Radiofrequency Hyperthermia Research Articles

Biodegradable Radiofrequency Responsive Nanoparticles for Augmented Thermal Ablation Combined with Triggered Drug Release in Liver Tumors.

Radiofrequency ablation (RFA) and doxorubicin (Dox) chemotherapy are separately approved for liver cancer therapy; however, both have limited success in the clinic due to suboptimal/nonuniform heating and systemic side effects, respectively. Here, we report a biodegradable nanoparticle (NP) system showing excellent RF hyperthermic response together with the ability to locally deliver Dox in the liver under RF trigger and control. The nanosystem was prepared by doping a clinically permissible dose (∼4.3 wt %, 0.03 ppm) of stannous ions in alginate nanoparticles (∼100 nm) coloaded with Dox at ∼13.4 wt % concentration and surface conjugated with galactose for targeting asialo-glycoprotein receptors in liver tumors. Targeted NP-uptake and increased cytotoxicity when combined with RF exposure was demonstrated in HEPG2 liver cancer cells. Following in vitro (chicken liver phantom) demonstration of locally augmented RF thermal response, in vivo scintigraphic imaging of 99Tc-labeled NPs was performed to optimize liver localization in Sprague-Dawley (SD) rats. RF ablation was performed in vivo using a cooled-tip probe, and uniformly enhanced (∼44%) thermal ablation was demonstrated with magnetic resonance imaging along with RF-controlled Dox release. In orthotopic rat liver tumor models, real-time infrared imaging revealed significantly higher (∼20 °C) RF thermal response at the tumor site, resulting in uniform augmented ablation (∼80%) even at a low RF power exposure of 15 W for just 1 min duration. Being a clinically acceptable, biodegradable material, alginate nanoparticles hold strong translational potential for augmented RF hyperthermia combined with triggered drug release.

Pilot study of radiofrequency hyperthermia in combination with gefitinib in gefitinib-effective patients with advanced NSCLC.

BackgroundNon‐small‐cell lung cancer (NSCLC) is the leading cause of death from cancer in China. Gefitinib is effective for patients with positive epidermal growth factor receptor gene mutation; however, acquired drug resistance counteracts the duration response. Hyperthermia is widely clinically applied in the treatment of solid tumors. This pilot study was designed to evaluate the feasibility of the combination of gefitinib and hyperthermia.MethodsPatients newly diagnosed with advanced NSCLC were screened. Eleven patients who responded to first‐line gefitinib treatment were enrolled in the study. Along with 250 mg gefitinib daily, local radiofrequency hyperthermia was administered twice a week until tumor progression was observed. The serum, heat shock protein (HSP)70, was also frequently detected during the course.ResultsThe most common toxicity included skin rash (81.8%) and abnormal liver function (45.5%) when treated with gefitinib, and fatty scleroma (36.4%) was observed when combined with hyperthermia. Grade 3 side effects (skin rash) occurred in only one patient. Median progression‐free survival was 22 months (95% confidence interval [CI]: 12.95–31.05 months) and median overall survival was 26 months (95% CI: 22.81–29.19 months). Serum HSP70 concentration increased and maintained a significantly high level compared with the baseline before hyperthermia administration.ConclusionsThe novel therapy of gefitinib combined with radiofrequency hyperthermia is safe and effective for advanced NSCLC patients. Whether an improvement in therapeutic efficacy is associated with the elevation of serum HSP70 concentration requires further study.

Simulation and experimental evaluation of selective heating characteristics of 13.56 MHz radiofrequency hyperthermia in phantom models

Hyperthermia with a radiofrequency electric field can treat a cancer by delivering energy to heat and kill cancer cells. For a deeply located tumor, focused energy to raise its local temperature selectively is crucial for effective cancer treatment with minimal injury to normal tissues. We evaluated the selective heating characteristics of hyperthermia with 13.56 MHz radiofrequency energy in phantom models by experimental and computational approaches. Phantom materials with different electrical properties such as distilled water, normal saline, egg white and porcine meat were used. Temperature rise in depthwise during heating at 75 W output power was compared. The temperature of the egg white increased selectively in the distilled water but not significantly in the saline. Numerical simulation was performed using SEMCAD X software to calculate the distributions of specific absorption rate (SAR) and temperature, which enabled us to elucidate the selective heating mechanism in those phantom models.

