Improving image guided liver ablation

We want to work with patients to design research investigating this minimally invasive treatment for cancer that has spread to the liver

Background

Despite advances in treatment, cancer that has spread to the liver is difficult to treat. We want to design research to find out if ablation - a ‘pinhole surgical’ technique performed by an Interventional Radiologist - can be made more effective.

What is ablation?

Microwave ablation involves an adapted needle being placed through the skin and directly into a small liver tumour to cook it from the inside. It is a ‘pinhole surgical’ technique performed by an ‘Interventional Radiologist’ (a doctor specialising in image guided procedures), in a CT scanner.

Advantages of ablation

• Less invasive than surgery
• Low complication rates
• Short hospital stay (typically overnight)
• Low cost
• A liver sparing approach, meaning it can be repeated
• Suitable for patients receiving chemotherapy

However, using this technique, as many as half of tumours eventually return afterwards, and we are therefore looking for ways to reduce this number by carrying out research. By comparison, surgery is associated with recurrence of around one in ten, although is possible in less than 1 in 5 cases.

How can we reduce the number of returning tumours?

1. We propose doing this by targeting tumours more accurately using a robot - a UK first.

2. We will use special software to decide whether ablation has been successful or not.

3. We hope to introduce a new technique which is not available in the UK called 'CT hepatic angiography'. This involves injection of contrast directly into the hepatic arteries which helps us look at the treatment throughout the procedure, and better decide when it is complete.

Initial results suggest these approaches are promising, but they need to be studied further before they might be recommended across the NHS.

Why is this research necessary?

The NHS needs more evidence about these new advancements before they can be used more widely.