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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。
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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。
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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 ONCOLOGY 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
Complications and adverse events of high-intensity focused ultrasound in its application to gynecological field - a systematic review and meta-analysis. 高强度聚焦超声应用于妇科领域的并发症和不良事件--系统回顾和荟萃分析。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-06-30 DOI: 10.1080/02656736.2024.2370969
Shan-Shan Lu, Lei-Lei Yang, Wei Yang, Jing Wang, Xia-Lin Zhang, Liu Yang, Yi Wen

Objective: To analyze and summarize the types, incidence rates and relevant influencing factors of adverse events (AEs) after high-intensity focused ultrasound ablation of gynecological diseases and provide reference and basis for handling such events in clinical practice.

Method: We searched PubMed, Cochrane Library, Web of Science and Embase databases to retrieve all literature since its establishment until February 2024. We evaluated the quality of included literature and publication bias and conducted a meta-analysis of single group rates for various AEs using Stata 17.0.

Results: This systematic review finally included 41 articles. We summarized 34 kinds of AEs in 7 aspects and conducted a single group rate meta-analysis and sub-group analysis of 16 kinds of AEs. Among the common AEs of High-Intensity Focused Ultrasound (HIFU), the incidence of lower abdominal pain/pelvic pain is 36.1% (95% CI: 24.3%∼48.8%), vaginal bleeding is 20.6% (95% CI: 13.9%∼28.0%), vaginal discharge is 14.0% (95% CI: 9.6%∼19.1%), myoma discharge is 24% (95% CI: 14.6%∼34.8%), buttock pain is 10.8% (95% CI: 6.0%∼16.5%) and sacral pain is 10% (95% CI: 8.8%∼11.2%). Serious complications include uterine rupture, necrotic tissue obstruction requiring surgical intervention, third degree skin burns and persistent lower limb pain or movement disorders.

Conclusion: The common AEs after HIFU surgery are mostly mild and controllable, and the incidence of serious complications is extremely low. By reasonable prevention and active intervention, these events can be further reduced, making it a safe and effective treatment method. It is a good choice for patients who crave noninvasive treatment or have other surgical contraindications.

