Image-guided laser ablation in the treatment of recurrence of renal tumours : technique and preliminary results

Abdominal recurrences of renal cell carcinoma (RCC) after surgery might represent a challenge for treatment, often requiring difficult surgeries or anticipated systemic therapy. Our aim is to illustrate a novel application of laser ablation for the treatment of abdominal recurrences of RCC. Patients with abdominal recurrences of renal cancer were treated under ultrasound/computed tomography guidance with a diode laser inserted into the lesion through a thin 21-G needle. A fixed 3-W power protocol was used, changing the illumination time according to lesion dimension and shape. Also, technical success, technical efficacy, local tumour progression, and major and minor complications were retrospectively analysed. Three patients were treated with image-guided laser ablation for abdominal recurrences of RCC. In all cases, it was possible to perform ablation as preoperatively planned and all three nodules (size of 6, 8, and 12 mm) were completely ablated with no evidence of residual enhancement after 6 weeks at contrast-enhanced CT. No minor or major complications were observed. No local tumour progression was reported up to 12 months from ablation. Image-guided laser ablation holds the potential to offer a minimally invasive treatment to patients with abdominal recurrence of RCC. Further studies are needed to evaluate the clinical role of this technique

Laser thermal ablation to treat a recurrent soft-tissue sarcoma of the leg : A case report

We present the case of a 52-year-old male patient with recurrence of a soft-tissue sarcoma of the left leg treated with percutaneous laser ablation. The patient received the diagnosis of sarcoma for the first time in 2011; further local recurrences and a pulmonary metastatic spread occurred during follow-up, so the patient has been treated several times with chemotherapy, limb-sparing surgery and radiotherapy. In September 2017, a new local recurrence of sarcoma occurred, for which limb amputation was proposed but refused by the patient. Laser ablation with ultrasound guidance was performed, with complete ablation at 6 months and limb salvage

Pancreatic ablation : minimally invasive treatment options

Despite the significant improvement of knowledge and technologies in tumor treatments, pancreatic tumor remains a complex disease still characterized by a poor prognosis. The increasing role of minimally invasive techniques started to drive the effort of scientific medicine to evaluate the possibilities of application of these techniques to pancreatic cancer. The purpose of this paper is to present a brief summary of the different ablative techniques available and proposed for pancreatic tumor treatment considering invasive, noninvasive, thermal and non-thermal techniques

Percutaneous laser ablation for benign and malignant thyroid diseases

Minimally invasive image-guided thermal ablation is becoming increasingly common as an alternative to surgery for the treatment of benign thyroid nodules. Among the various techniques for thermal ablation, laser ablation (LA) is the least invasive, using the smallest applicators available on the market and enabling extremely precise energy deposition. However, in some cases, multiple laser fibers must be used simultaneously for the treatment of large nodules. In this review, the LA technique is described, and its main clinical applications and results are discussed and illustrated

Virtual navigator automatic registration technology in abdominal application

Real-time Ultrasound (US) image fusion with a pre-acquired second imaging dataset - Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and/or CT/PET - has become widely used in recent years for both diagnosis and image-guided interventional procedures. Liver and kidneys are the main focused anatomical districts, related to abdominal application. There are still nowadays some drawbacks, regarding the adoption of the fusion imaging technique in everyday practice especially regarding its ease of use and the time needed in order to obtain a precise real-time fusion between US and the second imaging modality. The present work is a preliminary study on the feasibility and practical use of an Automatic registration algorithm for CT-US real-time fusion imaging. Data obtained by tests performed on a Doppler phantom, for the assessment of the precision of the registration procedure and in-vivo Automatic registration tests, are presented