Interventionelle radiologische Verfahren in der Onkologie – Update 2021

Was ist neu?

Transarterielle Tumorembolisationen Transarterielle Tumorembolisationen wie die transarterielle Chemoembolisation (TACE) und die selektive interne Radiotherapie (SIRT) haben sich als Therapieoption bei primären und sekundären Lebertumoren etabliert und werden in onkologischen Zentren i. d. R. routinemäßig durchgeführt.

Transkutane Thermoablationen Transkutane Thermoablationen wie Radiofrequenzablation (RFA) und Mikrowellenablation (MWA) haben sich als i. d. R. kurative Therapieoptionen bei primären und sekundären Lebertumoren etabliert. Darüber hinaus werden die Verfahren zunehmend auch bei Nieren- und Lungentumoren eingesetzt.

Neue Verfahren Mit hochintensivem fokussiertem Ultraschall (HIFU) ist eine nichtinvasive Thermoablation möglich, bisher zugelassene Indikationen sind die Behandlung von Uterusmyomen, Prostatakarzinomen und Knochentumoren. Die irreversible Elektroporation (IRE) ist ein nichtthermisches Ablationsverfahren, das sich insbesondere in der Therapie von fortgeschrittenen, inoperablen Pankreaskarzinomen etabliert hat.

Abstract

Interventional radiology plays a crucial role in oncology. The most common interventional treatments are transarterial embolisation as well as percutaneous thermal ablations. Transarterial embolisation, such as transarterial chemoembolization (TACE) or selective internal radiation therapy (SIRT) are well established, usually palliatively intended treatment options for primary and secondary hepatic malignancies. Embolisation is usually well tolerated under conscious sedation and can be repeated several times. Percutaneous thermoablation is a local ablative, usually curatively intended treatment for hepatic, renal and pulmonary tumors. As a minimally invasive technique, it competes against surgery and radiation therapy. There are different types of thermoablation, most commonly used are radiofrequency ablation (RFA), microwave ablation (MWA) and cryo-ablation. Ablation is usually performed in general anesthesia, less common in conscious sedation. New interventional treatments are high intensity focused ultrasound (HIFU) and irreversible electroporation (IRE). HIFU allows a non-invasive, imaging-guided thermoablation that is currently certified for uterine myoma, prostate cancer and bone tumors. IRE is a minimal invasive non-thermal ablation that is especially established for locally advanced tumors that show a close relationship to large vessels, for example pancreatic cancer.

Schlüsselwörter

TACE - SIRT - Thermoablation

Key words

TACE - SIRT - thermoablation

Publication History

Article published online:
03 August 2021

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