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Karl-göran Tranberg - One of the best experts on this subject based on the ideXlab platform.
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changes in immunocompetent cells after interstitial Laser Thermotherapy of breast cancer
Cancer Immunology Immunotherapy, 2011Co-Authors: Kristín-huld Haraldsdóttir, Karin Jansner, Kjell Ivarsson, Unne Stenram, Karl-göran TranbergAbstract:Background Local tumour destruction has been shown to give rise to changes in immunocompetent cells. The aim of this study was to describe the effect of interstitial Laser Thermotherapy (ILT) of breast carcinoma in the tumour and in regional lymph nodes.
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interstitial Laser Thermotherapy of a rat liver tumour effect of hepatic inflow occlusion
Lasers in Surgery and Medicine, 2011Co-Authors: Christian Sturesson, Stefan Anderssonengels, Kjell Ivarsson, Unne Stenram, Karl-göran TranbergAbstract:Interstitial Laser Thermotherapy was used to treat rat liver tumours. The aim was to investigate the influence of temperature and temporary hepatic inflow occlusion on tumour growth and blood perfusion.
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interstitial Laser Thermotherapy ilt of breast cancer
Ejso, 2008Co-Authors: Kristín-huld Haraldsdóttir, S Gotberg, Kjell Ivarsson, Christian Ingvar, Unne Stenram, Karl-göran TranbergAbstract:AIM: To find out if ILT can be used as radical treatment of breast cancer. METHOD: Twenty-four patients, aged 39-84 (mean 61), with invasive breast cancer were treated with ILT. All underwent mammography, ultrasound and core biopsy before treatment. The tumour was an invasive ductal carcinoma in 15 patients, a lobular carcinoma in eight and lobular-ductal cancer in one. Average tumour diameter was 14mm on ultrasound (5-35). Patients were treated in the outpatient clinics under local anaesthesia. Probes were placed under ultrasound guidance, in 19 patients, and ILT was performed with a diode Laser at a steady-state temperature of 48 degrees C for 30min using temperature feedback control. Standard surgical excision was performed 12 (4-23) days after ILT and was preceded by Doppler ultrasound. RESULTS: Treatment-induced necrosis of invasive cancer was 33% (range 0-100) and was complete in three patients. At follow-up before surgery, the extent of Laser damage could not be judged with ultrasound, although abolished tumour blood flow was demonstrated after treatment resulting in large necroses. Efficacy of treatment varied negatively with tumour size. The inefficacy of ILT was mainly due to the underestimation of tumour size by mammography and ultrasound and the shortcomings of these methods to demonstrate tumour borders, tumour irregularity and carcinoma in situ (CIS). ILT was well tolerated. Five patients had breast tenderness, and three patients had pain, during the first day after treatment. Small skin necroses were observed in two patients. CONCLUSION: Small breast cancers can be treated radically with ILT. The method may become useful in the treatment of breast cancer but needs further refinement, even for small well-defined breast cancers, if it is going to be employed for radical treatment.
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Resistance to tumour challenge after tumour Laser Thermotherapy is associated with a cellular immune response
British Journal of Cancer, 2005Co-Authors: Kjell Ivarsson, Karin Jansner, L Myllymäki, Unne Stenram, Karl-göran TranbergAbstract:Previous studies in our laboratory have shown that interstitial Laser Thermotherapy (ILT) of an experimental liver tumour is superior to surgical excision, at least partly due to a Laser-induced immunological effect. The aim of the present study was to investigate the time–response relationship of the ILT-induced immunisation and the cellular response of macrophages and lymphocytes. A dimethylhydrazine-induced adenocarcinoma was transplanted into the liver of syngeneic rats. Rats with tumour were treated 6–8 days later (tumour size 0.25–0.40 cm^3) with ILT of tumour or resection of the tumour-bearing lobe. Two groups of rats without tumour were treated with resection of a normal liver lobe or ILT of normal liver. A challenging tumour was implanted into the liver of each rat 2, 5 or 10 weeks after primary treatment. Rats were killed 6, 12 and 48 days (or earlier due to their condition) after challenge ( n =8 in all groups). Immunohistochemical techniques were used to determine lymphocytes (CD8, CD4) and macrophages (ED1, ED2) in rats having had treatment of a primary tumour. Interstitial Laser Thermotherapy of the first tumour was followed by eradication of challenging tumour and absence of tumour spread. This contrasted with rapid growth and spread of challenging tumour in the other groups. In the challenging vital tumour tissue and in the interface between the tumour and surroundings, the number of ED1 macrophages and CD8 lymphocytes was higher in rats having been treated with the ILT of tumour than in those having undergone resection of the tumour-bearing lobe. The number of ED2 macrophages and CD4 lymphocytes was low and did not vary between these two groups. Interstitial Laser Thermotherapy elicited an immune response that eradicated a challenging tumour and was associated with increased numbers of tumour-infiltrating macrophages and CD8 lymphocytes.
