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The value of susceptibility weighted imaging for immediate assessing the hyperacute outcome of MRgFUS ablation for uterine fibroids: a preliminary study. 易感加权成像对即时评估 MRgFUS 子宫肌瘤消融术超急性结果的价值:一项初步研究。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-07-14 DOI: 10.1080/02656736.2024.2377346
Yaoqu Huang, Shouguo Zhou, Yinghua Su, Zhuochao Pang, Shihua Cai

Purpose: To investigate the value of susceptibility weighted imaging (SWI) for assessing the hyperacute outcome of ablation of uterine fibroids immediately after magnetic resonance-guided focused ultrasound (MRgFUS) treatment.

Methods: This retrospective imaging study included patients who underwent SWI and contrast-enhanced (CE) MR within 15 min of MRgFUS ablation for uterine fibroids. Two readers independently assessed the SWI features of ablative lesions and their association with the non-perfused volume (NPV) ratio. The intraclass correlation coefficient (ICC) and diagnostic value of SWI findings were calculated.

Results: A total of 27 uterine fibroids from 21 participants (mean age 40.1 ± 7.2 years) were analyzed. 51.9% (14/27) leiomyomas had NPV ratio ≥90%. In post-ablation SWI images, the interobserver ICC for the relative signal intensity and hypointense peripheral rim were 0.613 and 0.843, respectively (both p < .001). There was a significant difference in the prevalence of hypointense peripheral rim in leiomyomas with NPV ratio ≥90% and < 90% (p < .01), while the prevalence of relative signal intensity showed no significant difference (p > .05). When using the complete hypointense peripheral rim as a diagnostic criterion to identify NPV ratio ≥ 90%, readers 1 and 2 showed diagnostic sensitivity, specificity, and accuracy of 85.7%, 76.9%, 81.5%, and 78.6%, 76.9%, 77.8%, respectively.

Conclusion: Identifying a complete hypointense peripheral rim on SWI may be a potential imaging marker for assessing the hyperacute outcome of uterine fibroids ablation by MRgFUS, specifically in determining whether the NPV ratio is ≥90%.

目的:研究磁共振引导下聚焦超声(MRgFUS)治疗后立即进行的感性加权成像(SWI)对评估子宫肌瘤消融术超急性结果的价值:这项回顾性成像研究纳入了在MRgFUS消融治疗子宫肌瘤后15分钟内接受SWI和造影剂增强(CE)MR检查的患者。两名阅读者独立评估了消融病灶的 SWI 特征及其与非灌注容积 (NPV) 比值的关系。计算了SWI结果的类内相关系数(ICC)和诊断价值:结果:共分析了 21 名参与者(平均年龄为 40.1 ± 7.2 岁)的 27 个子宫肌瘤。51.9%(14/27)的子宫肌瘤NPV比值≥90%。在消融后的 SWI 图像中,相对信号强度和低密度周边边缘的观察者间 ICC 分别为 0.613 和 0.843(均 p p > .05)。当使用完整的低密度外周缘作为诊断标准以确定 NPV 比率≥ 90% 时,读者 1 和读者 2 的诊断敏感性、特异性和准确性分别为 85.7%、76.9%、81.5% 和 78.6%、76.9%、77.8%:在SWI上识别完整的低密度外周边缘可能是评估MRgFUS子宫肌瘤消融术超急性结果的潜在成像标志,特别是在确定NPV比值是否≥90%时。
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引用次数: 0
Impact of surrounding tissue-type and peri-electrode gap in stereoelectroencephalography guided (SEEG) radiofrequency thermocoagulation (RF-TC): a computational study. 立体脑电图引导(SEEG)射频热凝(RF-TC)中周围组织类型和电极周围间隙的影响:一项计算研究。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-06-16 DOI: 10.1080/02656736.2024.2364721
Santiago Collavini, Juan J Pérez, Enrique Berjano, Mariano Fernández-Corazza, Silvia Oddo, Ramiro M Irastorza

Purpose: To use computational modeling to provide a complete and logical description of the electrical and thermal behavior during stereoelectroencephalography-guided (SEEG) radiofrequency thermo-coagulation (RF-TC).

Methods: A coupled electrical-thermal model was used to obtain the temperature distributions in the tissue during RF-TC. The computer model was first validated by an ex vivo model based on liver fragments and later used to study the impact of three different factors on the coagulation zone size: 1) the difference in the tissue surrounding the electrode (gray/white matter), 2) the presence of a peri-electrode gap occupied by cerebrospinal fluid (CSF), and 3) the energy setting used (power-duration).

Results: The model built for the experimental validation was able to predict both the evolution of impedance and the short diameter of the coagulation zone (error < 0.01 mm) reasonably well but overestimated the long diameter by 2 - 3 mm. After adapting the model to clinical conditions, the simulation showed that: 1) Impedance roll-off limited the coagulation size but involved overheating (around 100 °C); 2) The type of tissue around the contacts (gray vs. white matter) had a moderate impact on the coagulation size (maximum difference 0.84 mm), and 3) the peri-electrode gap considerably altered the temperature distributions, avoided overheating, although the diameter of the coagulation zone was not very different from the no-gap case (<0.2 mm).

Conclusions: This study showed that computer modeling, especially subject- and scenario-specific modeling, can be used to estimate in advance the electrical and thermal performance of the RF-TC in brain tissue.

