Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Lars Lönn, Københavns universitet, Rigshospitalet, Denmark
- Second opponent: Senior Consultant Magnus Rizell, Sahlgrenska Universitetssjukhuset, Sweden
- Third member and chair of the evaluation committee: Professor Kirsten Krogh-Sørensen, University of Oslo
Chair of the Defence
Professor II Kirsten Muri Boberg, University of Oslo
Principal Supervisor
Senior Consultant Eric Dorenberg, Oslo University Hospital
Summary
Treatment of liver tumors is often multi-modal including systemic chemotherapy and surgical interventions. However, for many patients surgery is not an option, and in some tumors the clinical effect of systemic chemotherapy has been limited. In these cases, minimally invasive image guided treatments using interventional radiology techniques can be an option. One of these treatments is thermal ablation, using heat-generating needles to destruct the tumor. Large vessels close to the tumor can however reduce the efficacy of the treatment. Transarterial treatment, using catheters to deliver chemotherapeutics and embolic agents directly into the hepatic arteries under image guidance can also be an option. However, especially in primary liver cancer, hepatocellular carcinoma (HCC), the liver function might be a limiting factor for this treatment.
In this thesis we have explored the possibility of using a non-invasive ablation method, high intensity focused ultrasound (HIFU), guided by magnetic resonance imaging (MR) for ablations close to large veins in the liver in an experimental setting. We have evaluated the clinical effect of transarterial chemoembolization using drug eluting embolics (DEE-TACE) in metastatic uveal melanoma (MUM), a disease with relatively poor prognosis and limited systemic treatment options. We also evaluated the clinical effect of DEE-TACE in patients with HCC with regard to newly developed tools for assessing liver function, the ALBI and P-ALBI scores.
We found that liver tissue close to large vessels can be successfully ablated using MRgHIFU. Further, we found a questionable clinical effect of DEE-TACE in MUM, as there were many cases with early progression of disease. We found that the ALBI and P-ALBI scores might be useful prognostic tools in patients with HCC treated with DEE-TACE. This may help to improve patient selection for this treatment.
Additional information
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