Online Oncology Days
Day 2 | Liver Cancer Treatment

Online Oncology Days | Day 2 - April 13, 2022 | 7 pm (CEST) / 1 pm (EDT)

Liver Cancer Treatment​ | Interventional Oncology/Ultrasound

Personalized Image-Guided Treatment

The treatment of patients with liver cancer requires a careful balance of adequate oncologic control and the preservation of both liver function and performance status. Surgery is considered the most effective chance at cure in this patient group, however, most patients are not eligible (1). The emerging field of interventional oncology offers the patient treatment options for almost all stages of the disease, all minimal invasive, all image-guided. In this session, we will present how innovative image guidance can offer personalized cancer care.

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Program
  • Improving Liver Ablation: The Essential Role of Fusion Imaging - Prof. Franco Orsi
  • Angio-CT Guidance for Liver Treatment - Prof. Boris Guiu
  • Live Q&A
Why should you attend?
  1. To learn how to set up the Interventional Oncology suite for imaging-guided percutaneous liver ablation
  2. To understand how smart fusion imaging can improve liver ablation therapy
  3. To understand how imaging tools can improve treatment results
  4. To understand the current evidence of combining angiography and CT in Interventional Oncology procedures

INFORMATION ON SPEAKERS AND THEIR PRESENTATIONS

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Moderator: Dr. Pavan Najran, MBChB FRCR
Consultant Interventional Radiologist
The Christie, NHS Foundation Trust
Manchester, United Kingdom

Dr. Pavan Najran graduated from the University of Birmingham medical school, training in surgery before undertaking clinical radiology training in the west midlands. He completed a fellowship in interventional oncology at The Christie before his appointment as a Consultant in diagnostic and Interventional Radiology. He has a keen interest in research gaining a number of publications in both interventional and diagnostic oncology. Dr. Najran has a sub-speciality interest in vascular and gastrointestinal oncological intervention.

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Speaker: Prof. Franco Orsi, MD
Interventional Radiologist
Clinical Director of Interventional Radiology Department
European Institute of Oncology (IEO )
Milan, Italy

Prof. Franco Orsi is chief of the Department of Interventional Radiology at the European Institute of Oncology, where he developed a multidisciplinary clinical platform of Interventional Oncology. He is particularly experienced in percutaneous imaging-guided ablations and in the development of extended modalities of integrated imaging for precise treatment guidance. He is also professor of Radiation Oncology at the Milan University, visiting researcher of the MRI research center in the Massachusetts General Hospital in 1997 and Fellow of Cardiovascular and Interventional RadiologicalSociety in Europe (CIRSE) since 2005.

Presentation Title: Improving Liver Ablation: The Essential Role of Fusion Imaging
Precision in tumor targeting is one of the most important factors affecting both safety and efficacy in minimally invasive cancer therapy. The “imaging” is the key to a precise and accurate percutaneous approach in case of liver ablation. Fusion imaging technique, integrating real-time ultrasound imaging with CT enhanced panoramic views, allows for more accurate planning and guidance in percutaneous ablation procedures. In the liver, fusion imaging is not only for local treatment of tumors but affects all kinds of percutaneous approaches on simplification and safety.

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Speaker: Prof. Boris Guiu, MD, PhD
Interventional Radiologist
Head of Department St-Eloi University Hospital
St-Eloi University Hospitall (CHRU Montpellier)
Montpellier, France

Prof. Boris Guiu is the chairman of the Department of Radiology at the St-Eloi University Hospital and professor of radiology at the University of Montpellier. His major research interest is interventional radiology of the liver with a special interest in intra-arterial and percutaneous treatments in the high-end multimodal interventional suite. Dr. Guiu is a member of AASLD, CIRSE, European Society of Radiology, and French Radiological Society. In 2019, he won the European Award of Excellence and Innovation in Interventional Radiology. He serves as a reviewer for many journals including Liver International and Lancet Oncology. Dr. Guiu has published >200 peer-reviewed papers. More recently, he described the liver venous deprivation technique, combining both portal and hepatic vein embolization for liver preparation before major hepatectomy. He is the coordinator of 7 clinical trials in liver interventional radiology, the most recent one randomizing immune-checkpoint inhibitor/antiangiogenic and radiofrequency ablation versus radiofrequency ablation in small HCC.