目的:利用计算模型对立体脑电图引导(SEEG)射频热凝(RF-TC)过程中的电热行为进行完整、合理的描述:方法:使用电热耦合模型获取射频热凝过程中组织内的温度分布。该计算机模型首先通过基于肝脏碎片的体外模型进行验证,随后用于研究三种不同因素对凝固区大小的影响:1)电极周围组织的差异(灰质/白质);2)是否存在被脑脊液(CSF)占据的电极周围间隙;3)使用的能量设置(功率-持续时间):结果:为实验验证而建立的模型能较好地预测阻抗的变化和凝血区的短直径(误差小于 0.01 毫米),但高估了长直径 2 - 3 毫米。根据临床条件调整模型后,模拟结果表明1)阻抗滚降限制了凝固的大小,但涉及过热(约 100 °C);2)触点周围的组织类型(灰质与白质)对凝固的大小有一定影响(最大差异为 0.84 mm);3)电极周围的间隙大大改变了温度分布,避免了过热,尽管凝固区的直径与无间隙的情况差别不大(结论:这项研究表明,计算机建模,尤其是针对特定对象和场景的建模,可用于提前估算脑组织中射频热转导的电热性能。
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引用次数: 0
Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer. 对无法手术的复发性分化型甲状腺癌进行抢救性射频消融,然后进行体外放射治疗。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-05-30 DOI: 10.1080/02656736.2024.2358054
Chung-Shih Chen, Sheng-Dean Luo, Yen-Hsiang Chang, Chen Kai Chou, Shun-Yu Chi, Shao-Chun Wu, Yen-Hao Chen, Johnson Chia-Shen Yang, Eng-Yen Huang, Yu-Ming Wang, Wei-Che Lin

Purpose: The treatment of recurrent thyroid cancer with critical organ invasion is challenging. The combination of radiofrequency ablation (RFA) and external beam radiation therapy (EBRT) has been proposed as an effective option. This study evaluates outcomes for inoperable residual/recurrent differentiated thyroid cancer (rDTC) patients treated with RFA followed by EBRT.

Materials and methods: Patients with rDTC treated with RFA followed by EBRT were retrospectively studied. RFA was performed using a free-hand, 'moving-shot' technique under US or CT guidance. For lesions invading critical structures intolerant to 'en bloc' high-temperature RFA, limited-field EBRT using 6- or 10-MV photons was used for adjuvant treatment at a dose of 66 Gy in 33 daily fractions. Toxicities and outcomes were reviewed.

Results: Between April 2020 and January 2022, 11 patients with 14 rDTC lesions underwent RFA followed by EBRT. Five patients had metastatic lesions at rDTC diagnosis. With a median follow-up period of 33.7 months, all patients maintained locoregional control, while achieving a 2-year survival rate of 90.9%. This combined treatment achieved a volume reduction ratio of 92.1% ± 5.1%. The mean nadir thyroglobulin level in patients without initial distant metastases after treatment was 1.40 ± 0.81 ng/ml. Regarding treatment-related complications, one patient (9%) experienced temporary hoarseness after RFA, grade 2 radiation dermatitis occurred in 3 patients (27.2%), and grade 2 dysphagia was noted in 4 patients (36.4%). No grade 3 or greater toxicities occurred.

Conclusions: Salvage RFA followed by EBRT is feasible, effective and safe for patients with rDTC.

目的:复发性甲状腺癌伴有重要器官侵犯的治疗具有挑战性。射频消融(RFA)和体外放射治疗(EBRT)的结合被认为是一种有效的选择。本研究评估了无法手术的残留/复发分化型甲状腺癌(rDTC)患者接受射频消融术和EBRT治疗后的疗效:回顾性研究了接受RFA和EBRT治疗的rDTC患者。在 US 或 CT 引导下,采用徒手 "移动射击 "技术进行 RFA。对于不能耐受 "整体 "高温RFA的侵犯重要结构的病灶,采用6或10-MV光子的有限场EBRT进行辅助治疗,剂量为66 Gy,每天分33次进行。结果:2020年4月至2022年1月期间,11名患者的14个rDTC病灶接受了RFA治疗,随后接受了EBRT治疗。5名患者在确诊为rDTC时已有转移病灶。中位随访时间为 33.7 个月,所有患者均保持了局部控制,2 年生存率达到 90.9%。联合治疗的体积缩小率为92.1% ± 5.1%。治疗后无远处转移的患者的甲状腺球蛋白平均水平为(1.40 ± 0.81)纳克/毫升。在治疗相关并发症方面,1例患者(9%)在RFA治疗后出现暂时性声音嘶哑,3例患者(27.2%)出现2级放射性皮炎,4例患者(36.4%)出现2级吞咽困难。没有出现3级或更严重的毒性反应:抢救性 RFA 后进行 EBRT 对 rDTC 患者是可行、有效和安全的。
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引用次数: 0
Omental metastases in patients with pseudomyxoma peritonei or colorectal peritoneal metastases - is routine omentectomy justified? 腹膜假性肌瘤或结直肠腹膜转移患者的网膜转移--常规网膜切除术是否合理?
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-06-27 DOI: 10.1080/02656736.2024.2372356
Malin Enblad, Helgi Birgisson, Lana Ghanipour, Peter Cashin, Wilhelm Graf

Background: The greater omentum is routinely resected during cytoreductive surgery (CRS), but few studies have analyzed the rationale behind this. This study aimed to assess the prevalence of omental metastases (OM) and the correlation between macroscopically suspected and microscopically confirmed OM, in patients with pseudomyxoma peritonei (PMP) or colorectal peritoneal metastases (PM).

