Experimental Data and Clinical Studies of Laser Ablation

  • Claudio Maurizio Pacella
  • Tian’an Jiang


This chapter presents an overview of the most salient experimental data derived from studies on animal models or live animal organs that are the basis of the most relevant clinical studies performed in order to establish which were the most suitable physical parameters to kill cancer cells in a safe, selective, rapid, reproducible, predictable, relatively easy, and less expensive way than alternatives. An additional final paragraph provides information on the most used laser systems in the main and important applications examined and described in the various dedicated chapters.


Laser ablation Laser treatment Tumor treatment Minimally invasive treatment Tissue ablation Thermal ablation Patient care 


  1. 1.
    Bown SG. Phototherapy in tumors. World J Surg. 1983;7(6):700–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Hoye RC, Thomas LB, Riggle GC, Ketcham A. Effects of neodymium laser on normal liver and Vx2 carcinoma transplanted into the liver of experimental animals. J Natl Cancer Inst. 1968;41(5):1071–82.PubMedGoogle Scholar
  3. 3.
    Matthewson K, Coleridge-Smith P, O’Sullivan JP, Northfield TC, Bown SG. Biological effects of intrahepatic neodymium:yttrium-aluminum-garnet laser photocoagulation in rats. Gastroenterology. 1987;93(3):550–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Dachman AH, McGehee JA, Beam TE, Burris JA, Powell DA. US-guided percutaneous laser ablation of liver tissue in a chronic pig model. Radiology. 1990;176(1):129–33.PubMedCrossRefGoogle Scholar
  5. 5.
    Bosman S, Phoa SS, Bosma A, van Gemert MJ. Effect of percutaneous interstitial thermal laser on normal liver of pigs: sonographic and histopathological correlations. Br J Surg. 1991;78(5):572–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Matsumoto R, Selig AM, Colucci VM, Jolesz FA. Interstitial Nd:YAG laser ablation in normal rabbit liver: trial to maximize the size of laser-induced lesions. Lasers Surg Med. 1992;12(6):650–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Dowlatshahi K, Babich D, Bangert JD, Kluiber R. Histologic evaluation of rat mammary tumor necrosis by interstitial Nd:YAG laser hyperthermia. Lasers Surg Med. 1992;12(2):159–64.PubMedCrossRefGoogle Scholar
  8. 8.
    Amin Z, Thurrell W, Spencer GM, Harries SA, Grant WE, Bown SG, et al. Computed tomography-pathologic assessment of laser-induced necrosis in rat liver. Investig Radiol. 1993;28(12):1148–54.CrossRefGoogle Scholar
  9. 9.
    Pacella CM, Rossi Z, Bizzarri G, Papini E, Marinozzi V, Paliotta D, et al. Ultrasound-guided percutaneous laser ablation of liver tissue in a rabbit model. Eur Radiol. 1993;3:26–32.CrossRefGoogle Scholar
  10. 10.
    van Hillegersberg R, van Staveren HJ, Kort WJ, Zondervan PE, Terpstra OT. Interstitial Nd:YAG laser coagulation with a cylindrical diffusing fiber tip in experimental liver metastases. Lasers Surg Med. 1994;14(2):124–38.PubMedCrossRefGoogle Scholar
  11. 11.
    Malone DE, Wyman DR, DeNardi FG, McGrath FP, De Gara CJ, Wilson BC. Hepatic interstitial laser photocoagulation. An investigation of the relationship between acute thermal lesions and their sonographic images. Investig Radiol. 1994;29(10):915–21.CrossRefGoogle Scholar
  12. 12.
    Germer CT, Albrecht D, Roggan A, Isbert C, Buhr HJ. Experimental study of laparoscopic laser-induced thermotherapy for liver tumours. Br J Surg. 1997;84(3):317–20.PubMedCrossRefGoogle Scholar
  13. 13.
    Matthewson K, Barr H, Tralau C, Bown SG. Low power interstitial Nd YAG laser photocoagulation: studies in a transplantable fibrosarcoma. Br J Surg. 1989;76(4):378–81.PubMedCrossRefGoogle Scholar
  14. 14.
    Steger AC, Lees WR, Shorvon P, Walmsley K, Bown SG. Multiple-fibre low-power interstitial laser hyperthermia: studies in the normal liver. Br J Surg. 1992;79(2):139–45.PubMedCrossRefGoogle Scholar
  15. 15.
    Hashimoto D, Takami M, Idezuki Y. In depth radiation therapy by Nd-YAG laser for malignant tumors of the liver under ultrasound imaging. Gastroenterology. 1985;88:1663.Google Scholar
  16. 16.