Comparison of Temperature Distribution in Agar Phantom and Gel Bolus Phantom by Radiofrequency Hyperthermia

Comparison of Temperature Distribution in Agar Phantom and Gel Bolus Phantom by Radiofrequency Hyperthermia

온도범위에 따른 비침습적 자기공명 온도측정방법의 최적화

Noninvasive temperature monitoring is feasible with Magnetic Resonance Imaging (MRI) based on temperature sensitive MR parameters such as and relaxation times, Proton Resonance Frequency shift (PRFs), diffusion, exchange process, magnetization transfer contrast, chemical exchange saturation transfer, etc. While the temperature monitoring is very useful to guide the thermal treatment such as RF hyperthermia or thermal ablation, the optimization of the MR thermometry method is essential because the range of temperature measurement depends on the choice of the measurement methods. Useful temperature range depends on the purpose of treatment methods, for example, to for RF hyperthermia and over for thermal ablation. In this paper, MR thermometry methods using and relaxation times and PRFs-based MR thermometry are tried on a 3.0 T MRI system and their results are reported and compared. In addition, the scanning protocol and temperature calculation algorithms from and relaxation times and PRFs are optimized for the different temperature ranges for the purpose of RF hyperthermia and/or thermal ablation.

Output-limiting symptoms induced by radiofrequency hyperthermia. Are they predictable?

Background: During radiofrequency (RF) hyperthermia treatment, hot-spot phenomena may occur and prevent treatment continuation if the output is not lowered. We previously reported a significant correlation between the initial energy output at which output-limiting symptoms occurred and patient status. Patients with a complete clinical response had significantly increased temperature, while some patients with partial clinical response and stable disease had increased temperature, depending on the occurrence of output-limiting symptoms. To predict the initial energy output at which output-limiting symptoms occur, we performed multiple regression analysis with the parameters of patients’ physical status. Materials and methods: Hyperthermia alone or concomitant with chemotherapy and/or radiotherapy was applied in 62 patients with malignant disease for a total of 310 treatments with a Thermotron RF-8 between December 2011 and April 2014. Results: No output-limiting symptoms were shown in 65.5% of 310 treatments. Pain (29.7%), micturition desire (1.9%), skin discomfort (0.6%), subcutaneous induration (1.6%), cold sensation (0.6%), and nausea (0.3%) were reported in the 310 treatments. A good predictive equation for initial energy output at which output-limiting symptoms occur was determined with two parameters, initial time of an output-limiting symptom onset, and thickness of the fat of the abdominal wall. Multiple regression analysis showed an adjusted R2 = 0.99 and variance inflation factor < 2. Conclusions: We present a good predictive equation for initial energy output at which output-limiting symptoms occur. It is critical to prevent RF hyperthermia-induced output-limiting symptoms and establish new prevention strategies.

Time-multiplexed two-channel capacitive radiofrequency hyperthermia with nanoparticle mediation.

BackgroundCapacitive radiofrequency (RF) hyperthermia suffers from excessive temperature rise near the electrodes and poorly localized heat transfer to the deep-seated tumor region even though it is known to have potential to cure ill-conditioned tumors. To better localize heat transfer to the deep-seated target region in which electrical conductivity is elevated by nanoparticle mediation, two-channel capacitive RF heating has been tried on a phantom.MethodsWe made a tissue-mimicking phantom consisting of two compartments, a tumor-tissue-mimicking insert against uniform background agarose. The tumor-tissue-mimicking insert was made to have higher electrical conductivity than the normal-tissue-mimicking background by applying magnetic nanoparticle suspension to the insert. Two electrode pairs were attached on the phantom surface by equal-angle separation to apply RF electric field to the phantom. To better localize heat transfer to the tumor-tissue-mimicking insert, RF power with a frequency of 26 MHz was delivered to the two channels in a time-multiplexed way. To monitor the temperature rise inside the phantom, MR thermometry was performed at a 3T MRI intermittently during the RF heating. Finite-difference-time-domain (FDTD) electromagnetic and thermal simulations on the phantom model were also performed to verify the experimental results.ResultsAs compared to the one-channel RF heating, the two-channel RF heating with time-multiplexed driving improved the spatial localization of heat transfer to the tumor-tissue-mimicking region in both the simulation and experiment. The two-channel RF heating also reduced the temperature rise near the electrodes significantly.ConclusionsTime-multiplexed two-channel capacitive RF heating has the capability to better localize heat transfer to the nanoparticle-mediated tumor region which has higher electrical conductivity than the background normal tissues.