Method: All patients without previous omentectomy, treated with initial CRS and hyperthermic intraperitoneal chemotherapy for PMP or colorectal PM, at Uppsala University Hospital in 2013-2021, were included. Macroscopic OM in surgical reports was compared with histopathological analyses.

Results: In all, 276 patients were included. In those with PMP, 112 (98%) underwent omentectomy and 67 (59%) had macroscopic suspicion of OM. In 5 (4%) patients, the surgeon was uncertain. Histopathology confirmed OM in 81 (72%). In patients with macroscopic suspicion, 96% had confirmed OM (positive predictive value, PPV). In patients with no suspicion, 24% had occult OM (negative predictive value, NPV = 76%). In patients with colorectal PM, 156 (96%) underwent omentectomy and 97 (60%) had macroscopic suspicion. For 5 (3%) patients, the surgeon was uncertain. OM was microscopically confirmed in 90 (58%). PPV was 85% and NPV was 89%. The presence of OM was a univariate risk factor for death in PMP (HR 3.62, 95%CI 1.08-12.1) and colorectal PM (HR 1.67, 95%CI 1.07-2.60), but not in multivariate analyses.

Conclusion: OM was common and there was a high risk of missing occult OM in both PMP and colorectal PM. These results support the practice of routine omentectomy during CRS.

背景:囊肿切除手术(CRS)通常会切除大网膜,但很少有研究分析其背后的原因。本研究旨在评估腹膜假性肌瘤(PMP)或结直肠腹膜转移瘤(PM)患者中网膜转移瘤(OM)的发生率以及宏观疑似OM与微观确诊OM之间的相关性:方法:纳入2013-2021年乌普萨拉大学医院所有既往未接受过卵巢切除术、因假性腹膜肌瘤或结直肠腹膜转移瘤接受过初始CRS和腹腔内热化疗的患者。将手术报告中的宏观OM与组织病理学分析进行比较:结果:共纳入 276 例患者。在PMP患者中,112人(98%)接受了网膜切除术,67人(59%)在宏观镜下怀疑有OM。5名(4%)患者的外科医生无法确定。81例(72%)患者的组织病理学证实为OM。在有宏观怀疑的患者中,96%确诊为 OM(阳性预测值,PPV)。在没有怀疑的患者中,24% 患有隐性 OM(阴性预测值,NPV = 76%)。在结直肠 PM 患者中,156 人(96%)接受了网膜切除术,97 人(60%)有宏观怀疑。5名(3%)患者的外科医生不确定。90例(58%)经显微镜确诊为OM。PPV为85%,NPV为89%。OM的存在是PMP(HR 3.62,95%CI 1.08-12.1)和结直肠PM(HR 1.67,95%CI 1.07-2.60)死亡的单变量风险因素,但在多变量分析中并非如此:结论:OM很常见,而且在PMP和结肠直肠癌PM中漏诊隐匿性OM的风险很高。这些结果支持在 CRS 期间进行常规卵巢切除术的做法。
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引用次数: 0
A retrospective comparative study on the treatment of non-metastatic pancreatic cancer using high-intensity focused ultrasound versus radical surgery. 使用高强度聚焦超声与根治手术治疗非转移性胰腺癌的回顾性比较研究。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-09-08 DOI: 10.1080/02656736.2024.2398557
Li Yu, Yunfei Liu, Zhiqiang Li, Yanyan Huang, Guangping Tu, Qiuling Shi, Lang Chen, Xiao Yu

Objective: To compare the efficacy and safety of high-intensity focused ultrasound (HIFU) and radical surgery for non-metastatic pancreatic cancer (PC).

Materials and methods: We retrospectively analyzed 89 stage I/II/III PC patients who underwent HIFU (n = 43) or surgery (n = 46) at the Third Xiangya Hospital from January 2020 to December 2021. Pain relief, Karnofsky Performance Scale (KPS), overall survival (OS), treatment-related complications and risk factors for OS were assessed.

Results: There was no significant difference in the pain relief rate at 30 days post-treatment between the two groups. However, compared with the surgery group, the HIFU group showed significantly lower post-treatment VAS scores (p = 0.019). In the surgery group, the KPS at 30 days post-treatment was lower than pretreatment KPS (70 vs 80; p = 0.015). This relationship was reversed in the HIFU group (80 vs 70; p = 0.024). Median OS favored surgery over HIFU (23 vs 10 months; p < 0.001), with a higher 1-year OS rate (69.57% vs 32.6%; p < 0.001). However, there was no significant difference in OS between the two groups for stage III patients (p = 0.177). Complications rated ≥ grade III were 2.33% in the HIFU group and 32.6% in the surgery group. Multivariate analyses showed that age, KPS, and treatment methods were independent prognostic factors for OS.

Conclusion: HIFU demonstrates advantages over surgery in terms of early KPS, VAS improvements, and safety for pancreatic cancer; however, long-term outcomes favor surgery. For III-stage disease, HIFU was noninferior to surgery in overall survival.

