TY - JOUR
T1 - Assessment of Ablation Therapy in Pancreatic Cancer
T2 - The Radiologist’s Challenge
AU - Granata, Vincenza
AU - Grassi, Roberta
AU - Fusco, Roberta
AU - Setola, Sergio Venanzio
AU - Palaia, Raffaele
AU - Belli, Andrea
AU - Miele, Vittorio
AU - Brunese, Luca
AU - Grassi, Roberto
AU - Petrillo, Antonella
AU - Izzo, Francesco
N1 - Funding Information:
The authors are grateful to Alessandra Trocino, librarian at?the National Cancer Institute of Naples, Italy. Moreover, the authors are grateful to Assunta Zazzaro for the collaboration.
Publisher Copyright:
© Copyright © 2020 Granata, Grassi, Fusco, Setola, Palaia, Belli, Miele, Brunese, Grassi, Petrillo and Izzo.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/11/27
Y1 - 2020/11/27
N2 - This article provides an overview of imaging assessment of ablated pancreatic cancer. Only studies reporting radiological assessment on pancreatic ablated cancer were retained. We found 16 clinical studies that satisfied the inclusion criteria. Radiofrequency ablation and irreversible electroporation have become established treatment modalities because of their efficacy, low complication rates, and availability. Microwave Ablation (MWA) has several advantages over radiofrequency ablation (RFA), which may make it more attractive to treat pancreatic cancer. Electrochemotherapy (ECT) is a very interesting emerging technique, characterized by low complication rate and safety profile. According to the literature, the assessment of the effectiveness of ablative therapies is difficult by means of the Response Evaluation Criteria in Solid Tumors (RECIST) criteria that are not suitable to evaluate the treatment response considering that are related to technique used, the timing of reassessment, and the imaging procedure being used to evaluate the efficacy. RFA causes various appearances on imaging in the ablated zone, correlating to the different effects, such as interstitial edema, hemorrhage, carbonization, necrosis, and fibrosis. Irreversible electroporation (IRE) causes the creation of pores within the cell membrane causing cell death. Experimental studies showed that Diffusion Weigthed Imaging (DWI) extracted parameters could be used to detect therapy effects. No data about functional assessment post MWA is available in literature. Morphologic data extracted by Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) do not allow to differentiate partial, complete, or incomplete response after ECT conversely to functional parameters, obtained with Position Emission Tomography (PET), MRI, and CT.
AB - This article provides an overview of imaging assessment of ablated pancreatic cancer. Only studies reporting radiological assessment on pancreatic ablated cancer were retained. We found 16 clinical studies that satisfied the inclusion criteria. Radiofrequency ablation and irreversible electroporation have become established treatment modalities because of their efficacy, low complication rates, and availability. Microwave Ablation (MWA) has several advantages over radiofrequency ablation (RFA), which may make it more attractive to treat pancreatic cancer. Electrochemotherapy (ECT) is a very interesting emerging technique, characterized by low complication rate and safety profile. According to the literature, the assessment of the effectiveness of ablative therapies is difficult by means of the Response Evaluation Criteria in Solid Tumors (RECIST) criteria that are not suitable to evaluate the treatment response considering that are related to technique used, the timing of reassessment, and the imaging procedure being used to evaluate the efficacy. RFA causes various appearances on imaging in the ablated zone, correlating to the different effects, such as interstitial edema, hemorrhage, carbonization, necrosis, and fibrosis. Irreversible electroporation (IRE) causes the creation of pores within the cell membrane causing cell death. Experimental studies showed that Diffusion Weigthed Imaging (DWI) extracted parameters could be used to detect therapy effects. No data about functional assessment post MWA is available in literature. Morphologic data extracted by Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) do not allow to differentiate partial, complete, or incomplete response after ECT conversely to functional parameters, obtained with Position Emission Tomography (PET), MRI, and CT.
KW - ablation treatment
KW - computed tomography
KW - functional imaging
KW - magnetic resonance imaging
KW - pancreatic cancer
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U2 - 10.3389/fonc.2020.560952
DO - 10.3389/fonc.2020.560952
M3 - Article
AN - SCOPUS:85097524514
VL - 10
JO - Frontiers in Oncology
JF - Frontiers in Oncology
SN - 2234-943X
M1 - 560952
ER -