Radiofrequency ablation of liver tumors: Actual limitations and potential solutions in the future

Over the past decade,radiofrequency ablation(RFA) has evolved into an important therapeutical tool for the treatment of non resectable primary and secondary liver tumors.The clinical benefit of RFA is represented in several clinical studies.They underline the safety and feasibility of this new and modern concept in treating liver tumors.RFA has proven its clinical impact not only in hepatocellular carcinoma(HCC) but also in metastatic disease such as colorectal cancer(CRC).Due to the increasing number of HCC and CRC,RFA might play an even more important role in the future.Therefore,the refinement of RFA technology is as important as the evaluation of data of prospective randomized trials that will help define guidelines for good clinical practice in RFA application in the future.The combination of hepatic resection and RFA extends the feasibility of open surgical procedures in patients with extensive tumors.Adverse effects of RFA such as biliary tract damage,liver failure and local recurrence remain an important task today but overall the long term results of RFA application in treating liver tumors are promising.Incomplete ablation of liver tumors due to insufficient technology of ablation needles,tissue cooling by the neighbouring blood vessels,large tumor masses and ablation of tumors in close vicinity to heat sensitive organs remain difficult tasks for RFA.Future solutions to overcome these limitations of RFA will include refinement of ultrasonographic guidance(accuracy of probe placement),improvements in needle technology(e.g.needles preventing charring)and intraductal cooling techniques.

Heat Shock Protein 70 Expression in Giant Cell Tumor of Bone and Its Clinical Application

Objective: To provide a better prognosis after the treatment of giant cell tumor of bone which is a common benign aggressive bone tumor by the use of thermoablation, Hsp70 expression of the tumor was explored and the relationship between the relative amount of expression of this protein and tumor recurrence was studied. Methods: Avascular parts of tumor tissues were collected from 11 patients, 3 male and 8 female with an average age of 32.27 years and were sent for the analysis of protein contents by the use of Western blot. A comparative protein analysis was used for the detection of Hsp70 and beta-actin. Monoclonal antibody was used for the identification of Hsp70. The measurement was carried out two times in one patient. The relationship between ratios of Hsp70/beta-actin and tumor recurrence during 3-year follow-up was carried out. Results: Tumor recurrence was found in 4 patients, 36.6% and none had lung metastasis. Significant HSP expression was found in all specimens. No patient with the ratio of HSP70/beta-actin expression lower than 0.66 had tumor recurrence. Sensitivity of the test was 75% and specificity was 100%. Conclusion: Expression of Hsp70 was found in giant cell tumor of bone and high relative expression of this protein related to tumor recurrence.

Current applications for magnetic resonance-guided focused ultrasound in the treatment of Parkinson’s disease

Magnetic resonance-guided focused ultrasound(MRgFUS)is a novel and minimally invasive technology.Since the US Food and Drug Administration approved unilateral ventral intermediate nucleus-MRgFUS for medication-refractory essential tremor in 2016,studies on new indications,such as Parkinson’s disease(PD),psychiatric diseases,and brain tumors,have been on the rise,and MRgFUS has become a promising method to treat such neurological diseases.Currently,as the second most common degenerative disease,PD is a research hotspot in the field of MRgFUS.The actions of MRgFUS on the brain range from thermoablation,blood-brain barrier(BBB)opening,to neuromodulation.Intensity is a key determinant of ultrasound actions.Generally,high intensity can be used to precisely thermoablate brain targets,whereas low intensity can be used as molecular therapies to modulate neuronal activity and open the BBB in conjunction with injected microbubbles.Here,we aimed to summarize advances in the application of MRgFUS for the treatment of PD,with a focus on thermal ablation,BBB opening,and neuromodulation,in the hope of informing clinicians of current applications.