摘要比较高强度聚焦超声(HIFU)和根治性手术治疗非转移性胰腺癌(PC)的有效性和安全性:我们回顾性分析了2020年1月至2021年12月在湘雅三医院接受HIFU(43例)或手术(46例)治疗的89例I/II/III期PC患者。对疼痛缓解程度、卡诺夫斯基表现量表(KPS)、总生存率(OS)、治疗相关并发症以及影响OS的风险因素进行了评估:结果:两组患者治疗后30天的疼痛缓解率无明显差异。然而,与手术组相比,HIFU 组治疗后的 VAS 评分明显较低(p = 0.019)。手术组治疗后 30 天的 KPS 低于治疗前的 KPS(70 vs 80;p = 0.015)。这种关系在 HIFU 组则相反(80 vs 70; p = 0.024)。中位生存期手术优于 HIFU(23 个月 vs 10 个月;p p = 0.177)。并发症≥III级的比例,HIFU组为2.33%,手术组为32.6%。多变量分析显示,年龄、KPS和治疗方法是OS的独立预后因素:结论:就早期KPS、VAS改善和安全性而言,HIFU治疗胰腺癌比手术治疗更有优势;但是,长期结果更倾向于手术治疗。对于III期疾病,HIFU的总生存率并不亚于手术。
{"title":"A retrospective comparative study on the treatment of non-metastatic pancreatic cancer using high-intensity focused ultrasound versus radical surgery.","authors":"Li Yu, Yunfei Liu, Zhiqiang Li, Yanyan Huang, Guangping Tu, Qiuling Shi, Lang Chen, Xiao Yu","doi":"10.1080/02656736.2024.2398557","DOIUrl":"https://doi.org/10.1080/02656736.2024.2398557","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of high-intensity focused ultrasound (HIFU) and radical surgery for non-metastatic pancreatic cancer (PC).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 89 stage I/II/III PC patients who underwent HIFU (<i>n</i> = 43) or surgery (<i>n</i> = 46) at the Third Xiangya Hospital from January 2020 to December 2021. Pain relief, Karnofsky Performance Scale (KPS), overall survival (OS), treatment-related complications and risk factors for OS were assessed.</p><p><strong>Results: </strong>There was no significant difference in the pain relief rate at 30 days post-treatment between the two groups. However, compared with the surgery group, the HIFU group showed significantly lower post-treatment VAS scores (<i>p</i> = 0.019). In the surgery group, the KPS at 30 days post-treatment was lower than pretreatment KPS (70 vs 80; <i>p</i> = 0.015). This relationship was reversed in the HIFU group (80 vs 70; <i>p</i> = 0.024). Median OS favored surgery over HIFU (23 vs 10 months; <i>p</i> < 0.001), with a higher 1-year OS rate (69.57% vs 32.6%; <i>p</i> < 0.001). However, there was no significant difference in OS between the two groups for stage III patients (<i>p</i> = 0.177). Complications rated ≥ grade III were 2.33% in the HIFU group and 32.6% in the surgery group. Multivariate analyses showed that age, KPS, and treatment methods were independent prognostic factors for OS.</p><p><strong>Conclusion: </strong>HIFU demonstrates advantages over surgery in terms of early KPS, VAS improvements, and safety for pancreatic cancer; however, long-term outcomes favor surgery. For III-stage disease, HIFU was noninferior to surgery in overall survival.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Directional microwave ablation in spine: experimental assessment of computational modeling. 脊柱定向微波消融:计算模型的实验评估。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-02-18 DOI: 10.1080/02656736.2024.2313492
Austin Pfannenstiel, Haileigh Avellar, Clay Hallman, Brandon L Plattner, Margaret A Highland, Francois H Cornelis, Warren L Beard, Punit Prakash

Background: Despite the theoretical advantages of treating metastatic bone disease with microwave ablation (MWA), there are few reports characterizing microwave absorption and bioheat transfer in bone. This report describes a computational modeling-based approach to simulate directional microwave ablation (dMWA) in spine, supported by ex vivo and pilot in vivo experiments in porcine vertebral bodies.

Materials and methods: A 3D computational model of microwave ablation within porcine vertebral bodies was developed. Ex vivo porcine vertebra experiments using a dMWA applicator measured temperatures approximately 10.1 mm radially from the applicator in the direction of MW radiation (T1) and approximately 2.4 mm in the contra-lateral direction (T2). Histologic assessment of ablated ex vivo tissue was conducted and experimental results compared to simulations. Pilot in vivo experiments in porcine vertebral bodies assessed ablation zones histologically and with CT and MRI.

Results: Experimental T1 and T2 temperatures were within 3-7% and 11-33% of simulated temperature values. Visible ablation zones, as indicated by grayed tissue, were smaller than those typical in other soft tissues. Posthumous MRI images of in vivo ablations showed hyperintensity. In vivo experiments illustrated the technical feasibility of creating directional microwave ablation zones in porcine vertebral body.

Conclusion: Computational models and experimental studies illustrate the feasibility of controlled dMWA in bone tissue.