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heat shock protein 70 hsp70 after Laser Thermotherapy of an adenocarcinoma transplanted into rat liver
Anticancer Research, 2003Co-Authors: Kjell Ivarsson, Karin Jansner, Unne Stenram, Linda Myllymaki, Anitha Bruun, Karl-göran TranbergAbstract:The heat shock proteins (HSPs) HSP70 and gp96 from necrotic tumour cells are considered to function as chaperones in presenting tumour antigens. We therefore studied HSP70 and immune cells in a transplantable carcinoma in the liver of rats after interstitial Laser Thermotherapy (ILT). Experiments were performed in Wistar FU rats using a dimethyl-hydrazine-induced adenocarcinoma implanted into the left lateral lobe of the liver. Rats were randomized to one of the following groups: a) ILT of tumour, b) sham ILT, or c) control. ILT was suboptimal and was performed at a steady-state temperature of 43 degrees C at the tumour margin for 30 minutes. Rats were killed 15 minutes, 5 hours, 10 hours, 15 hours or 12 days after treatment. Double immunohistochemistry was performed for HSP70 and ED1 macrophages or CD8 lymphocytes, and ELISA for serum concentrations of HSP70. After ILT, there was an increase of HSP70 immunoreactivity in tumours as compared to sham ILT. At the same time, tumour cells affected by ILT showed a shift of HSP70 from the cytoplasm to the nucleus with a peak at 10 hours. Few CD8-positive cells were found. There was an increase of tumour-infiltrating ED1 macrophages after ILT as compared to sham ILT at 10-15 hours after treatment. HSP70 was present in ED1 macrophages significantly more frequently after ILT than after sham ILT, and this was true both for HSP70 localized to the surface and the cytoplasm of the macrophage. There was a significant increase in serum HSP70 during the first 15 hours after ILT. In conclusion, Laser Thermotherapy resulted in increased HSP70 immunoreactivity within tumours and HSP70 shifts from cytoplasm to nucleus. Furthermore, it resulted in increased numbers of tumour-infiltrating macrophages and an increased presence of HSP70 in the membrane and cytoplasm of these macrophages. (Less)
Christopher Christophi - One of the best experts on this subject based on the ideXlab platform.
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Long-term Survival of Patients with Unresectable Colorectal Liver Metastases treated by Percutaneous Interstitial Laser Thermotherapy
World Journal of Surgery, 2004Co-Authors: Christopher Christophi, Caterina Malcontenti-wilson, Mehrdad Nikfarjam, Vijayaragavan MuralidharanAbstract:In situ ablation of colorectal cancer (CRC) liver metastases is an accepted form of treatment for selected patients. It is associated with low morbidity and mortality and increases the number of patients who may benefit from therapy compared to resection alone. This study assesses the impact of interstitial Laser Thermotherapy (ILT) on local tumor control and long-term survival in patients with unresectable CRC liver metastases. Percutaneous ILT was performed in patients with unresectable CRC liver metastases between January 1992 and December 1999 using a bare-tip quartz fiber connected to an Nd:YAG Laser source. This was prior to the routine use of a diffusing fiber for ablative therapy. Treatment was monitored with real-time ultrasonography. Tumors were considered unresectable based on their anatomic location or the extent of liver involvement. Patients with extrahepatic disease, more than five liver metastases, or tumors larger than 10 cm in diameter were excluded from this study. Local tumor control was assessed by dynamic computed tomography (CT) 6 months after therapy. Long-term follow-up was undertaken, and the impact of various factors on survival was analyzed. Eighty patients with a mean age of 63.8 years were suitable for ILT. In total, 168 liver tumors with a median diameter of 5 cm (range 1–10 cm) were so treated. There were no procedure-related deaths. The overall complication rate was 16%, with all cases managed conservatively. Bradycardia ( n = 5), pneumothorax ( n = 3), and persistent pyrexia ( n = 3) were the most common complications. Complete tumor ablation was noted in 67% of patients assessed by CT 6 months following the initial therapy. Median follow-up was 35 months (range 4–96 months), with 10 patients alive at the end of this period. Altogether there were 67 deaths, which were related to hepatic disease in 55 cases and to extrahepatic disease in 9; they were unrelated to malignancy in 3 others. Three patients were excluded from follow-up after ILT down-staging of tumors that allowed complete surgical resection. The median disease-free survival of patients treated by ILT was 24.6 months, with a 5-year survival of 3.8%. Poor tumor differentiation and the presence of more than two hepatic metastases were associated with lower overall survival ( p < 0.01). Fourteen patients treated by ILT for postoperative hepatic recurrences had the best outcome, with a median overall survival of 36.3 months and a 5-year survival of 17.2%. Percutaneous ILT is a minimally invasive, safe, effective technique that appears to improve overall survival in specific patients with unresectable CRC liver metastases, compared to the natural history of untreated disease reported in the literature.
