HomeRadiology: Imaging CancerVol. 2, No. 1 Previous Research HighlightsFree AccessTrifluoroacetic Acid as a Theranostic Ablation AgentGary D. LukerGary D. LukerGary D. LukerPublished Online:Jan 31 2020https://doi.org/10.1148/rycan.2020204005MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Take-Away Points■ Major Focus: To test efficacy of trifluoroacetic acid (TFA) for chemical ablation of liver tumors and optimize a fluorine 19 (19F) MRI sequence to detect TFA in tissue.■ Key Result: Real-time 19F MRI successfully detected TFA in porcine liver tissue, and histologic findings effectively verified coagulation and disruption of liver architecture.■ Impact: This study established an integrated imaging and therapy protocol to apply TFA as a theranostic agent for chemical ablation of solid tissue.Ablation methods encompass a wide range of minimally invasive techniques to destroy liver tumors, particularly smaller tumors in patients for whom surgery is not safe or feasible. Incomplete ablation remains a clinical challenge with residual tumor leading to local recurrence and potentially more aggressive disease. Although ablations most commonly use radiofrequency, laser, or other thermal methods, high-flow blood vessels can produce a local heat-sink effect that reduces peak temperatures of ablation and elimination of nearby tumors. Chemical ablations do not suffer from limitations of a local heat-sink, but agents used for chemical ablation may flow irregularly in tissue with associated off-target injury and systemic toxicities. To develop a theranostic agent for chemical ablation of liver tumors, the authors combined trifluoroacetic acid (TFA) as an ablation agent with fluorine 19 (19F) MRI. 19F MRI provides quantitative images with very minimal background signal, although low sensitivity typically requires millimolar concentrations of 19F to produce diagnostic quality images. Chemical ablation uses much higher concentrations, potentially overcoming sensitivity limits of 19F MRI. The investigators optimized a 19F MRI sequence to detect TFA in phantoms with signal-to-noise correlating directly with concentration. 19F MRI detected distribution and relative amounts of TFA used to ablate porcine liver tissue ex vivo, and histologic findings showed extensive damage to hepatocytes at concentrations of 0.5 mol/L TFA or higher. By developing a 19F MRI method to detect TFA in liver tissue, this research provides a new approach to optimize chemical ablation strategies and potentially a novel theranostic technique for future clinical translation.Highlighted ArticleEinstein SA, Thompson EA, Guo C, Whitley EM, Bankson JA, Cressman ENK. Application of trifluoroacetic acid as a theranostic agent for chemical ablation of solid tissue. J Vasc Interv Radiol 2020;31(1):169–175. doi: https://doi.org/10.1016/j.jvir.2019.05.002Highlighted ArticleEinstein SA, Thompson EA, Guo C, Whitley EM, Bankson JA, Cressman ENK. Application of trifluoroacetic acid as a theranostic agent for chemical ablation of solid tissue. J Vasc Interv Radiol 2020;31(1):169–175. doi: https://doi.org/10.1016/j.jvir.2019.05.002 Crossref, Medline, Google ScholarArticle HistoryPublished online: Jan 31 2020 FiguresReferencesRelatedDetailsRecommended Articles Colorectal Cancer Liver Metastases: Biopsy of the Ablation Zone and Margins Can Be Used to Predict Oncologic OutcomeRadiology2016Volume: 280Issue: 3pp. 949-959Combined Angio-CT Systems: A Roadmap Tool for Precision Therapy in Interventional OncologyRadiology: Imaging Cancer2021Volume: 3Issue: 5Hepatocellular Carcinoma: Intra-arterial Delivery of Doxorubicin-loaded Hollow Gold Nanospheres for Photothermal Ablation—Chemoembolization Therapy in RatsRadiology2016Volume: 281Issue: 2pp. 427-435Effects of Microwave Ablation on Arterial and Venous Vasculature after Treatment of Hepatocellular CarcinomaRadiology2016Volume: 281Issue: 2pp. 617-624Midterm Safety and Efficacy of Irreversible Electroporation of Malignant Liver Tumors Located Close to Major Portal or Hepatic VeinsRadiology2017Volume: 285Issue: 3pp. 1023-1031See More RSNA Education Exhibits Maximizing Procedural Success! A Trainee's Guide to Imaging Equipment in the IR SuiteDigital Posters2018The Emerging Role of Contrast-Enhanced Ultrasound in Oncological InterventionDigital Posters2018A Practical Guide of Locoregional Treatment for Patients with Hepatocellular CarcinomaDigital Posters2019 RSNA Case Collection Spindle cell lipomaRSNA Case Collection2022Extralobar Pulmonary Sequestration RSNA Case Collection2021Hepatic AdenomatosisRSNA Case Collection2021 Vol. 2, No. 1 Metrics Altmetric Score PDF download
Read full abstract