    Hahl J, Haapiainen R, Ovaska J, Puolakkainen P, Schroder T. Laser-induced hyperthermia in the treatment of liver tumors. Lasers Surg Med. 1990;10(4):319–21.PubMedCrossRefGoogle Scholar
  17. 17.
    Huang GT, Wang TH, Sheu JC, Daikuzono N, Sung JL, Wu MZ, et al. Low-power laserthermia for the treatment of small hepatocellular carcinoma. Eur J Cancer. 1991;27(12):1622–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Amin Z, Donald JJ, Masters A, Kant R, Steger AC, Bown SG, et al. Hepatic metastases: interstitial laser photocoagulation with real-time US monitoring and dynamic CT evaluation of treatment. Radiology. 1993;187(2):339–47.CrossRefGoogle Scholar
  19. 19.
    Nolsoe CP, Torp-Pedersen S, Burcharth F, Horn T, Pedersen S, Christensen NE, et al. Interstitial hyperthermia of colorectal liver metastases with a US-guided Nd-YAG laser with a diffuser tip: a pilot clinical study. Radiology. 1993;187(2):333–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Schroder T, Castren-Persons M, Lehtinen A, Taavitsainen M. Percutaneous interstitial laser hyperthermia in clinical use. Ann Chir Gynaecol. 1994;83(4):286–90.PubMedGoogle Scholar
  21. 21.
    Vogl TJ, Muller PK, Hammerstingl R, Weinhold N, Mack MG, Philipp C, et al. Malignant liver tumors treated with MR imaging-guided laser-induced thermotherapy: technique and prospective results. Radiology. 1995;196(1):257–65.PubMedCrossRefGoogle Scholar
  22. 22.
    Tranberg KG, Moller PH, Hannesson P, Stenram U. Interstitial laser treatment of malignant tumours: initial experience. Eur J Surg Oncol. 1996;22(1):47–54.PubMedCrossRefGoogle Scholar
  23. 23.
    Pacella CM, Bizzarri G, Ferrari FS, Anelli V, Valle D, Bianchini A, et al. [Interstitial photocoagulation with laser in the treatment of liver metastasis]. Radiol Med. 1996;92(4):438–447.Google Scholar
  24. 24.
    Heisterkamp J, van Hillegersberg R, Ijzermans JN. Interstitial laser coagulation for hepatic tumours. Br J Surg. 1999;86(3):293–304.PubMedCrossRefGoogle Scholar
  25. 25.
    Vogl TJ, Mack MG, Straub R, Roggan A, Felix R. Magnetic resonance imaging-guided abdominal interventional radiology: laser-induced thermotherapy of liver metastases. Endoscopy. 1997;29(6):577–83.PubMedCrossRefGoogle Scholar
  26. 26.
    Lee FT Jr, Mahvi DM, Chosy SG, Onik GM, Wong WS, Littrup PJ, et al. Hepatic cryosurgery with intraoperative US guidance. Radiology. 1997;202(3):624–32.PubMedCrossRefGoogle Scholar
  27. 27.
    Gillams AR, Lees WR. Survival after percutaneous, image-guided, thermal ablation of hepatica metastases from colorectal cancer. Dis Colon Rectum. 2000;45(5):656–61.CrossRefGoogle Scholar
  28. 28.
    Vogl TJ, Straub R, Eichler K, Sollner O, Mack MG. Colorectal carcinoma metastases in liver: laser-induced interstitial thermotherapy—local tumor control rate and survival data. Radiology. 2004;230(2):450–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Pacella CM, Valle D, Bizzarri G, Pacella S, Brunetti M, Maritati R, et al. Percutaneous laser ablation in patients with isolated unresectable liver metastases from colorectal cancer: Results of a phase II study. Acta Oncol. 2006;45(1):77–83.PubMedCrossRefGoogle Scholar
  30. 30.
    Gillams A, Cassoni A, Conway G, Lees W. Radiofrequency ablation of neuroendocrine liver metastases: the Middlesex experience. Abdom Imaging. 2005;30(4):435–41.PubMedCrossRefGoogle Scholar
  31. 31.
    Vogl TJ, Lehnert T, Eichler K, Proschek D, Floter J, Mack MG. Adrenal metastases: CT-guided and MR-thermometry-controlled laser-induced interstitial thermotherapy. Eur Radiol. 2007;17(8):2020–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Pacella CM, Bizzarri G, Magnolfi F, Cecconi P, Caspani B, Anelli V, et al. Laser thermal ablation in the treatment of small hepatocellular carcinoma: results in 74 patients. Radiology. 2001;221(3):712–20.PubMedCrossRefGoogle Scholar
  33. 33.