目的分析总结妇科疾病高强度聚焦超声消融术后不良事件(AEs)的类型、发生率及相关影响因素,为临床实践中处理此类事件提供参考和依据:方法:我们检索了PubMed、Cochrane Library、Web of Science和Embase数据库,检索了自数据库建立以来至2024年2月的所有文献。我们评估了纳入文献的质量和发表偏倚,并使用 Stata 17.0 对各种 AEs 的单组发生率进行了荟萃分析:本系统综述最终纳入了 41 篇文章。我们从 7 个方面总结了 34 种 AE,并对 16 种 AE 进行了单组发生率荟萃分析和亚组分析。在高强度聚焦超声(HIFU)常见的 AEs 中,下腹痛/盆腔痛的发生率为 36.1%(95% CI:24.3%∼48.8%),阴道出血的发生率为 20.6%(95% CI:13.9%∼28.0%),阴道分泌物为 14.0%(95% CI:9.6%∼19.1%),肌瘤分泌物为 24%(95% CI:14.6%∼34.8%),臀部疼痛为 10.8%(95% CI:6.0%∼16.5%),骶骨疼痛为 10%(95% CI:8.8%∼11.2%)。严重并发症包括子宫破裂、坏死组织阻塞(需要手术干预)、三度皮肤灼伤和持续性下肢疼痛或运动障碍:结论:HIFU术后常见的AE大多较轻且可控,严重并发症的发生率极低。通过合理的预防和积极的干预,可以进一步减少这些事件的发生,使其成为一种安全有效的治疗方法。对于渴望无创治疗或有其他手术禁忌症的患者来说,这是一个不错的选择。
{"title":"Complications and adverse events of high-intensity focused ultrasound in its application to gynecological field - a systematic review and meta-analysis.","authors":"Shan-Shan Lu, Lei-Lei Yang, Wei Yang, Jing Wang, Xia-Lin Zhang, Liu Yang, Yi Wen","doi":"10.1080/02656736.2024.2370969","DOIUrl":"10.1080/02656736.2024.2370969","url":null,"abstract":"<p><strong>Objective: </strong>To analyze and summarize the types, incidence rates and relevant influencing factors of adverse events (AEs) after high-intensity focused ultrasound ablation of gynecological diseases and provide reference and basis for handling such events in clinical practice.</p><p><strong>Method: </strong>We searched PubMed, Cochrane Library, Web of Science and Embase databases to retrieve all literature since its establishment until February 2024. We evaluated the quality of included literature and publication bias and conducted a meta-analysis of single group rates for various AEs using Stata 17.0.</p><p><strong>Results: </strong>This systematic review finally included 41 articles. We summarized 34 kinds of AEs in 7 aspects and conducted a single group rate meta-analysis and sub-group analysis of 16 kinds of AEs. Among the common AEs of High-Intensity Focused Ultrasound (HIFU), the incidence of lower abdominal pain/pelvic pain is 36.1% (95% CI: 24.3%∼48.8%), vaginal bleeding is 20.6% (95% CI: 13.9%∼28.0%), vaginal discharge is 14.0% (95% CI: 9.6%∼19.1%), myoma discharge is 24% (95% CI: 14.6%∼34.8%), buttock pain is 10.8% (95% CI: 6.0%∼16.5%) and sacral pain is 10% (95% CI: 8.8%∼11.2%). Serious complications include uterine rupture, necrotic tissue obstruction requiring surgical intervention, third degree skin burns and persistent lower limb pain or movement disorders.</p><p><strong>Conclusion: </strong>The common AEs after HIFU surgery are mostly mild and controllable, and the incidence of serious complications is extremely low. By reasonable prevention and active intervention, these events can be further reduced, making it a safe and effective treatment method. It is a good choice for patients who crave noninvasive treatment or have other surgical contraindications.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"41 1","pages":"2370969"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467868","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
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。
{"title":"The value of susceptibility weighted imaging for immediate assessing the hyperacute outcome of MRgFUS ablation for uterine fibroids: a preliminary study.","authors":"Yaoqu Huang, Shouguo Zhou, Yinghua Su, Zhuochao Pang, Shihua Cai","doi":"10.1080/02656736.2024.2377346","DOIUrl":"https://doi.org/10.1080/02656736.2024.2377346","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 <i>p</i> < .001). There was a significant difference in the prevalence of hypointense peripheral rim in leiomyomas with NPV ratio ≥90% and < 90% (<i>p</i> < .01), while the prevalence of relative signal intensity showed no significant difference (<i>p</i> > .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.</p><p><strong>Conclusion: </strong>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%.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"41 1","pages":"2377346"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616329","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
Alternating magnetic field guiding system for MNP hyperthermia treatment of deep-seated cancers. 交变磁场引导系统,用于 MNP 热疗治疗深部癌症。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-08-29 DOI: 10.1080/02656736.2024.2391008
Robert V Stigliano, Ilona Danelyan, Giga Gabriadze, Levan Shoshiashvili, Ian Baker, P Jack Hoopes, Roman Jobava, Fridon Shubitidze

Objectives: Demonstrate the potential application of a novel, endoscope-like device to guide and focus an alternating magnetic field (AMF) for treating deep-seated cancers via magnetic nanoparticle hyperthermia (MNPH).

Methods: AMF delivery, MNP activation, and eddy current distribution characteristics are investigated through experimental studies in phantoms and computational simulations using a full 3-dimensional human model. The 3D simulations compare the novel device to traditional AMF designs, including a MagForce-like, two-coil system (used clinically) and a single surface-coil system.

Results: The results demonstrate that this approach can deliver the same magnetic field strength at the prostate's centroid as traditional AMF designs, while reducing eddy current heating by 2 to 6 times. At the same level of normal tissue heating, this method provides 5.0 times, 1.5 times, and 0.92 times the magnetic field strength to the nearest, centroid, and farthest regions of the prostate, respectively.