Thermal magnetic resonance: physics considerations and electromagnetic field simulations up to 23.5 Tesla (1GHz).

BackgroundGlioblastoma multiforme is the most common and most aggressive malign brain tumor. The 5-year survival rate after tumor resection and adjuvant chemoradiation is only 10 %, with almost all recurrences occurring in the initially treated site. Attempts to improve local control using a higher radiation dose were not successful so that alternative additive treatments are urgently needed. Given the strong rationale for hyperthermia as part of a multimodal treatment for patients with glioblastoma, non-invasive radio frequency (RF) hyperthermia might significantly improve treatment results.MethodsA non-invasive applicator was constructed utilizing the magnetic resonance (MR) spin excitation frequency for controlled RF hyperthermia and MR imaging in an integrated system, which we refer to as thermal MR. Applicator designs at RF frequencies 300 MHz, 500 MHz and 1GHz were investigated and examined for absolute applicable thermal dose and temperature hotspot size. Electromagnetic field (EMF) and temperature simulations were performed in human voxel models. RF heating experiments were conducted at 300 MHz and 500 MHz to characterize the applicator performance and validate the simulations.ResultsThe feasibility of thermal MR was demonstrated at 7.0 T. The temperature could be increased by ~11 °C in 3 min in the center of a head sized phantom. Modification of the RF phases allowed steering of a temperature hotspot to a deliberately selected location. RF heating was monitored using the integrated system for MR thermometry and high spatial resolution MRI. EMF and thermal simulations demonstrated that local RF hyperthermia using the integrated system is feasible to reach a maximum temperature in the center of the human brain of 46.8 °C after 3 min of RF heating while surface temperatures stayed below 41 °C. Using higher RF frequencies reduces the size of the temperature hotspot significantly.ConclusionThe opportunities and capabilities of thermal magnetic resonance for RF hyperthermia interventions of intracranial lesions are intriguing. Employing such systems as an alternative additive treatment for glioblastoma multiforme might be able to improve local control by “fighting fire with fire”. Interventions are not limited to the human brain and might include temperature driven targeted drug and MR contrast agent delivery and help to understand temperature dependent bio- and physiological processes in-vivo.

Radiofrequency heating of nanomaterials for cancer treatment: Progress, controversies, and future development

In recent years, the application of nanomaterials to biological and biomedicine areas has attracted intensive interest. One of the hot topics is the nanomaterial mediated radiofrequency (RF) hyperthermia or ablation, i.e., using RF fields/waves to heat tumor tissues treated with nanomaterials to destroy cancerous cells while minimizing the side-heating effect. However, there are currently many contradictive results reported concerning the heating effect of nanomaterials under a RF field. This paper provided a comprehensive review to nanomaterial mediated RF ablation from both experimental and theoretical aspects. Three heating mechanisms were discussed, i.e., laser heating, magnetic field heating, and electric field heating in RF spectrum, with the focus on the last one. The results showed that while diluted pure metallic nanoparticles could be heated significantly by a laser through the surface plasmon resonance, they cannot be easily heated by a RF electric field. Further studies are proposed focusing on nanoparticle structure and morphology, electromagnetic frequency and localized heating effect to pave the way for future development.

A novel strategy of radiofrequency hyperthermia (neothermia) in combination with preoperative chemoradiotherapy for the treatment of advanced rectal cancer: a pilot study.

