Leiden University Scholarly Publications

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Hendriks, P. (2024)

Advancements of interventional oncology treatments for early stage hepatocellular carcinoma

Doctoral Thesis
Interventional oncology has rapidly developed into a significant pillar in the treatment of liver cancer. Thermal ablation is an example of an interventional oncology treatment, in which a needle can be directly inserted into the tumor from outside the body. The tip of this needle can become extremely hot through the use of radiofrequency or microwaves, effectively burning the tumor from the inside out. Transarterial therapies are other interventional oncology treatments that can be administered through the arteries of the affected part of the liver. Small microspheres containing radioactive material or chemotherapy block the blood supply to the tumor and deliver the treatment locally.
Part one of this thesis describes the research into ablation margin confirmation. Standardized pre- and post-ablation CT scans were registered and used to quantify the obtained ablation margin. This workflow was first tested in the IAMCOMPLETE study. Potentially, this software tool could...Show moreInterventional oncology has rapidly developed into a significant pillar in the treatment of liver cancer. Thermal ablation is an example of an interventional oncology treatment, in which a needle can be directly inserted into the tumor from outside the body. The tip of this needle can become extremely hot through the use of radiofrequency or microwaves, effectively burning the tumor from the inside out. Transarterial therapies are other interventional oncology treatments that can be administered through the arteries of the affected part of the liver. Small microspheres containing radioactive material or chemotherapy block the blood supply to the tumor and deliver the treatment locally.
Part one of this thesis describes the research into ablation margin confirmation. Standardized pre- and post-ablation CT scans were registered and used to quantify the obtained ablation margin. This workflow was first tested in the IAMCOMPLETE study. Potentially, this software tool could identify patients at risk for local recurrent cancer.
Part two of this thesis studies combined treatment regimens of early stage HCC. The HORA EST HCC study was the first clinical trial to combine thermal ablation with radioembolization. Hyperaemia around the ablation zone was found to cause radiation dose accumulation in the tissue susceptible to local residual tumor after thermal ablation.
In part three of this thesis, the long-term affect after radioembolization was studied.
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Interventional oncology
Hepatocellular carcinoma
Thermal ablation
Radioembolization
Transarterial chemoembolization
All authors
Hendriks, P.
Supervisor
Geus-Oei, L.F. de; Coenraad, M.J.
Co-supervisor
Burgmans, M.C.
Committee
Osanto, S.; Lam, M.G.E.H.; Bale, R.; Overduin, C.G.; Hoek, B. van
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Date
2024-09-05
ISBN (print)
9789465061610

Funding

Sponsorship
Sponsoring of the clinical research: Health~Holland, Maag-Lever-Darm Stichting (MLDS), Quirem Medical B.V., Medtronic inc. Sponsoring of the publication of this thesis: Dutch Society for Interventional Radiology (NVIR) and Philips.