Conclusions: These results demonstrate proof-of-concept for an endoscopic magnetic field guiding and focusing system capable of delivering clinically relevant AMF from a distance. This innovative approach offers a promising alternative to conventional field delivery methods by directing AMF through the body, concentrating it in the tumor region, reducing eddy currents in surrounding healthy tissue, and avoiding exposure of nearby metallic implants.

目标:展示一种类似内窥镜的新型装置的潜在应用,该装置可引导和聚焦交变磁场(AMF),通过磁性纳米粒子热疗(MNPH)治疗深层癌症:方法:通过人体模型的实验研究和全三维人体模型的计算模拟,对交变磁场的输送、磁性纳米粒子的激活和涡流分布特性进行了研究。三维模拟将新型设备与传统的 AMF 设计(包括类似 MagForce 的双线圈系统(临床使用)和单表面线圈系统)进行了比较:结果表明,这种方法可以在前列腺中心点提供与传统 AMF 设计相同的磁场强度,同时将涡流加热降低 2 到 6 倍。在相同的正常组织加热水平下,这种方法为前列腺的最近、中心和最远区域提供的磁场强度分别为 5.0 倍、1.5 倍和 0.92 倍:这些结果证明了内窥镜磁场引导和聚焦系统的概念,该系统能够远距离提供临床相关的 AMF。这种创新方法通过引导 AMF 穿过身体、将其集中在肿瘤区域、减少周围健康组织中的涡流以及避免附近金属植入物的暴露,为传统磁场传输方法提供了一种很有前景的替代方法。
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引用次数: 0
Evaluation of magnetic resonance thermometry performance during MR-guided hyperthermia treatment of soft-tissue sarcomas in the lower extremities and pelvis. 评估在磁共振引导下对下肢和骨盆软组织肉瘤进行热疗时的磁共振测温性能。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-09-22 DOI: 10.1080/02656736.2024.2405105
Spyridon N Karkavitsas, Marianne Göger-Neff, Maria Kawula, Kemal Sumser, Benjamin Zilles, Martin Wadepohl, Guillaume Landry, Christopher Kurz, Wolfgang G Kunz, Olaf Dietrich, Lars H Lindner, Margarethus M Paulides

Introduction: This study evaluated the performance of magnetic resonance thermometry (MRT) during deep-regional hyperthermia (HT) in pelvic and lower-extremity soft-tissue sarcomas.

Materials and methods: 17 pelvic (45 treatments) and 16 lower-extremity (42 treatments) patients underwent standard regional HT and chemotherapy. Pairs of double-echo gradient-echo scans were acquired during the MR protocol 1.4 s apart. For each pair, precision was quantified using phase data from both echoes ('dual-echo') or only one ('single-echo') in- or excluding body fat pixels in the field drift correction region of interest. The precision of each method was compared to that of the MRT approach using a built-in clinical software tool (SigmaVision). Accuracy was assessed in three lower-extremity patients (six treatments) using interstitial temperature probes. The Jaccard coefficient quantified pretreatment motion; receiver operating characteristic analysis assessed its predictability for acceptable precision (<1 °C) during HT.

Results: Compared to the built-in dual-echo approach, single-echo thermometry improved the mean temporal precision from 1.32 ± 0.40 °C to 1.07 ± 0.34 °C (pelvis) and from 0.99 ± 0.28 °C to 0.76 ± 0.23 °C (lower extremities). With body fat-based field drift correction, single-echo mean accuracy improved from 1.4 °C to 1.0 °C. Pretreatment bulk motion provided excellent precision prediction with an area under the curve of 0.80-0.86 (pelvis) and 0.81-0.83 (lower extremities), compared to gastrointestinal air motion (0.52-0.58).

Conclusion: Single-echo MRT exhibited better precision than dual-echo MRT. Body fat-based field-drift correction significantly improved MRT accuracy. Pretreatment bulk motion showed improved prediction of acceptable MRT temporal precision over gastrointestinal air motion.

