Pub Date : 2024-01-01Epub Date: 2024-07-14DOI: 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%.
{"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":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":"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}
Pub Date : 2024-01-01Epub Date: 2024-06-16DOI: 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.
{"title":"Impact of surrounding tissue-type and peri-electrode gap in stereoelectroencephalography guided (SEEG) radiofrequency thermocoagulation (RF-TC): a computational study.","authors":"Santiago Collavini, Juan J Pérez, Enrique Berjano, Mariano Fernández-Corazza, Silvia Oddo, Ramiro M Irastorza","doi":"10.1080/02656736.2024.2364721","DOIUrl":"https://doi.org/10.1080/02656736.2024.2364721","url":null,"abstract":"<p><strong>Purpose: </strong>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).</p><p><strong>Methods: </strong>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 <i>ex vivo</i> 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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</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":"141330888","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}
Pub Date : 2024-01-01Epub Date: 2024-05-30DOI: 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.
{"title":"Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer.","authors":"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","doi":"10.1080/02656736.2024.2358054","DOIUrl":"https://doi.org/10.1080/02656736.2024.2358054","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Salvage RFA followed by EBRT is feasible, effective and safe for patients with rDTC.</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":"141179504","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}
Pub Date : 2024-01-01Epub Date: 2024-06-27DOI: 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.
{"title":"Omental metastases in patients with pseudomyxoma peritonei or colorectal peritoneal metastases - is routine omentectomy justified?","authors":"Malin Enblad, Helgi Birgisson, Lana Ghanipour, Peter Cashin, Wilhelm Graf","doi":"10.1080/02656736.2024.2372356","DOIUrl":"https://doi.org/10.1080/02656736.2024.2372356","url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</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":"141467840","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}
Pub Date : 2024-01-01Epub Date: 2024-09-08DOI: 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}
Pub Date : 2024-01-01Epub Date: 2024-02-18DOI: 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.
{"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}
Pub Date : 2024-01-01Epub Date: 2024-01-08DOI: 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.
{"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}
Pub Date : 2024-01-01Epub Date: 2024-02-11DOI: 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.
{"title":"Risk factors of chronic kidney disease in cisplatin-based hyperthermia intraperitoneal chemotherapy.","authors":"Chih-Chung Cheng, Hung-Chieh Yeh, Pei-Wen Su, Chien-Lin Ho, Sheng-Chi Chang","doi":"10.1080/02656736.2024.2304250","DOIUrl":"10.1080/02656736.2024.2304250","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</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":"139717531","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}
Pub Date : 2024-01-01Epub Date: 2024-02-05DOI: 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}
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}