背景:尽管利用微波消融(MWA)治疗转移性骨病具有理论上的优势,但有关微波在骨中的吸收和生物传热特性的报道却很少。本报告介绍了一种基于计算建模的脊柱定向微波消融(dMWA)模拟方法,并辅以猪椎体的体内外试验:开发了猪椎体内微波消融的三维计算模型。使用 dMWA 施用器进行的猪椎体体外实验测得的温度为:微波辐射方向距施用器径向约 10.1 毫米(T1)和反外侧方向约 2.4 毫米(T2)。对消融的体外组织进行了组织学评估,并将实验结果与模拟结果进行了比较。在猪椎体中进行的试验性体内实验从组织学角度并通过 CT 和 MRI 评估了消融区:实验 T1 和 T2 温度分别为模拟温度值的 3-7% 和 11-33%。可见消融区(如灰色组织所示)小于其他软组织中的典型消融区。体内消融后的核磁共振成像显示出高强度。体内实验表明,在猪椎体中创建定向微波消融区在技术上是可行的:计算模型和实验研究说明了在骨组织中控制定向微波消融的可行性。
{"title":"Directional microwave ablation in spine: experimental assessment of computational modeling.","authors":"Austin Pfannenstiel, Haileigh Avellar, Clay Hallman, Brandon L Plattner, Margaret A Highland, Francois H Cornelis, Warren L Beard, Punit Prakash","doi":"10.1080/02656736.2024.2313492","DOIUrl":"10.1080/02656736.2024.2313492","url":null,"abstract":"<p><strong>Background: </strong>Despite the theoretical advantages of treating metastatic bone disease with microwave ablation (MWA), there are few reports characterizing microwave absorption and bioheat transfer in bone. This report describes a computational modeling-based approach to simulate directional microwave ablation (dMWA) in spine, supported by <i>ex vivo</i> and pilot <i>in vivo</i> experiments in porcine vertebral bodies.</p><p><strong>Materials and methods: </strong>A 3D computational model of microwave ablation within porcine vertebral bodies was developed. <i>Ex vivo</i> porcine vertebra experiments using a dMWA applicator measured temperatures approximately 10.1 mm radially from the applicator in the direction of MW radiation (T1) and approximately 2.4 mm in the contra-lateral direction (T2). Histologic assessment of ablated <i>ex vivo</i> tissue was conducted and experimental results compared to simulations. Pilot <i>in vivo</i> experiments in porcine vertebral bodies assessed ablation zones histologically and with CT and MRI.</p><p><strong>Results: </strong>Experimental T1 and T2 temperatures were within 3-7% and 11-33% of simulated temperature values. Visible ablation zones, as indicated by grayed tissue, were smaller than those typical in other soft tissues. Posthumous MRI images of <i>in vivo</i> ablations showed hyperintensity. <i>In vivo</i> experiments illustrated the technical feasibility of creating directional microwave ablation zones in porcine vertebral body.</p><p><strong>Conclusion: </strong>Computational models and experimental studies illustrate the feasibility of controlled dMWA in bone tissue.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11357707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139899826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Meta-analysis of cryoablation versus radiofrequency ablation in the treatment of malignant liver tumors. 冷冻消融与射频消融治疗恶性肝肿瘤的元分析。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI: 10.1080/02656736.2023.2300347
Xiangzhong Huang, Xinjian Xu, Hongtao Du, Qiulian Sun, Minyu Wu

Objective: A meta-analysis was conducted to assess the efficacy and safety of cryoablation (CRA) compared with radiofrequency ablation (RFA).

Methods: A systematic search of PubMed, EMBASE, Cochrane Library, Wanfang, CNKI, and VIP databases was conducted to identify clinical controlled studies comparing CRA versus RFA for hepatic malignancies up to July 2022. The meta-analysis was performed using RevMan 5.3.

Results: A comprehensive analysis was conducted on 8 clinical controlled studies involving a total of 943 patients. There were no significant differences in the incidence of complications, complete ablation of lesions, local recurrence, and 1-year survival between the CRA and RFA groups (OR = 0.98, 95%CI: 0.61-1.55, p = 0.92; OR = 1.08, 95%CI: 0.62-1.90, p = 0.78; OR = 1.28, 95%CI: 0.49-3.36, p = 0.61; and OR = 1.14, 95%CI: 0.63-2.06, p = 0.66, respectively).

Conclusion: The efficacy and safety profile of CRA was comparable to that of RFA in the context of ablation therapy for hepatic malignancies. These findings suggested that CRA may be a valuable alternative to RFA in the treatment of hepatic malignancies.