The safety of weekly regional hyperthermia performed with 8 MHz radiofrequency (RF) capacitive heating equipment has been established in rectal cancer. We aimed to standardize hyperthermia treatment for scientific evaluation and for assessing local tumor response to RF hyperthermia in rectal cancer. Forty-nine patients diagnosed with rectal adenocarcinoma were included in the study. All patients received chemoradiation with intensity-modulated radiation therapy 5 days/week (dose, 50 Gy/25 times) concomitant with 5 days/week for five times of capecitabine (1700 mg/m2 per day) and once a week for five times of 50 min irradiations by an 8 MHz RF capacitive heating device. Thirty-three patients underwent surgery 8 weeks after treatment. Three patients did not undergo surgery because of progressive disease (PD) and 13 refused. Eight (16.3%) patients had a pathological complete response (ypCR) after surgery. Among patients without surgery, 3 (6.1%) had clinical complete response (CR) and 3 (6.1%) had local CR but distant PD (CRPD). Ninety percent of ypCR + CR patients were shown in 6.21 W min−1 m−2/treatment or higher group of average total accumulated irradiation output with 429°C min−1 m−2 or higher group of total accumulated thermal output. However, a patient with CRPD was in the higher total accumulated thermal output group. We propose a new quantitative parameter for the hyperthermia and demonstrated that patients can benefit from mild irradiation with mild temperature. Using these parameters, the exact output, optimal thermal treatment, and contraindications or indications of this modality could be determined in a multi-institutional, future study.

Abstract No. 425 - Radiofrequency hyperthermia-enhanced local chemotherapy of esophageal squamous cancers

No. 425 Radiofrequency hyperthermia-enhanced local chemotherapy of esophageal squamous cancers Y. shi, F. Zhang, Z. Bai, J. Wang, L. Qiu, X. Yang; Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Radiology, University of Washington School of Medicine, Seattle, WA Purpose: To determine whether radiofrequency (RF) hyperthermia could enhance the therapeutic effect of cisplatin and 5-fluorouracil (5-FU) on esophageal squamous cancers (ESC). Materials and Methods: Human ESC cells (ESCC) were first labeled with red fluorescent protein (RFP) via a lentivirus transfection approach. For both in vitro confirmation and in vivo validation studies, RFP-ESCCs and 24 RFP-ESCengrafted mice were divided into four study groups with various treatments of (i) combination therapy with chemotherapy (cisplatin and 5-FU) plus MR imaging-heating-guidewire (MRIHG)-mediated local RF hyperthermia; (ii) chemotherapy only; (iii) RF hyperthermia only; and (iv) phosphate-buffered saline (PBS). In vitro cell proliferation was quantified by MTS assay, while in vivo validation with size changes of ESC masses and RFP-ESC signals among different treatment groups were monitored by ultrasound imaging and optical imaging over time with subsequent pathology correlation. Results: Of in vitro experiments, MTS assay demonstrated lowest cell proliferation of combination therapy compared to those of three control groups (23.4 7% VS 44.6 7.5% VS 95.8 2% VS 100 3%, po0.05). Of in vivo experiments, ultrasound imaging showed smaller tumor volumes with combination therapy than those with three control treatments (0.65 0.08 VS 1.27 0.04 VS 2.63 0.16 VS 2.71 0.19, Po0.05). Optical imaging demonstrated a decrease of RFPESC signals for the combination therapy group in comparison to those for three control groups (0.57 0.09 VS 1.37 0.17 VS 2.37 0.35 VS 2.54 0.35, Po0.05), which were well correlated with histologic confirmation. Conclusion: Local RF hyperthermia can enhance chemotherapeutic effect on human ESCs, which may open a new avenue for efficient management of esophageal malignancies. Educational Exhibit Abstract No. 426 Use of hands free gesture-based imaging control for vessel identification during hepatic transarterial chemoembolization and selective internal radiotherapy procedures Z.L. Bercu, V.V. Patil, R.S. Patel, E. Kim, S.F. Nowakowski, R.A. Lookstein, A.M. Fischman; Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY Learning Objectives: 1. Understand the technical implementation of an inexpensive gesture-based input device for intra-procedural control of picture archiving and communications systems (PACS). 2. Understand the importance of vessel identification for transarterial chemoembolization (TACE) and selective internal radiotherapy (SIRT) procedures. 3. Understand how gesture-based device integration can lead to lower radiation doses to both the patient and operator through reduced need of angiograms. 4. Understand how gesture-based device integration can lead to faster, safer, and more accurate TACE and SIRT procedures. Background: TACE and MAA both require detailed appreciation for normal and variant hepatic anatomy. Identification of the cystic, gastric, gastroduodenal, falciform, and accessory arteries is critical to reduce the risk of nontarget chemoembolization or radiotherapy delivery. Patients may have variant anatomy difficult to deduce on angiography alone. Vessel identification is essential during subselective TACE and SIRT for complex disease. Use of CT/MRI is invaluable but often not available readily and delays case progression with the need to “scrub out.” The ability to review prior imaging in real-time in the angiosuite facilitates proper vessel identification, reduced need for radiation, and increased safety. Clinical Findings/Procedure Details: The Leap Motion Controller (Leap Motion, Inc., San Francisco, CA) allows for gesture mapping to input commands. It is inexpensive and Posters and Exhibits ’ JVIR S186 P os te rs an d Ex hi bi ts