    Pacella CM, Bizzarri G, Cecconi P, Caspani B, Magnolfi F, Bianchini A, et al. Hepatocellular carcinoma: long-term results of combined treatment with laser thermal ablation and transcatheter arterial chemoembolization. Radiology. 2001;219(3):669–78.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Pacella CM, Francica G, Di Lascio FM, Arienti V, Antico E, Caspani B, et al. Long-term outcome of cirrhotic patients with early hepatocellular carcinoma treated with ultrasound-guided percutaneous laser ablation: a retrospective analysis. J Clin Oncol. 2009;27(16):2615–21.PubMedCrossRefGoogle Scholar
  35. 35.
    Eichler K, Zangos S, Gruber-Rouh T, Vogl TJ, Mack MG. Magnetic resonance-guided laser-induced thermotherapy in patients with oligonodular hepatocellular carcinoma: long-term results over a 15-year period. J Clin Gastroenterol. 2012;46(9):796–801.PubMedCrossRefGoogle Scholar
  36. 36.
    Francica G, Petrolati A, Di Stasio E, Pacella S, Stasi R, Pacella CM. Effectiveness, safety, and local progression after percutaneous laser ablation for hepatocellular carcinoma nodules up to 4 cm are not affected by tumor location. AJR Am J Roentgenol. 2012;199(6):1393–401.PubMedCrossRefGoogle Scholar
  37. 37.
    Francica G, Petrolati A, Di Stasio E, Pacella S, Stasi R, Pacella CM. Influence of ablative margin on local tumor progression and survival in patients with HCC </=4 cm after laser ablation. Acta Radiol. 2012;53(4):394–400.PubMedCrossRefGoogle Scholar
  38. 38.
    Eichler K, Zangos S, Mack MG, Hammerstingl R, Gruber-Rouh T, Gallus C, et al. First human study in treatment of unresectable liver metastases from colorectal cancer with irinotecan-loaded beads (DEBIRI). Int J Oncol. 2012;41(4):1213–20.PubMedPubMedCentralCrossRefGoogle Scholar
  39. 39.
    Vogl TJ, Naguib NN, Lehnert T, Nour-Eldin NE, Eichler K, Zangos S, et al. Initial experience with repetitive transarterial chemoembolization (TACE) as a third line treatment of ovarian cancer metastasis to the liver: indications, outcomes and role in patient’s management. Gynecol Oncol. 2012;124(2):225–9.PubMedCrossRefGoogle Scholar
  40. 40.
    Vogl TJ, Gruber-Rouh T, Eichler K, Nour-Eldin NE, Trojan J, Zangos S, et al. Repetitive transarterial chemoembolization (TACE) of liver metastases from gastric cancer: local control and survival results. Eur J Radiol. 2013;82(2):258–63.PubMedCrossRefGoogle Scholar
  41. 41.
    Vogl TJ, Dommermuth A, Heinle B, Nour-Eldin NE, Lehnert T, Eichler K, et al. Colorectal cancer liver metastases: long-term survival and progression-free survival after thermal ablation using magnetic resonance-guided laser-induced interstitial thermotherapy in 594 patients: analysis of prognostic factors. Investig Radiol. 2014;49(1):48–56.CrossRefGoogle Scholar
  42. 42.
    Pacella CM, Stasi R, Bizzarri G, Pacella S, Graziano FM, Guglielmi R, et al. Percutaneous laser ablation of unresectable primary and metastatic adrenocortical carcinoma. Eur J Radiol. 2008;66(1):88–94.PubMedCrossRefGoogle Scholar
  43. 43.
    Vogl TJ, Straub R, Eichler K, Woitaschek D, Mack MG. Malignant liver tumors treated with MR imaging-guided laser-induced thermotherapy: experience with complications in 899 patients (2,520 lesions). Radiology. 2002;225(2):367–77.PubMedCrossRefGoogle Scholar
  44. 44.
    Arienti V, Pretolani S, Pacella CM, Magnolfi F, Caspani B, Francica G, et al. Complications of laser ablation for hepatocellular carcinoma: a multicenter study. Radiology. 2008;246(3):947–55.PubMedCrossRefGoogle Scholar
  45. 45.
    Vogl TJ, Fieguth HG, Eichler K, Straub R, Lehnert T, Zangos S, et al. [Laser-induced thermotherapy of lung metastases and primary lung tumors]. Radiologe. 2004;44(7):693–9.Google Scholar
  46. 46.
    Rosenberg C, Puls R, Hegenscheid K, Kuehn J, Bollman T, Westerholt A, et al. Laser ablation of metastatic lesions of the lung: long-term outcome. AJR Am J Roentgenol. 2009;192(3):785–92.PubMedCrossRefGoogle Scholar
  47. 47.
    Sponza M, Aprile G, Gasparini D, Iaiza E, De Pauli F, Giovannoni M, et al. Percutaneous laser-induced thermoablation (LIT) of non-resectable lung metastases and primary lung tumors: a preliminary evaluation of technical aspects and local efficiency. ASCO annual meeting proceedings (post-meeting edition). J Clin Oncol. 2006;24:18S.Google Scholar
  48. 48.