目的:对冷冻消融术(CRA)与射频消融术(RFA)的疗效和安全性进行荟萃分析:方法:对冷冻消融术(CRA)与射频消融术(RFA)的疗效和安全性进行荟萃分析:对 PubMed、EMBASE、Cochrane Library、万方、CNKI 和 VIP 数据库进行了系统检索,以确定截至 2022 年 7 月在肝脏恶性肿瘤方面比较 CRA 与 RFA 的临床对照研究。荟萃分析使用 RevMan 5.3.Results.进行:对8项临床对照研究进行了综合分析,共涉及943名患者。CRA组和RFA组在并发症发生率、病灶完全消融率、局部复发率和1年生存率方面无明显差异(OR = 0.98,95%CI:0.61-1.55,P = 0.92;OR = 1.08,95%CI:0.62-1.90,P = 0.78;OR = 1.28,95%CI:0.49-3.36,P = 0.61;OR = 1.14,95%CI:0.63-2.06,P = 0.66)。结论:结论:在肝脏恶性肿瘤消融治疗中,CRA的疗效和安全性与RFA相当。这些研究结果表明,在肝恶性肿瘤的治疗中,CRA可能是RFA的一种有价值的替代疗法。
{"title":"Meta-analysis of cryoablation versus radiofrequency ablation in the treatment of malignant liver tumors.","authors":"Xiangzhong Huang, Xinjian Xu, Hongtao Du, Qiulian Sun, Minyu Wu","doi":"10.1080/02656736.2023.2300347","DOIUrl":"10.1080/02656736.2023.2300347","url":null,"abstract":"<p><strong>Objective: </strong>A meta-analysis was conducted to assess the efficacy and safety of cryoablation (CRA) compared with radiofrequency ablation (RFA).</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE, Cochrane Library, Wanfang, CNKI, and VIP databases was conducted to identify clinical controlled studies comparing CRA versus RFA for hepatic malignancies up to July 2022. The meta-analysis was performed using RevMan 5.3.</p><p><strong>Results: </strong>A comprehensive analysis was conducted on 8 clinical controlled studies involving a total of 943 patients. There were no significant differences in the incidence of complications, complete ablation of lesions, local recurrence, and 1-year survival between the CRA and RFA groups (OR = 0.98, 95%CI: 0.61-1.55, <i>p</i> = 0.92; OR = 1.08, 95%CI: 0.62-1.90, <i>p</i> = 0.78; OR = 1.28, 95%CI: 0.49-3.36, <i>p</i> = 0.61; and OR = 1.14, 95%CI: 0.63-2.06, <i>p</i> = 0.66, respectively).</p><p><strong>Conclusion: </strong>The efficacy and safety profile of CRA was comparable to that of RFA in the context of ablation therapy for hepatic malignancies. These findings suggested that CRA may be a valuable alternative to RFA in the treatment of hepatic malignancies.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139402806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk factors of chronic kidney disease in cisplatin-based hyperthermia intraperitoneal chemotherapy. 顺铂腹腔热化疗中慢性肾病的风险因素。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-11 DOI: 10.1080/02656736.2024.2304250
Chih-Chung Cheng, Hung-Chieh Yeh, Pei-Wen Su, Chien-Lin Ho, Sheng-Chi Chang

Purpose: Cisplatin is commonly prescribed in hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancy. Acute kidney injury (AKI) is regarded as a common complication after HIPEC combined with cytoreductive surgery (CRS). However, post-HIPEC chronic kidney disease (CKD) is scarce and less investigated. This study aims to investigate the incidence of CKD following cisplatin-based HIPEC and to analyse the associated risk factors.

Materials and methods: From January 2016 to August 2021, a total of 55 patients treated with CRS and cisplatin-based HIPEC for peritoneal carcinomatosis were categorized retrospectively into groups, with and without CKD. Demographics, comorbidity, surgery, postoperative management, and complications were collected to evaluate risk factors for cisplatin-based HIPEC-related CKD. Univariate and multivariate analyses were conducted to confirm the correlation between different variables and CKD occurrence.

Results: Of the 55 patients, 24 (43.6%) patients developed AKI and 17 (70.8%) patients of these AKI patients progressed to CKD. Multivariate regression analysis identified intraoperative use of parecoxib (Odds Ratio (OR) = 4.39) and intraoperative maximum temperature > 38.5°C (OR = 6.40) as major risk factors for cisplatin-based HIPEC-related CKD occurrence. Though type II diabetes mellitus and intraoperative complications were the independent risk factors of AKI following cisplatin-based HIPEC, but they were not shown in CKD analysis.

Conclusion: Intraoperative use of parecoxib during cisplatin-based HIPEC emerged as a significant risk factor for postoperative CKD. Clinicians should exercise caution in prescribing parecoxib during HIPEC procedures. Additionally, maintaining intraoperative body temperature below 38.5°C might be crucial to mitigate the risk of CKD development. This study underscores the importance of identifying and preventing specific risk factors to improve long-term renal outcomes in patients undergoing cisplatin-based HIPEC.

目的:顺铂是腹膜恶性肿瘤热腹腔化疗(HIPEC)的常用药物。急性肾损伤(AKI)被认为是 HIPEC 联合细胞减毒手术(CRS)后的常见并发症。然而,HIPEC术后慢性肾脏疾病(CKD)却很少见,而且研究较少。本研究旨在调查顺铂为基础的HIPEC术后CKD的发生率,并分析相关风险因素:自2016年1月至2021年8月,共55例接受CRS和顺铂为基础的HIPEC治疗的腹膜癌患者被回顾性地分为有CKD和无CKD两组。研究人员收集了患者的人口统计学特征、合并症、手术、术后管理和并发症等信息,以评估与顺铂类 HIPEC 相关的 CKD 风险因素。进行了单变量和多变量分析,以确认不同变量与 CKD 发生之间的相关性:结果:在 55 例患者中,有 24 例(43.6%)发生了 AKI,其中有 17 例(70.8%)进展为 CKD。多变量回归分析发现,术中使用帕瑞昔布(Odds Ratio (OR) = 4.39)和术中最高温度> 38.5°C(OR = 6.40)是顺铂类 HIPEC 相关 CKD 发生的主要风险因素。虽然II型糖尿病和术中并发症是顺铂HIPEC术后发生AKI的独立风险因素,但在CKD分析中并未显示:结论:在基于顺铂的HIPEC术中使用帕瑞昔布是导致术后CKD的重要风险因素。临床医生在 HIPEC 手术期间应谨慎使用帕瑞昔布。此外,将术中体温维持在 38.5°C 以下可能是降低发生 CKD 风险的关键。本研究强调了识别和预防特定风险因素对改善顺铂 HIPEC 患者长期肾脏预后的重要性。
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引用次数: 0
Computed tomography-guided microwave ablation for right middle lobe pulmonary nodules: a retrospective, single-center, case-control study. 计算机断层扫描引导下的微波消融治疗右肺中叶结节:一项回顾性、单中心、病例对照研究。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-05 DOI: 10.1080/02656736.2024.2307479
Yanting Hu, Guoliang Xue, Xinyu Liang, Zhichao Li, Nan Wang, Pikun Cao, Gang Wang, Haitao Zhang, Xiaohuan Zheng, Aiguang Wang, Wenhua Zhao, Cuiping Han, Zhigang Wei, Xin Ye