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interstitial Laser Thermotherapy for liver tumours
British Journal of Surgery, 2003Co-Authors: Mehrdad Nikfarjam, Christopher ChristophiAbstract:Background: Primary hepatocellular carcinoma (HCC) and metastases from colorectal cancer are the most common malignant liver tumours. Surgical resection is the optimum treatment in suitable patients. Interstitial Laser Thermotherapy (ILT) is gaining acceptance for the treatment of irresectable liver tumours and as a potential alternative to surgery. An understanding of the principles of therapy and review of clinical outcomes may allow better use of this technology. Method: An electronic search using the Medline database was performed for studies on the treatment of hepatic malignancy published between January 1983 and February 2003. Results: Current information on the efficacy of ILT is based on prospective studies. ILT appears to be a safe and minimally invasive technique that consistently achieves tumour destruction. The extent of destruction depends on the fibre design, delivery system, tumour size and tumour biology. Real-time magnetic resonance imaging provides the most accurate assessment of Laser-induced tumour necrosis. In selected patients with HCC and colorectal cancer liver metastases, ILT achieves complete tumour necrosis, provides long-term local control, and improves survival, compared with the natural history of the disease. In addition, ILT has survival benefits for patients with other tumour types, especially those with isolated liver metastases from a breast cancer primary. Conclusion: ILT improves overall survival in specific patients with liver tumours. Advances in Laser technology and refinements in technique, and a better understanding of the processes involved in Laser-induced tissue injury, may allow ILT to replace surgery as the procedure of choice in selected patients with liver malignancies. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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interstitial Laser Thermotherapy in the treatment of colorectal liver metastases
Journal of Surgical Oncology, 2001Co-Authors: Vijayaragavan Muralidharan, Christopher ChristophiAbstract:Metastatic liver disease is the commonest cause of death in patients with colorectal cancer. A small proportion of these patients (10%) may be treated by surgical resection with five year survival approaching 35-40%. Alternative treatment modalities for localised hepatic disease include in situ ablative techniques that have the advantages of percutaneous application and minimal morbidity. These include Interstitial Laser Thermotherapy (ILT), Radio Frequency Ablation, Percutaneous Microwave therapy, and Focussed Ultrasound Therapy. This article focuses specifically on the development and utilisation of ILT in the treatment of colorectal liver metastases. It provides a review of the pathophysiological factors involved, present status of clinical studies, and future directions. ILT is a safe technique for the treatment of colorectal liver metastases. It may be delivered by minimally invasive techniques to lesions considered unresectable by present criteria. Limitations include the extent and completeness of tumour necrosis achieved as well as imaging techniques. Clinical problems include a lack of controlled studies. Assessment of long-term survival in prospective randomised trials is needed to assess the efficacy of this procedure.
Johan Olsrud - One of the best experts on this subject based on the ideXlab platform.
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mri thermometry in phantoms by use of the proton resonance frequency shift method application to interstitial Laser Thermotherapy
Physics in Medicine and Biology, 1998Co-Authors: Johan Olsrud, Ronnie Wirestam, Sara Brockstedt, Freddy Stahlberg, Karl-göran Tranberg, Annika M. K. Nilsson, Bertil R PerssonAbstract:In this work the temperature dependence of the proton resonance frequency was assessed in agarose gel with a high melting temperature (95C) and in porcine liver in vitro at temperatures relevant to Thermotherapy (25-80C). Furthermore, an optically tissue-like agarose gel phantom was developed and evaluated for use in MRI. The phantom was used to visualize temperature distributions from a diffusing Laser fibre by means of the proton resonance frequency shift mehod. An approximately linear relationship (0.0085 ppm ) between proton resonance frequency shift and temperature change was found for agarose gel, whereas deviations from a linear relationship were observed for porcine liver. The optically tissue-like agarose gel allowed reliable MRI temperature monitoring, and the MR relaxation times ( and ) and the optical properties were found to be independently alterable. Temperature distributions around a diffusing Laser fibre, during irradiation and subsequent cooling, were assessed with high spatial resolution (voxel size=4.3 mm) and with random uncertainties ranging from 0.3C to 1.4C (1 SD) with a 40 s scan time.
