Enhancing Targeted Treatment for HCC: Investigating the Influence of Catheter Type on Particle Distribution within a Patient-Specific 3D-Liver Vascular Tree.
Verhaeghe Luca, 2023
Hepatocellular carcinoma (HCC) is a common and deadly form of liver cancer. After the initial screening of nodules via ultrasound and the definitive diagnosis of HCC through imaging, patients are stratified according to the modified Barcelona Clinic Liver Cancer (mBCLC) staging system. This staging system includes 5 classes, spanning from the very early stage (0) to the terminal stage (D). Among them, there is the intermediate stage (BCLC B), for which intra-arterial therapies are a suitable form of treatment. These are minimally invasive procedures and primarily consist of transarterial chemoembolization (TACE) and transarterial radioembolization (TARE). The latter involves the injection of radioactive microspheres, with an intravascular catheter, into the hepatic arteries to eradicate tumor cells. This study addresses two primary objectives concerning TARE treatment. Firstly, it investigates the impact of two catheter types with different flow patterns: linear flow and radial flow. These comparisons were made using dye experiments conducted on a 3D-printed, patient-specific setup, created based on cone-beam CT imaging. The study focused on comparing the distribution of injected dye between the two catheter types and found no significant difference; the dye dispersed uniformly according to the imposed flow distribution in both cases. Secondly, research into microsphere particles was performed. As particles behave differently from dye, the aforementioned experiments should be replicated using microsphere particles relevant to TARE treatment. Their distribution is more relevant and significant to the clinical setting. To achieve this objective, an exploratory study was conducted to assess measurement methods. Its goal is to explore effective particle quantification tactics that can be applied in subsequent research. Both the coulter counter and flow cytometry were tested, with the first one showing promise. However, further testing and optimization are required. Community Outreach This master’s thesis aims to contribute positively to society in three distinct ways. The first goal is to facilitate further research that aims to compare catheters, specifically by exploring optimized measurement methods for particles. The second objective is to prompt reflection among medical professionals regarding the potential influence of the type of catheter chosen for intra-arterial interventions on the outcome. Emphasizing that along with the correct choice of chemoembolization agent, the selection of a catheter type tailored to the specific indication of a case is an integral part of the treatment process. Additionally, this study also seeks to bring attention to the technology enabling the creation of the 3D model utilized in the conducted experiments. The ongoing research that aims to validate this model holds significant potential and massive implications. If successful, it could profoundly impact not just liver interventions, but all procedures related to interventional tumor treatment. This could pave the way for personalized, patient-specific treatments, optimizing the therapeutic process and minimizing the systemic impact of chemotherapy through targeted localization.
Promotor | Charlotte Debbaut |
Opleiding | Geneeskunde |
Domein | Gastro- enterologie |
Kernwoorden | HCC TARE |