    Regine R, Stavolo C, Maglione F. Laser thermoablation of small pulmonary tumors: immediate and long-term follow-up CT features. In: C 23; First world congress of thoracic imaging and diagnosis in chest disease, Pozzuoli, Italy, 2005.Google Scholar
  49. 49.
    Sartori S, Mauri G, Tombesi P, Di Vece F, Bianchi L, Pacella CM. Ultrasound-guided percutaneous laser ablation is safe and effective in the treatment of small renal tumors in patients at increased bleeding risk. Int J Hyperth. 2018;35(1):19–25.CrossRefGoogle Scholar
  50. 50.
    Patelli G, Ranieri A, Paganelli A, Mauri G, Pacella CM. Transperineal laser ablation for percutaneous treatment of benign prostatic hyperplasia: a feasibility study. Cardiovasc Intervent Radiol. 2017;40(9):1440–6.PubMedCrossRefGoogle Scholar
  51. 51.
    Schena E, Saccomandi P, Fong Y. Laser ablation for cancer: past, present and future. J Funct Biomater. 2017;8(2):E19.PubMedCrossRefGoogle Scholar
  52. 52.
    Pacella CM, Bizzarri G, Francica G, Bianchini A, De Nuntis S, Pacella S, et al. Percutaneous laser ablation in the treatment of hepatocellular carcinoma with small tumors: analysis of factors affecting the achievement of tumor necrosis. J Vasc Interv Radiol. 2005;16(11):1447–57.PubMedCrossRefGoogle Scholar
  53. 53.
    Walser EM. Percutaneous laser ablation in the treatment of hepatocellular carcinoma with a tumor size of 4 cm or smaller: analysis of factors affecting the achievement of tumor necrosis. J Vasc Interv Radiol. 2005;16(11):1427–9.PubMedCrossRefGoogle Scholar
  54. 54.
    Di Costanzo GG, Tortora R, D’Adamo G, De Luca M, Lampasi F, Addario L, et al. Radiofrequency ablation versus laser ablation for the treatment of small hepatocellular carcinoma in cirrhosis: a randomized trial. J Gastroenterol Hepatol. 2015;30(3):559–65.PubMedCrossRefGoogle Scholar
  55. 55.
    Nikfarjam M, Muralidharan V, Malcontenti-Wilson C, Christophi C. Progressive microvascular injury in liver and colorectal liver metastases following laser induced focal hyperthermia therapy. Lasers Surg Med. 2005;37(1):64–73.PubMedCrossRefGoogle Scholar
  56. 56.
    Germain D, Chevallier P, Laurent A, Savart M, Wassef M, Saint-Jalmes H. MR monitoring of laser-induced lesions of the liver in vivo in a low-field open magnet: temperature mapping and lesion size prediction. J Magn Reson Imaging. 2001;13(1):42–9.PubMedCrossRefGoogle Scholar
  57. 57.
    Vogl TJ, Eichler K, Straub R, Engelmann K, Zangos S, Woitaschek D, et al. Laser-induced thermotherapy of malignant liver tumors: general principals, equipment(s), procedure(s)—side effects, complications and results. Eur J Ultrasound. 2001;13(2):117–27.PubMedCrossRefGoogle Scholar
  58. 58.
    Vogl TJ, Straub R, Zangos S, Mack MG, Eichler K. MR-guided laser-induced thermotherapy (LITT) of liver tumours: experimental and clinical data. Int J Hyperthermia. 2004;20(7):713–24.PubMedCrossRefGoogle Scholar
  59. 59.
    Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nolsoe CP, et al. Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver—update 2012: A WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol. 2013;39(2):187–210.PubMedCrossRefGoogle Scholar
  60. 60.
    Meloni MF, Andreano A, Zimbaro F, Lava M, Lazzaroni S, Sironi S. Contrast enhanced ultrasound: roles in immediate post-procedural and 24-h evaluation of the effectiveness of thermal ablation of liver tumors. J Ultrasound. 2012;15(4):207–14.PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Di Costanzo GG, D’Adamo G, Tortora R, Zanfardino F, Mattera S, Francica G, et al. A novel needle guide system to perform percutaneous laser ablation of liver tumors using the multifiber technique. Acta Radiol. 2013;54(8):876–81.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Claudio Maurizio Pacella
    • 1
  • Tian’an Jiang
    • 2
  1. 1.Department of Diagnostic Imaging and Interventional RadiologyRegina Apostolorum HospitalAlabano LazialeItaly
  2. 2.Department of UltrasoundFirst Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhouChina

Personalised recommendations