Purpose: This retrospective, single-center, case-control study evaluated the safety and efficacy of Computed tomography (CT)-guided microwave ablation (MWA) for pulmonary nodules located in the right middle lobe (RML), a challenging location associated with a high frequency of complications.

Methods: Between May 2020 and April 2022, 71 patients with 71 RML pulmonary nodules underwent 71 MWA sessions. To comparison, 142 patients with 142 pulmonary nodules in non-RML were selected using propensity score matching. The technical success, technique efficacy, complications, and associated factors were analyzed. The duration of the procedure and post-ablation hospital stay were also recorded.

Results: Technical success was achieved in 100% of all patients. There were no significant differences in technique efficacy rates between the RML and non-RML groups (97.2% vs. 95.1%, p = 0.721). However, both major (47.9% vs. 19.7%, p < 0.001) and minor (26.8% vs. 11.3%, p = 0.004) pneumothorax were more common in the RML group than non-RML group. MWA for RML pulmonary nodules was identified as an independent risk factor for pneumothorax (p < 0.001). The duration of procedures (51.7 min vs. 35.3 min, p < 0.001) and post-ablation hospital stays (4.7 days vs. 2.8 days, p < 0.001) were longer in the RML group than non-RML group.

Conclusions: CT-guided MWA for RML pulmonary nodules showed comparable efficacy compared with other lobes, but posed a higher risk of pneumothorax complications, necessitating longer MWA procedure times and extended hospital stays.

目的:这项回顾性、单中心、病例对照研究评估了计算机断层扫描(CT)引导下微波消融术(MWA)治疗右肺中叶(RML)肺结节的安全性和有效性:2020年5月至2022年4月期间,71名患有71个RML肺结节的患者接受了71次MWA治疗。作为对比,采用倾向得分匹配法选出了142名患有142个非RML肺结节的患者。对技术成功率、技术疗效、并发症和相关因素进行了分析。此外,还记录了手术时间和消融术后的住院时间:结果:100%的患者都获得了技术成功。RML组和非RML组的技术有效率无明显差异(97.2% vs. 95.1%,P = 0.721)。不过,RML 组比非 RML 组更常见严重气胸(47.9% 对 19.7%,P = 0.004)。针对 RML 肺结节的 MWA 被确定为气胸的独立风险因素(P P P 结论):与其他肺叶相比,CT引导下MWA治疗RML肺结节的疗效相当,但气胸并发症的风险较高,因此需要延长MWA手术时间和住院时间。
{"title":"Computed tomography-guided microwave ablation for right middle lobe pulmonary nodules: a retrospective, single-center, case-control study.","authors":"Yanting Hu, Guoliang Xue, Xinyu Liang, Zhichao Li, Nan Wang, Pikun Cao, Gang Wang, Haitao Zhang, Xiaohuan Zheng, Aiguang Wang, Wenhua Zhao, Cuiping Han, Zhigang Wei, Xin Ye","doi":"10.1080/02656736.2024.2307479","DOIUrl":"10.1080/02656736.2024.2307479","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective, single-center, case-control study evaluated the safety and efficacy of Computed tomography (CT)-guided microwave ablation (MWA) for pulmonary nodules located in the right middle lobe (RML), a challenging location associated with a high frequency of complications.</p><p><strong>Methods: </strong>Between May 2020 and April 2022, 71 patients with 71 RML pulmonary nodules underwent 71 MWA sessions. To comparison, 142 patients with 142 pulmonary nodules in non-RML were selected using propensity score matching. The technical success, technique efficacy, complications, and associated factors were analyzed. The duration of the procedure and post-ablation hospital stay were also recorded.</p><p><strong>Results: </strong>Technical success was achieved in 100% of all patients. There were no significant differences in technique efficacy rates between the RML and non-RML groups (97.2% vs. 95.1%, <i>p</i> = 0.721). However, both major (47.9% vs. 19.7%, <i>p</i> < 0.001) and minor (26.8% vs. 11.3%, <i>p</i> = 0.004) pneumothorax were more common in the RML group than non-RML group. MWA for RML pulmonary nodules was identified as an independent risk factor for pneumothorax (<i>p</i> < 0.001). The duration of procedures (51.7 min vs. 35.3 min, <i>p</i> < 0.001) and post-ablation hospital stays (4.7 days vs. 2.8 days, <i>p</i> < 0.001) were longer in the RML group than non-RML group.</p><p><strong>Conclusions: </strong>CT-guided MWA for RML pulmonary nodules showed comparable efficacy compared with other lobes, but posed a higher risk of pneumothorax complications, necessitating longer MWA procedure times and extended hospital stays.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radiofrequency ablation for solitary T1N0M0 papillary thyroid carcinoma in the danger triangle area: a preliminary analysis. 射频消融治疗危险三角区单发T1N0M0甲状腺乳头状癌:初步分析。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-05 DOI: 10.1080/02656736.2024.2305256
Dan-Ling Zhang, Sheng Chen, Yuhan Qiu, Jian-Chuan Yang, Zhiliang Hong, Jianwei Li, Song-Song Wu