简介:这项研究评估了盆腔和下肢软组织肉瘤深部区域热疗(HT)期间磁共振温度测量(MRT)的性能。在磁共振扫描过程中,每隔 1.4 秒采集一对双回波梯度回波扫描。对于每对扫描,使用两个回波("双回波")或仅一个回波("单回波")的相位数据,在感兴趣场漂移校正区域内或排除体脂肪像素,对精确度进行量化。使用内置的临床软件工具(SigmaVision)将每种方法的精确度与 MRT 方法的精确度进行了比较。使用间质温度探针对三名下肢患者(六次治疗)进行了准确性评估。杰卡尔系数量化了治疗前的运动;接收器操作特征分析评估了其可接受精度的预测性(结果:与内置双回波方法相比,单回波测温法将平均时间精度从 1.32 ± 0.40 ℃ 提高到 1.07 ± 0.34 ℃(骨盆),从 0.99 ± 0.28 ℃ 提高到 0.76 ± 0.23 ℃(下肢)。通过基于体脂的场漂移校正,单次回波平均准确度从 1.4 ℃ 提高到 1.0 ℃。与胃肠道空气运动(0.52-0.58)相比,治疗前的体积运动提供了极好的精确预测,曲线下面积为 0.80-0.86(骨盆)和 0.81-0.83(下肢):结论:单回波磁共振成像比双回波磁共振成像的精确度更高。结论:单回波 MRT 比双回波 MRT 具有更高的精确度。基于体脂的场漂移校正显著提高了 MRT 的精确度。与胃肠道空气运动相比,治疗前体液运动能更好地预测可接受的 MRT 时间精度。
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引用次数: 0
Ultrasound-guided percutaneous microwave ablation for metabolic-associated fatty liver disease-related hepatocellular carcinoma (HCC) versus hepatitis virus B-related HCC: a propensity score matching study. 超声引导下经皮微波消融治疗代谢相关性脂肪肝相关性肝细胞癌(HCC)与乙型肝炎病毒相关性肝细胞癌:倾向评分匹配研究。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-10-27 DOI: 10.1080/02656736.2024.2419912
Yannan Qiao, Sitong Chen, Yang Liu, Lu Li, Liting He, Zhiyu Han, Fangyi Liu, Zhigang Cheng, Xiaoling Yu, Jie Yu, Chuan Pang, Ping Liang

Objectives: To compare the long-term outcomes of microwave ablation (MWA) for primary hepatocellular carcinoma (HCC) in patients with metabolic-associated fatty liver disease (MAFLD) with those infected by hepatitis virus B (HBV).

Methods: The clinical data of HCC patients under the treatment of MWA were analyzed retrospectively between 2010 and 2021 at Chinese PLA General Hospital. Patients were divided into MAFLD-HCC and HBV-HCC group according to the chronic liver disease etiology. The propensity score matching (PSM) was performed to reduce the interference of confounders. The primary outcomes were overall survival (OS), recurrence-free survival (RFS), cancer-specific survival (CSS) and intrahepatic distant recurrence (IDR).

Results: A total of 648 patients (age range, 18-91 years) with 1019 lesions were enrolled including 601 with HBV-HCC and 47 with MAFLD-HCC. After a variable ratio of 1:n ≤ 4 PSM, 100 patients were included in the HBV-HCC and 41 in the MAFLD-HCC group. No statistical differences in OS and CSS (p = 0.880 and p = 0.980, respectively) were observed between the two groups in the matched cohort, while MAFLD-HCC exhibited better RFS and lower IDR rates compared to HBV-HCC (p = 0.043 and p = 0.041, respectively). Additionally, MAFLD-HCC generated lower ascending range in the liver function indexes like ΔALT (46.7 vs. 98.5, p < 0.001), ΔTBIL (1.9 vs. 7.5, p = 0.001) and ΔAST (38.1 vs. 148.6, p < 0.001) than HBV-HCC after MWA.

Conclusions: MWA is an effective treatment for HCC patients with MAFLD. The recurrence prognosis of MAFLD-HCC was better than HBV-HCC and the degree of liver injury after MWA was lower.

