Thermal Ablation of Liver Tumours: The Crucial Role of 3D Imaging
- PDF / 177,555 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 116 Downloads / 180 Views
LETTER TO THE EDITOR
Thermal Ablation of Liver Tumours: The Crucial Role of 3D Imaging Giovanni Mauri1,2 • Luigi Solbiati3,4 • Franco Orsi1 • Lorenzo Monfardini5
Received: 26 May 2020 / Accepted: 5 June 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
To the Editor, We read with great interest the new CIRSE Standards of Practice on Thermal Ablation of Liver Tumours from Crocetti et al. [1] reintroduced after 10 years from the previous Quality Improvement Guidelines. Particularly, besides several upgrading in clinical aspects such as clinical indications, we highly appreciated the higher relevance dedicated to imaging guidance, which is, in our opinion, a key aspects of liver tumours ablation, and one of the field with the most relevant technological advancements in recent years. Image guidance is crucial for all the steps of a successful ablation, from preoperative planning, to correct lesion targeting, procedure monitoring, and immediate result assessment. Even if we agree that in the real practice ‘‘guidance system is chosen largely on the basis of operator preference and local availability’’, we think some points should be highlighted in a ‘‘standard of practice document’’. In the past, excellent results have been reported with the guidance of each single imaging modality. Ablations were performed in diagnostic TC rooms, or
& Lorenzo Monfardini [email protected] 1
Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
2
Department of Oncology and Hematolgy-Oncology, Universita` degli studi di Milano, 20122 Milan, Italy
3
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
4
Department of Radiology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
5
Division of Interventional Radiology, Fondazione Poliambulanza, Via Bissolati 58, 25124 Brescia, Italy
in operatory theatres equipped with only US machine. However, nowadays technological advancements allow interventional radiologists to work in dedicated operatory theatres, where multimodal 3D imaging availability should be regarded as standard. If availability of PET/CT or MRI in the operatory room still is limited, in 2020 a standard IR room for ablations should be equipped with US and at least CT or cone-beam CT. Also, fusion imaging systems allowing for real-time fusion of US and 3D imaging such as CT or cone beam CT [2, 3], are nowadays largely available for all the major US machines, and their use can be no more regarded as an ancillary procedure. In the paper by Crocetti et al. it is stated that immediate post ablation imaging ‘‘is essential to demonstrate sufficient ablative margins’’. While totally agree with this statement, we think it is no more enough to rely only on ‘‘the transient hyperechoic zone that is seen on ultrasound within and surrounding a tumour during and immediately after RFA’’ [4] to have a precise ablation evalu
Data Loading...
