Interstitial hyperthermia of colorectal liver metastases with a US-guided Nd-YAG laser with a diffuser tip: a pilot clinical study.
Ultrasound (US)-guided interstitial hyperthermia performed with the neodymium yttrium aluminum garnet laser with a diffuser tip involves placement of a laser fiber in solid tissue followed by irradiation from within the center of the tumor to be treated. The authors previously described the development of a US-guided technique that permits simultaneous interstitial laser irradiation and temperature measurements, with real-time US monitoring. With the use of a dedicated diffuser tip modification of the bare laser fiber, it has proved possible to produce spherical coagulations with a diameter comparable to that of liver metastases of clinical relevance. This technique was used in 11 patients with 16 colorectal liver metastases, 12 of which were radically ablated. Real-time US and interstitial temperature monitoring during treatment had a positive predictive value of 86% and negative predictive value of 100% in judging the final result. The technique is feasible, effective, and safe, but the effect on patient survival must be tested in future randomized clinical studies.
Nolsøe
C P
CP
Department of Ultrasound, Herlev Hospital, University of Copenhagen, Denmark.
Torp-Pedersen
S
S
Burcharth
F
F
Horn
T
T
Pedersen
S
S
Christensen
N E
NE
Olldag
E S
ES
Andersen
P H
PH
Karstrup
S
S
Lorentzen
T
T
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D017075:Laser Coagulation; D053685:Laser Therapy; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014463:Ultrasonography