研究目的比较代谢相关性脂肪肝(MAFLD)患者与乙型肝炎病毒(HBV)感染者微波消融(MWA)治疗原发性肝细胞癌(HCC)的长期疗效:方法:回顾性分析中国人民解放军总医院2010年至2021年间接受MWA治疗的HCC患者的临床资料。根据慢性肝病病因将患者分为MAFLD-HCC组和HBV-HCC组。为减少混杂因素的干扰,进行了倾向评分匹配(PSM)。主要结果为总生存期(OS)、无复发生存期(RFS)、癌症特异性生存期(CSS)和肝内远处复发(IDR):共有 648 名患者(年龄在 18-91 岁之间)入组,病灶数量为 1019 个,其中包括 601 名 HBV-HCC 患者和 47 名 MAFLD-HCC 患者。经过 1:n ≤ 4 PSM 的可变比例后,100 名患者被纳入 HBV-HCC 组,41 名患者被纳入 MAFLD-HCC 组。在配对队列中,两组患者的 OS 和 CSS 无统计学差异(分别为 p = 0.880 和 p = 0.980),而与 HBV-HCC 相比,MAFLD-HCC 表现出更好的 RFS 和更低的 IDR 率(分别为 p = 0.043 和 p = 0.041)。此外,MAFLD-HCC 的肝功能指标,如 ΔALT(46.7 对 98.5,p = 0.001)和 ΔAST(38.1 对 148.6,p 结论:MWA 是治疗 HBV-HCC 的有效方法:MWA是治疗患有MAFLD的HCC患者的有效方法。MAFLD-HCC的复发预后优于HBV-HCC,且MWA后的肝损伤程度较低。
{"title":"Ultrasound-guided percutaneous microwave ablation for metabolic-associated fatty liver disease-related hepatocellular carcinoma (HCC) versus hepatitis virus B-related HCC: a propensity score matching study.","authors":"Yannan Qiao, Sitong Chen, Yang Liu, Lu Li, Liting He, Zhiyu Han, Fangyi Liu, Zhigang Cheng, Xiaoling Yu, Jie Yu, Chuan Pang, Ping Liang","doi":"10.1080/02656736.2024.2419912","DOIUrl":"https://doi.org/10.1080/02656736.2024.2419912","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the long-term outcomes of microwave ablation (MWA) for primary hepatocellular carcinoma (HCC) in patients with metabolic-associated fatty liver disease (MAFLD) with those infected by hepatitis virus B (HBV).</p><p><strong>Methods: </strong>The clinical data of HCC patients under the treatment of MWA were analyzed retrospectively between 2010 and 2021 at Chinese PLA General Hospital. Patients were divided into MAFLD-HCC and HBV-HCC group according to the chronic liver disease etiology. The propensity score matching (PSM) was performed to reduce the interference of confounders. The primary outcomes were overall survival (OS), recurrence-free survival (RFS), cancer-specific survival (CSS) and intrahepatic distant recurrence (IDR).</p><p><strong>Results: </strong>A total of 648 patients (age range, 18-91 years) with 1019 lesions were enrolled including 601 with HBV-HCC and 47 with MAFLD-HCC. After a variable ratio of 1:<i>n</i> ≤ 4 PSM, 100 patients were included in the HBV-HCC and 41 in the MAFLD-HCC group. No statistical differences in OS and CSS (<i>p</i> = 0.880 and <i>p</i> = 0.980, respectively) were observed between the two groups in the matched cohort, while MAFLD-HCC exhibited better RFS and lower IDR rates compared to HBV-HCC (<i>p</i> = 0.043 and <i>p</i> = 0.041, respectively). Additionally, MAFLD-HCC generated lower ascending range in the liver function indexes like ΔALT (46.7 vs. 98.5, <i>p</i> < 0.001), ΔTBIL (1.9 vs. 7.5, <i>p</i> = 0.001) and ΔAST (38.1 vs. 148.6, <i>p</i> < 0.001) than HBV-HCC after MWA.</p><p><strong>Conclusions: </strong>MWA is an effective treatment for HCC patients with MAFLD. The recurrence prognosis of MAFLD-HCC was better than HBV-HCC and the degree of liver injury after MWA was lower.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"41 1","pages":"2419912"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500020","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
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 ONCOLOGY 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":"41 1","pages":"2307479"},"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
期刊
International Journal of Hyperthermia
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