3:57 PM, Abstract No. 149 - Radiofrequency hyperthermia (RFH)-enhanced herpes simplex virus-thymidine kinase (HSV-TK) gene therapy of hepatocellular carcinoma

3:57 PM, Abstract No. 149 - Radiofrequency hyperthermia (RFH)-enhanced herpes simplex virus-thymidine kinase (HSV-TK) gene therapy of hepatocellular carcinoma

3:48 PM, Abstract No. 288 - Radiofrequency hyperthermia (RFH)-enhanced chemotherapy of pancreatic cancers monitored by dual-modality imaging

3:48 PM, Abstract No. 288 - Radiofrequency hyperthermia (RFH)-enhanced chemotherapy of pancreatic cancers monitored by dual-modality imaging

Radiofrequency Ablation of Drug‐Resistant Cancer Cells Using Molecularly Targeted Carboxyl‐Functionalized Biodegradable Graphene

Under ultralow radiofrequency (RF) power, transferrin-conjugated graphene nanoparticles can thermally ablate drug- or radiation-resistant cancer cells very effectively. The results suggest that graphene-based RF hyperthermia can be an efficient method to manage drug-/radiation-resistant cancers.

Simulation of the electromagnetic field and temperature distribution in human tissue in RF hyperthermia

In this publication colloid with superparamagnetic nanoparticles is considered. Also Brown and Neel relaxation processes were taken into account. With assumption that effective value of the field in particle is equal to the exciting field, formulae for power losses in ferrofluid is derived. At the end discussion of the influence of the different particle parameters on the generated power is given. Streszczenie. W artykule tym przedstawiono sposob obliczania mocy wytwarzanej przez koloid zawierający superparamagnetyczne nanocząsteczki. Zjawisko relaksacji Browna i Neele'a zostalo uwzglednione przy wyprowadzaniu wzorow na moc. Na koniec przedyskutowano wplyw roznych parametrow cząsteczki na wytworzoną moc. (Symulacja pola elektromagnetycznego i rozkladu temperatury w tkance ludzkiej w czasie RF hipertermii)

Nanoheating without Artificial Nanoparticles Part II. Experimental Support of the Nanoheating Concept of the Modulated Electro-Hyperthermia Method, Using U937 Cell Suspension Model

There are intensive debates about the effects and mechanisms of radiofrequency (RF) hyperthermia in oncology. We theoretically modelled the mechanism of the nanoheating effect of the RF current at the cellular and subcellular level. Then, we experimentally investigated the mechanism of heating in comparison with selective modulated electrohyperthermia and water-bath heating conventional hyperthermia (WHT) using the U937 suspension cell line model. The two heating-processes resulted in different distributions of energy-absorption, causing different mechanisms of the thermal processes. Both of the mechanisms are thermal (fit to Arrhenius plot) but the selectively absorbed energy by the plasma membrane rafts and the cell-cell contacts of the cells results in earlier cell-destruction than in case of unselective homogeneous heating. This thermal effect is used for the characterisation of selective heating. The experimental results clearly support the previous theoretical considerations; the cell killing effect can be realised at lower temperature ranges in the case of the modulated electro-hyperthermia (mEHT, trade-name: oncothermia) method than with WHT.