Presentation Title: Angio-CT Guidance for Liver Treatment
The ideal Interventional Oncology (IO) suite uses multimodality imaging, integrating not only Ultrasound (US) and Angio but also CT. The Angio-CT system provides useful three-dimensional soft tissue information for tumor identification and monitoring of therapy response. A single volumetric 3D acquisition can replace almost all 2D DSA acquisitions, allowing for a radiation exposure reduction to the patient. The CT also allows for an accurate guidance in thermal ablation treatment and provides useful information on ablation margins directly at the end of the treatment. The Angio-CT opens possibilities to perform CT during hepatic arteriography and arterial portography to increase the sensitivity for liver tumor identification and detecting all their feeding arteries, having directly an effect on the endovascular IO treatment. The 4D features are not only producing incredible images, but also provide insights into flow dynamics to shorten and simplify complex embolization procedures.

Scientific Evidence: Liver Cancer Treatment | Interventional Oncology/Ultrasound

Download scientific evidence on oncology solutions using Canon technologies here.

Interventional Oncology

Lauranne Piron et al. | Radiation Exposure During Transarterial Chemoembolization: Angio-CT Versus Cone-Beam CT | Cardiovasc Intervent Radiol (2019).
https://pubmed.ncbi.nlm.nih.gov/31222382/

Emily L Marshall et al. | Radiation Dose during Transarterial Radioembolization: A Dosimetric Comparison of Cone-Beam CT and Angio-CT Technologies | J Vasc Interv Radiol (2021)
https://pubmed.ncbi.nlm.nih.gov/33358328/

Alex Lionberg et al. | Hybrid angiography-CT for transarterial radioembolization: a pictorial essay | Abdom Radiol (NY) (2021)
https://pubmed.ncbi.nlm.nih.gov/33394098/

Julien Garnon et al. | Hydrodissection of the Gallbladder Bed: A Technique for Ablations Located Close to the Gallbladder | Cardiovasc Intervent Radiol (2019)
https://pubmed.ncbi.nlm.nih.gov/30963191/

Jonathan Fergus et al. | Implementation of a hybrid angiography-CT system: increased short-term revenue at an academic radiology department | Abdom Radiol (NY) (2021)
https://pubmed.ncbi.nlm.nih.gov/34228198/

V Schembri et al. | Percutaneous ablation of obscure hypovascular liver tumours in challenging locations using arterial CT-portography guidance | Diagn Interv Imaging (2020)
https://pubmed.ncbi.nlm.nih.gov/33012694/

Qian Yu et al. | Real-time arteriography-directed percutaneous microwave ablation for small or poorly characterized hepatic lesions using hybrid Angio-CT | Abdom Radiol (NY) (2022)
https://pubmed.ncbi.nlm.nih.gov/35218383/


Ultrasound

Timo Alexander Auer et al. | Value of contrast-enhanced ultrasound (CEUS) in Focal Liver Lesions (FLL) with inconclusive findings on cross-sectional imaging | Clin Hemorheol Microcirc (2020)
https://pubmed.ncbi.nlm.nih.gov/31658052/

R Takai Takamatsu et al. | Impact of an ultrasound-guided radiofrequency ablation training program on the outcomes in patients with hepatocellular carcinoma | Diagn Interv Imaging (2019)
https://pubmed.ncbi.nlm.nih.gov/31477516/

Meng-Na He et al. | Application of superb microvascular imaging in focal liver lesions | World J Gastroenterol (2017)
https://pubmed.ncbi.nlm.nih.gov/29209117/

Fan Yang et al. | Superb microvascular imaging technique in depicting vascularity in focal liver lesions: more hypervascular supply patterns were depicted in hepatocellular carcinoma | Cancer Imaging (2019)
https://pubmed.ncbi.nlm.nih.gov/31888768/

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References

  1. El-Serag HB, et al. | Treatment and outcomes of treating of hepatocellular carcinoma among Medicare recipients in the United States: a population-based study | J Hepatol. 2006

Disclaimers

  • The opinions expressed in this material are solely those of the presenter and not necessarily those of Canon Medical Systems. Canon Medical Systems does not guarantee the accuracy or reliability of the information provided herein.
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