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Interventional Oncology
Ripal T. Gandhi
Attending Physician
Vascular and Interventional Radiology
Miami Cardiac and Vascular Institute
Associate Clinical Professor
Herbert Wertheim College of Medicine at Florida International University
Assistant Clinical Professor
University of South Florida School of Medicine
Miami, Florida
Suvranu Ganguli
Associate Chief of Interventional Radiology
Co-Director, Center for Image-Guided Cancer Therapy
Massachusetts General Hospital
Assistant Professor of Radiology
Harvard Medical School
Boston, Massachusetts
1874 illustrations
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Library of Congress Cataloging-in-Publication Data
Interventional oncology (2015)
Interventional oncology / [edited by]SuvranuGanguli,Ripal
T. Gandhi, Salomão Faintuch.
p. ; cm. – (Practical guides in interventional radiology)
Includes bibliographical references and index.
ISBN 978-1-62623-081-1 – ISBN 978-1-62623-082-8
(electronic)
I. Ganguli, Suvranu, editor. II. Gandhi, Ripal T., editor.
III. Faintuch, Salomão, editor. IV. Title. V. Series: Practical
guides in interventional radiology.
[DNLM: 1. Neoplasms–radiotherapy. 2. Radiography,
Interventional–methods. 3. Diagnostic Imaging. QZ 269]
RC271.R3
616.99'40642–dc23 2015014982
© 2016 Thieme Medical Publishers, Inc.
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ISBN 978-1-62623-081-1
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Important note: Medicine is an ever-changing science
undergoing continual development. Research and clinical
experience are continually expanding our knowledge, in
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therapy. Insofar as this book mentions any dosage or appli-
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To my parents, without whom none of my achievements would be possible. Thank you for your continuous
love and for sacrificing all that you have. You have supported me in every way possible. I will never be able
to repay you.
Ripal T. Gandhi, MD
Tomy parents, who epitomize humanity,sacrifice, and the quest forknowledge, whichhavebeen instilled in me
and my siblings bytheirexample.To myboys—Ronan, Kieran, and Arik—who make every dayan adventure.And
to my wife and partner-in-life, Kriston, without whom nothing I have and will accomplish would be possible.
Suvranu Ganguli, MD
Contents
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii
Series Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Chapter 1. Percutaneous Ablation of Renal Cell Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Shawn Ahmed, Raul N. Uppot, and Debra A. Gervais
Chapter 2. Adrenal Malignancy: Ablation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Aradhana M. Venkatesan and Bradford J. Wood
Chapter 3. Ablation of Lung Cancer, Pulmonary Metastatic Disease, and
Chest Wall Malignancy
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Charles McGraw, Scott Genshaft, Fereidoun Abtin, Antonio Gutierrez and Robert Suh
Chapter 4. Hepatocellular Carcinoma: Ablation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Riccardo Lencioni
Chapter 5. Hepatocellular Carcinoma: Chemoembolization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Siddharth A. Padia and Matthew J. Kogut
Chapter 6. Hepatocellular Carcinoma: Radioembolization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Avnesh S. Thakor, Arash Eftekhari, Edward Wolfgang Lee, Darren Klass, and David Liu
Chapter 7. Colorectal Hepatic Metastatic Disease: Ablation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Muneeb Ahmed
Chapter 8. Colorectal Cancer Hepatic Metastatic Disease: Intra-arterial Therapies. 126
Govindarajan Narayanan and Prasoon P. Mohan
Chapter 9. Carcinoid and Neuroendocrine Tumors: Intra-ar terial Therapies . . . . . . . . . 140
Elena N. Petre, Karen Brown, and Constantinos Sofocleous
Chapter 10. Cholangiocarcinoma: Ablation and Intra-arterial Therapies . . . . . . . . . . . . . . . 154
Matthew Brown, Paul J. Rochon, Rajan K. Gupta, and Charles E. Ray, Jr.
Chapter 11. Bone Tumors: Ablation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
Matthew R. Callstrom and A. Nicholas Kurup
Chapter 12. Portal Vein Embolization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Steven L. Hsu and Sanjeeva P. Kalva
Chapter 13. Emerging Technologies in Interventional Oncology . . . . . . . . . . . . . . . . . . . . . . . . 192
Omar Zurkiya and Rahmi Oklu
Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
vii
Foreword
I was excited to be asked to write a foreword for
Interventional Oncology because interventional
oncology is the fastest growing part of interventional
radiology and, in my opinion, the most important
development in clinical care of cancer patients in the
last decade. With the growth and evolution of this
treatment, patients can now be offered the various
and diverse forms of treatments described in this
book.
The practice of interventional oncology, which
stresses both clinical care and a variety of technical
considerations,isnot a simple field. In fact, I suspect in
a few years it may be considered a separate subspe-
cialty within the confines of interventional radiology.
Drs. Ganguli and Gandhi, who are well known in
the interventional community, have selected leaders
in the fi eld and experts in the various techniques of
interventional oncology. Their superb editing has
produced a very easy-to-read and well-organized
book on the subject. The specific chapters and the
way in which the editors have presented the infor-
mation allow the reader to look at specific problems
of interventional oncology (e.g., treating bone metas-
tasis or colorectal cancer). What makes this book
distinct is the concise way in which the chapters are
written and organized. The material included is so
pertinent to both an academic and general practice
interventionalist. The editors have produced a book
that is a thorough summary of the salient techniques,
results, potential complications, and expectations of
success.
Interventional Oncology is a great book to read and
a must-have for those interested and practicing in
interventional oncology.
Peter R. Mueller, MD
Professor of Radiology
Harvard Medical School
Massachusetts General Hospital
Division Head Interventional Radiology
viii