AB226. The effects of transrectal radiofrequency hyperthermia on patients with chronic prostatitis and the changes of IL-8, IL-10, TNF-α, PGE2, β2-endorphin levels in pre-treatment and post-treatment

ObjectiveTo assess the effectiveness of transrectal radiofrequency hyperthermia in men with chronic prostatitis (CP), and explore the changes of IL-8, IL-10, TNF-equency hyperthermia in men wi CP patients pre-treatment and post-treatment.Materials and methodsPatients diagnosed with chronic prostatitis were randomized to 6 weeks of tamsulosin plus clarithromycin, transrectal radiofrequency hyperthermia (TRFH) or TRFH with tamsulosin plus clarithromycin group, respectively. The primary outcome measure was evaluated by the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). The expression of EPS interleukin-8 (IL-8), interleukin 10 (IL-10), tumor necrosis factor (TNF-α), prostaglandin E2 (PGE2) and β2-endorphin (βNIH-) were detected by ELISA in the pre-treatment and post-treatment of CP.ResultsA total of 159 patients were randomized in the study. The NIH-CPSI total, domain and pain scores significantly decreased from baseline in all groups, After treatment, IL-8 and IL-10 was significantly decreased in the TRFH with tamsulosin plus clarithromycin group compared to the other two groups(P<0.05), Among the three groups, there was no significant changes of TNF-, domain and pain scores significantly, the levels of PGE2 was significantly decreased (P<0.05), while the TNF-, domain and pain scores significantly decreased from baseline in all groin plus clarithromycin group compared to the tamsulosin plus clarithromycin group (P<0.05). In the CP patients, the results showed that there was a significant negative correlation between β2-EP and pain (r=–0.747, P<0.05) or QoL (r=–0.595, P<0.05), while there was a significant positive correlation between TNF-α and micturition (r=0.619, P<0.05) or QoL (r=0.663, P<0.05), between PGE2 and pain (r=0.650, P<0.05) or QoL (r=0.685, P<0.05).ConclusionsComparison with pre-treatment, differences in IL-8, IL-10, TNF-ɑ,PGE2 and with pre-treatment, differences in IL-8, IL-10, TNF-ɑn TNF-α and micturition in scores significantly decreased from baseline in all groin plus clarithromy effects of TRFH with tamsulosin plus clarithromycin group are superior to the TRFH group or the tamsulosin plus clarithromycin group alone.

Comparative Study of Magnetic Properties and Antitumor Effect of Nanocomplexes from Oxides Iron Nanoparticles and Doxorubicin During Radio-Frequency Hyperthermia of the Walker-256 Carcinosarcoma

A comparative study of magnetic properties using the method of magnetometry with vibration magnetometer and spectra of electron paramagnetic resonance (EPR) nanocomplexes (NCs) of nanoparticles Fe2O3, Fe3O4and antitumor antibiotic doxorubicin (DOXO) have shown that changes in saturation magnetic moments are similar to changes in integral intensity of EPR spectra. The greatest magnetic moments of saturation and integral intensity of EPR spectra were demonstrated by samples of Fe3O4in NC with doxorubicin, which had the highest antitumor effect in radiofrequency hyperthermia of Walker-256 carcinosarcoma. The presented research provides the evidence of stronger antitumor effect of Fe3O4and DOXO NC in comparison to NC from γ- Fe2O3and DOXO at combined action of constant magnetic field and electromagnetic field. This can be a basis for development of bioengineering technology of magnetic cancer nanotherapy in conditions of moderate hyperthermia (&lt; 39°C).

