Colorectal liver metastases (2022 – CME) – online course
Authors: G. Mauri, F. Orsi and G. M. Varano
Reviewers: F. Deschamps, D. Filippiadis, T. Jahnke, S. Müller-Hülsbeck and Dr. Colin Nice
This course corresponds to chapter 2.2.5 Interventional Oncology (IO) in the European Curriculum and Syllabus for IR.
The multidisciplinary management of patients with metastatic colorectal cancer is rapidly evolving, and interventional radiologists are playing an increasingly important role in this field. Minimally invasive treatments such as image-guided ablation, radioembolisation and chemoembolisation are widely recognised as effective treatments for patients unsuitable for surgical resection of metastatic disease.
In this module, an overview of the most important aspects of successful management of patients with liver metastases from colorectal cancer are presented to the interventioinal radiologist. The focus will be on anatomy, as well as indications and contraindications of the most commonly used techniques (image-guided ablation, radioembolisation, chemoembolisation) with a particular focus on technical aspects of the procedures. Subsequently, the module will address post-procedural management and outcomes reported in the literature regarding these techniques.
- Recognise the relationship between the malignant process and the major hepatic vascular and biliary structures which can be damaged during therapies, and their bearing on any proposed intervention
- Understand the relation between the liver and other structures, such as extrahepatic bile ducts, gallbladder, bowel, diaphragm and body wall, and their bearing on any proposed intervention
- Understand the process of development of metastatic malignancy in the liver with particular reference to tumour vascularisation and its bearing on appropriate therapies, both vascular and non-vascular
- Become familiar with the use of microcatheters and micro-guidewires for super-selective treatments (especially chemoembolisation)
- Know where selective or super-selective treatments will be beneficial over lobar treatments
- Know how to protect adjacent structures (duodenum, stomach, skin, etc.) during radioembolisation
- Become familiar with the different radioembolic particles available and the difference between them
- Understand how to plan a dose for radioembolisation
- Know when a single lobar treatment needs to be done and where both lobes can be treated
- Understand the difference between cTACE and DCB TACE
- Demonstrate competence in the current technologies available in IGA including ethanol, radiofrequency and microwave ablation
- Have an understanding of evolving technologies in this area, including cryotherapy and irreversible electroporation
- Recognise the limitations of current ablation technologies and have knowledge of techniques used to achieve larger volumes of ablation (e.g. overlapping ablations, perfused devices and adjunctive techniques)
This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 2.2.5 Interventional Oncology (IO).
The format of the course is easy to use and interactive by including texts, graphics, videos and a quiz to support your learning. The course duration is around one hour and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1 European CME credit (ECMEC). The CME accreditation for this course will expire on January 10, 2024. A non-CME accredited version of the course will remain available for two more years.
Access to complete and revisit the course is granted for an enrolment period of 90 days.
The CME certificate will be available in the myCIRSE area past the enrolment period if the course is completed before January 10, 2024.
Release date: January 2022