hybrid stabilization techniques

Summary

References

Section IX Organ-specific cancers – prostate

27 Prostate ablations

Introduction

Patient selection

Cancer detection and treatment guidance

Patient selection

Targeting strategies

Image guidance for prostate ablation

Ultrasound guidance

MR guidance

Computed tomography guidance

Positron emission tomography guidance

Prostate ablation techniques

High-intensity focused ultrasound

Cryoablation

Other techniques

Postprocedure evaluation

Complications and outcomes

Local control

Conclusion

Acknowledgments

References

Section X Specialized interventional techniques in cancer care

28 Vascular access: Venous and arterial ports

Hepatic intra-arterial port

Indications

Rationale

Technique

Access route

Arterial flow remodeling

Catheter positioning

Contraindications

Results

Port/catheter placement

Chemotherapy

Venous catheters and ports

Description

Indications

Preoperative assessment

Access route

Catheter tip location

Update on vein thrombosis prophylaxis and treatment

Catheter-related infection

References

29 Palliative care and symptom management

Palliative care and communication with cancer patients

Overview of palliative care

Overview of hospice care

Communication with cancer patients

Prognostication

Breaking bad news

Medical symptom management

Pain

Treatment – non-drug therapy

Treatment – drug therapy

Non-opioid analgesics

Opioid analgesics

Adjuvant analgesics

Bone metastases

Refractory pain

Nausea and vomiting

Constipation

Constitutional symptoms

Ascites

Psychiatric symptoms

Depression

Anxiety

Coordinating care in patients with advanced cancer

Summary

References

30 CT-guided neurolysis for cancer-related abdominal and pelvic pain

Introduction

Celiac plexus neurolysis

Anatomy

Technique

Positioning and approach

Antecrural

Retrocrural

Outcomes

Complications

Superior hypogastric neurolysis

Anatomy

Technique

Positioning and approach

Outcomes

Complications

Ganglion impar neurolysis

Anatomy

Technique

Outcomes

Complications

References

31 Palliative procedures for ascites and effusion

Introduction

Diagnostic tests

Management of ascites

Diuretics and sodium restriction

Large-volume paracentesis

Permanent indwelling catheters

Pigtail or Cope-type loop catheter

Tenckhoff catheter

PleurX and Asept catheters

Peritoneal Port-A-Catheters

Peritoneovenous shunts

Transjugular intrahepatic portosystemic shunts

Other suggested methods for treatment of malignant ascites

Management of malignant effusions

Thoracentesis

Chest drainage catheters

Pigtail catheters

Tunneled catheters

Summary of recommendations and guidelines

References

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Jean Francois Geschwind,Michael Soulen,Interventional Oncology,Image Guided