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mri thermometry in phantoms by use of the proton resonance frequency shift method application to interstitial Laser Thermotherapy
Physics in Medicine and Biology, 1998Co-Authors: Johan Olsrud, Ronnie Wirestam, Sara Brockstedt, Freddy Stahlberg, Karl-göran Tranberg, Annika M. K. Nilsson, Bertil PerssonAbstract:In this work the temperature dependence of the proton resonance frequency was assessed in agarose gel with a high melting temperature (95 degrees C) and in porcine liver in vitro at temperatures relevant to Thermotherapy (25-80 degrees C). Furthermore, an optically tissue-like agarose gel phantom was developed and evaluated for use in MRI. The phantom was used to visualize temperature distributions from a diffusing Laser fibre by means of the proton resonance frequency shift method. An approximately linear relationship (0.0085 ppm degrees C(-1)) between proton resonance frequency shift and temperature change was found for agarose gel, whereas deviations from a linear relationship were observed for porcine liver. The optically tissue-like agarose gel allowed reliable MRI temperature monitoring, and the MR relaxation times (T1 and T2) and the optical properties were found to be independently alterable. Temperature distributions around a diffusing Laser fibre, during irradiation and subsequent cooling, were assessed with high spatial resolution (voxel size = 4.3 mm3) and with random uncertainties ranging from 0.3 degrees C to 1.4 degrees C (1 SD) with a 40 s scan time.
Bertil R Persson - One of the best experts on this subject based on the ideXlab platform.
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mri thermometry in phantoms by use of the proton resonance frequency shift method application to interstitial Laser Thermotherapy
Physics in Medicine and Biology, 1998Co-Authors: Johan Olsrud, Ronnie Wirestam, Sara Brockstedt, Freddy Stahlberg, Karl-göran Tranberg, Annika M. K. Nilsson, Bertil R PerssonAbstract:In this work the temperature dependence of the proton resonance frequency was assessed in agarose gel with a high melting temperature (95C) and in porcine liver in vitro at temperatures relevant to Thermotherapy (25-80C). Furthermore, an optically tissue-like agarose gel phantom was developed and evaluated for use in MRI. The phantom was used to visualize temperature distributions from a diffusing Laser fibre by means of the proton resonance frequency shift mehod. An approximately linear relationship (0.0085 ppm ) between proton resonance frequency shift and temperature change was found for agarose gel, whereas deviations from a linear relationship were observed for porcine liver. The optically tissue-like agarose gel allowed reliable MRI temperature monitoring, and the MR relaxation times ( and ) and the optical properties were found to be independently alterable. Temperature distributions around a diffusing Laser fibre, during irradiation and subsequent cooling, were assessed with high spatial resolution (voxel size=4.3 mm) and with random uncertainties ranging from 0.3C to 1.4C (1 SD) with a 40 s scan time.
Bertil Persson - One of the best experts on this subject based on the ideXlab platform.
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mri thermometry in phantoms by use of the proton resonance frequency shift method application to interstitial Laser Thermotherapy
Physics in Medicine and Biology, 1998Co-Authors: Johan Olsrud, Ronnie Wirestam, Sara Brockstedt, Freddy Stahlberg, Karl-göran Tranberg, Annika M. K. Nilsson, Bertil PerssonAbstract:In this work the temperature dependence of the proton resonance frequency was assessed in agarose gel with a high melting temperature (95 degrees C) and in porcine liver in vitro at temperatures relevant to Thermotherapy (25-80 degrees C). Furthermore, an optically tissue-like agarose gel phantom was developed and evaluated for use in MRI. The phantom was used to visualize temperature distributions from a diffusing Laser fibre by means of the proton resonance frequency shift method. An approximately linear relationship (0.0085 ppm degrees C(-1)) between proton resonance frequency shift and temperature change was found for agarose gel, whereas deviations from a linear relationship were observed for porcine liver. The optically tissue-like agarose gel allowed reliable MRI temperature monitoring, and the MR relaxation times (T1 and T2) and the optical properties were found to be independently alterable. Temperature distributions around a diffusing Laser fibre, during irradiation and subsequent cooling, were assessed with high spatial resolution (voxel size = 4.3 mm3) and with random uncertainties ranging from 0.3 degrees C to 1.4 degrees C (1 SD) with a 40 s scan time.
