The activity of Professor Gianpaolo Carrafiello has been largely dedicated to research since the early beginning of his career, focusing especially on the field of Interventional Radiology. He has participated to the advance of research in many fields of the vast Interventional Radiology world, giving significant contribution to the growth of this discipline in Italy.
Professor Gianpaolo Carrafiello has been a pioneer in the field of percutaneous thermal ablation, a treatment modality that has been increasingly used in the recent years for benign and malignant tumors of different organs, and that is today a cornerstone of interventional oncology. He has a strong knowledge in this field, since he has been not only among the first physicians to perform treatments with this technique at the very early stages of its development, but he also has significantly contributed to its technical development. Moreover, he has always kept a focus on percutaneous thermal ablation during his career, spreading the knowledge and bringing insights through the publication of papers, the participation to national and international conferences, and the organization of conferences himself.He has actively studied the application of percutaneous thermal ablation treatment in various pathologies, assessing feasibility, technical issues, patient selection, complications and outcome, including: Lung (primary lung cancer, lung metastases), Thyroid and Parathyroids (thyroid goiter, thyroid nodule, hyperparathyroidism), Pancreas (primary pancreatic cancer, pancreatic metastases), Kidney (renal cell carcinoma, complex cystic lesions, angiomyolipomas), Adrenal (adenomas, adrenocortical carcinomas, pheochromocytomas -and paragangliomas-, metastases), Liver (hepatocellular carcinoma, cholangiocarcinoma, metastases), Uterus (fibroids), Bone (metastases).
Another strong research interest of Professor Gianpaolo Carrafiello has always been imaging guidance for interventional procedures, including percutaneous thermal ablation. In particular, he has made significant research on Cone-Beam Computed Tomography (CBCT), experimenting its use as a guidance for endovascular and percutaneous procedures. Through the publication of papers and congress talks, he has contributed to the spread of knowledge regarding this technology, which has revolutionized interventional radiology, extending indications and treatment possibilities for patients with several benign and malignant pathologies.
The three main and most used thermal ablation modalities in clinical practice are radiofrequency ablation, microwave ablation and cryoablation. While during the early times percutaneous thermal ablation largely corresponded to radiofrequency ablation, the use of microwave ablation has progressively grown, replacing nowadays radiofrequency ablation in many institutions for treatment of different pathologies, including the liver. Professor Gianpaolo Carrafiello has a world-recognized experience in the use of microwave ablation, as among ablation techniques, he particularly dedicated his clinical and research activity to this “new” modality, and showed that the use of microwave ablation was possible in ways that were not conceived before. Once limited by the relatively less predictable ablation volume when compared to radiofrequency ablation, microwave ablation is today the method of choice for percutaneous ablation of localizedhepatocellular carcinoma; in fact, microwave ablation has important advantages over radiofrequency ablation, one of the main being that it’s known for being less susceptible to the “heat-sink effect”. When treating a liver tumor with ablation, physicians want to be sure that the ablation volume expands at least 5mm beyond the lesion, obtaining a safe ablation margin, which has been widely demonstrated to reduce the recurrence of disease. Professor Carrafiello, with his experience, brings a meaningful insight in the project aimed at better define the influence of vessels on the ablation volume in percutaneous thermal ablation of liver lesions.