Objectives: To evaluate the feasibility, efficacy, and safety of radiofrequency ablation (RFA) for solitary T1N0M0 papillary thyroid carcinoma (PTC) in the danger triangle area.

Methods: 94 participants (mean age 44.45 ± 13.08; 73 females) with solitary T1N0M0 PTC in the danger triangle area who underwent percutaneous RFA at the hospital from January 2018 to April 2020 were retrospectively analyzed. Key ablation procedures included sufficient paratracheal fluid isolation, low-power, and short active tip (5 mm working electrode). Tumor size changes at different time points after RFA, technical success rates, tumor disappearance, disease progression, and complications were recorded and compared.

Results: Contrast-enhanced ultrasonography revealed that complete tumor ablation was performed with a 100% success rate in these patients. Post-ablation, the maximum diameter and volume of the ablation zone increased at the first and third month (p < 0.001), followed by a gradual decrease in size, without significant difference by the 6th month. The tumor disappearance rate was 76.59% (72/94), with higher rates in the T1a group compared to the T1b group (80% [64/80] VS57.1% [8/14], p < 0.001). There were no local recurrences. The incidence of new lesions and LNM was 3.2% (3/94), limited to the T1a subgroup. Further ablation was successfully applied to all new lesions and LMN. Mild voice changes were the only complication, with a rate of 3.2% (3/94), resolved within 4 months after RFA.

Conclusions: Sufficient paratracheal fluid isolation combined with a low-power, short active tip radiofrequency ablation strategy is a safe and effective method for treating solitary T1N0M0 PTC in the danger triangle area.

目的评估射频消融(RFA)治疗危险三角区单发T1N0M0甲状腺乳头状癌(PTC)的可行性、有效性和安全性。方法:回顾性分析2018年1月至2020年4月在该院接受经皮RFA治疗的危险三角区单发T1N0M0 PTC患者94例(平均年龄44.45±13.08;女性73例)。关键消融程序包括充分的气管旁液体隔离、低功率和短活动尖端(5 毫米工作电极)。记录并比较了RFA术后不同时间点的肿瘤大小变化、技术成功率、肿瘤消失、疾病进展和并发症:结果:对比增强超声波检查显示,这些患者的肿瘤完全消融成功率为 100%。消融术后,消融区的最大直径和体积在第一个月和第三个月有所增加(p p 结论):充分的气管旁液体隔离结合低功率、短主动脉尖射频消融策略是治疗危险三角区单发 T1N0M0 PTC 的一种安全有效的方法。
{"title":"Radiofrequency ablation for solitary T1N0M0 papillary thyroid carcinoma in the danger triangle area: a preliminary analysis.","authors":"Dan-Ling Zhang, Sheng Chen, Yuhan Qiu, Jian-Chuan Yang, Zhiliang Hong, Jianwei Li, Song-Song Wu","doi":"10.1080/02656736.2024.2305256","DOIUrl":"10.1080/02656736.2024.2305256","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility, efficacy, and safety of radiofrequency ablation (RFA) for solitary T1N0M0 papillary thyroid carcinoma (PTC) in the danger triangle area.</p><p><strong>Methods: </strong>94 participants (mean age 44.45 ± 13.08; 73 females) with solitary T1N0M0 PTC in the danger triangle area who underwent percutaneous RFA at the hospital from January 2018 to April 2020 were retrospectively analyzed. Key ablation procedures included sufficient paratracheal fluid isolation, low-power, and short active tip (5 mm working electrode). Tumor size changes at different time points after RFA, technical success rates, tumor disappearance, disease progression, and complications were recorded and compared.</p><p><strong>Results: </strong>Contrast-enhanced ultrasonography revealed that complete tumor ablation was performed with a 100% success rate in these patients. Post-ablation, the maximum diameter and volume of the ablation zone increased at the first and third month (<i>p</i> < 0.001), followed by a gradual decrease in size, without significant difference by the 6th month. The tumor disappearance rate was 76.59% (72/94), with higher rates in the T1a group compared to the T1b group (80% [64/80] VS57.1% [8/14], <i>p</i> < 0.001). There were no local recurrences. The incidence of new lesions and LNM was 3.2% (3/94), limited to the T1a subgroup. Further ablation was successfully applied to all new lesions and LMN. Mild voice changes were the only complication, with a rate of 3.2% (3/94), resolved within 4 months after RFA.</p><p><strong>Conclusions: </strong>Sufficient paratracheal fluid isolation combined with a low-power, short active tip radiofrequency ablation strategy is a safe and effective method for treating solitary T1N0M0 PTC in the danger triangle area.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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International Journal of Hyperthermia
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