Effects of Thermotherapy on Th1/Th2 Cells in Esophageal Cancer Patients Treated with Radiotherapy

To investigate the effects of double radiofrequency hyperthermia on Th1/Th2 cells in esophageal cancer patients treated with radiotherapy. 22 patients with esophageal cancer were divided into a radiotherapy group (10 cases) and a combined group (double radiofrequency hyperthermia combined with radiotherapy group, 12 cases). Both groups received conventional radiotherapy using a cobalt-60 therapy apparatus (TD60-66Gy/30-33F). Patients in the combined group also underwent double radiofrequency hyperthermia (2F/W, 8-10F). Before and after treatment, Th1, Th2, Tc1 and Tc2 cells in peripheral blood were determined with flow cytometry. In the radiotherapy group, Th1 cell contents before and after radiotherapy were 17.5 ± 5.26% and 9.69 ± 4.86%, respectively, with a significant difference (p<0.01). The Th1/Th2 ratio was significantly decreased from 28.2 ± 14.3 to 16.5 ± 10.4 (p<0.01). In the combined group, Th1 cell content before radiotherapy was 15.9 ± 8.18%, and it increased to 18.6 ± 8.84 after radiotherapy (p>0.05), the Th1/Th2 ratio decreasing from 38.4 ± 36.3 to 28.1 ± 24.0 (p>0.05). Changes in Th2, Tc1 and Tc2 cell levels were not significant in the two groups before and after therapy (p>0.05). Double radiofrequency hyperthermia can promote the conversion from Th2 to Th1 cells, and regulate the balance of Th1/Th2 cells.

8:09 AM; Abstract No. 90 - Pre-clinical study of intrabiliary radiofrequency hyperthermia -enhanced local chemotherapy of cholangiocarcinoma monitored by dual-modality molecular imaging

M O N D A Y: S cintific S esions Materials and Methods: Consecutive patients that underwent TACE in 2000-2013 were included. NTE was defined as presence of ethiodized oil in organs other than liver seen on non-contrast CT performed day after TACE. CTs and angiography images were reviewed on PACS by abdominal imaging and interventional radiologist. Medical record were reviewed for clinical outcomes. Chi-square and Fischer exact tests were used for statistical analysis. Results: 583 TACE procedures for 360 patients were evaluated. HCC was treated in 394 cases (68%), 110 neuroendocrine tumors (19%) and 79 metastases (14%). Overall incidence of NTE was 33% (194), with 20% to lung, 13% gallbladder, 5% stomach, 1% pancreas, 1% spleen, 0.5% duodenum and 0.3% adrenal. S-TACE (164 cases) resulted in lower NTE rate (21% (34/164) vs. 38% (159/419), po0.001). Organ-specific incidence of NTE was reduced with S-TACE for stomach (1% (2/164) vs. 6% (25/419), p1⁄40.01) and gallbladder (4% (7/164) vs. 16% (67/ 419), po0.001), but not for lungs (16% (26/164) vs. 21% (88/ 419), p1⁄40.17). NTE to pancreas, duodenum and spleen occurred only with L-TACE. Two cases of NTE to adrenal occurred only with S-TACE. Pulmonary symptoms were present in 23/469 (5%) cases without lung oil deposition, but much more frequent in patients with lung oil deposition 24/114 (21%), (po0.001). 3/8 (38%) patients with pancreas oil deposition had clinical pancreatitis. Eight patients were admitted to intensive care unit, 7 (1.7%) after L-TACE and 1 (0.6%) after S-TACE. In 7 there was evidence of NTE, in 6 cases to lung and in 2 to gallbladder. Three patients (0.5%) expired during the post TACE admission; all of them had L-TACE and lung NTE. Patients with NTE had longer hospital stay 2.6 vs 1.9 days, p1⁄40.01. Conclusion: Transarterterial chemoembolization has a high rate of non-targeted embolization, which can be reduced significantly using a superselective approach. Non-targeted embolization was associated with longer hospital stay and complicated post procedure course.