International Journal of Hyperthermia最新文献

Purpose: This retrospective study aimed to evaluate the feasibility and safety of co-ablation (Co-A) for lung malignancies in patients with usual interstitial pneumonia (UIP).

Materials and methods: We retrospectively reviewed the clinical records of 1,537 consecutive patients treated for malignant lung tumors. UIP was assessed using standard-dose computed tomography (CT). Overall, 14 patients (12 men and two women; mean age ± standard deviation: 71.68 ± 7.83 years, range: 60-87 years) with UIP underwent CT-guided percutaneous Co-A. The mean tumor size was 29.14 mm (standard deviation: 12.60; range: 12-45 mm). Follow-up was performed using CT 1 and 3 months after Co-A. Complications and safety outcomes were also assessed.

Results: The median follow-up duration for all patients was 3 months (range: 1-5 months). The mortality rate was 0% within 30 d of ablation. Major complications, including pneumonia and bronchopleural fistula, occurred in 14.3% (2/14) of patients. The technical success rate was 100%.

Conclusion: Co-A appears to be a safe and effective treatment for lung malignancies in patients with UIP.

Purpose: To investigate the safety and efficacy of high-intensity focused ultrasound (HIFU) in the treatment of postpartum placenta increta and to analyze the influencing factors of intraoperative blood loss and curettage times.

Methods: From January 2016 to December 2018, a retrospective analysis was conducted on 160 patients with placenta increta treated by HIFU combined with (or without) curettage in our hospital. Intraoperative blood loss and the number of curettage procedures were recorded. The clinical outcomes and the influencing factors of bleeding and the number of curettage procedures were analyzed.

Results: No serious complications occurred during HIFU treatment. The median volume of blood loss during suction curettage was 20 ml (range: 5-600 ml). Blood loss was significantly higher in patients with a large placental diameter (p = 0.007). The risk of requiring multiple curettage procedures was significantly higher in patients with a large placental diameter (p = 0.023). The interval time between HIFU and suction curettage was identified as a protective factor, a longer interval was associated with fewer curettage procedures (p = 0.015).

Conclusion: Based on the results of our large-sample study, HIFU appears to be safe and effective in the treatment of postpartum placenta increta. Blood loss volume is associated with the largest diameter of the placenta. The risk of requiring multiple curettage procedures is related to the largest diameter of the placenta, While the interval time between HIFU and suction curettage is a protective factor for reducing curettage times.

Objective: The present study aimed to analyze the relationship between the incidence of complications and tumor size following thermal ablation of benign thyroid nodules (BTNs).

Methods: In this retrospective study, 1198 patients who underwent thermal ablation for unifocal BTN were enrolled. Receiver Operating Characteristic analysis was performed to select the cutoff values of the maximum diameter (MD) for dividing patients into different groups or subgroups. Multivariable logistic regression was performed to identify the risk factors. Propensity score matching (PSM) was employed to control for confounding variables.

Results: The overall complication rate was 3.8% (45/1198). Major complications included hoarseness (2.4%), nodule rupture (0.3%) and delayed hemorrhage (0.1%), whereas minor complications were limited to intraoperative hemorrhage (0.9%). The difference in the overall complication rate between the smaller group (< 3.15 cm) and the larger group (> 3.15 cm) was significant (1.0% vs. 6.5%, p < 0.001). In the subgroup analysis, a significant difference was observed between the 3.15-4.15 cm and > 4.15 cm subgroups (4.2% vs. 8.7%, p = 0.023); however, no significant difference was identified between the < 2.35 and 2.35-3.15 cm subgroups (0.6% vs. 1.6%, p = 0.390). Multivariable logistic regression indicated that MD and the nodule component were associated with complications. After PSM, no significant difference in complication rates was observed between MWA and RFA in either the smaller group (p = 1.000) or the larger group (p = 0.186).

Conclusions: The incidence of complications in thermal ablation is greater for larger thyroid nodules, particularly for predominantly solid nodules with MDs greater than 3.15 cm.

Background: Currently high-intensity focused ultrasound (HIFU) is widely used to treat uterine fibroids (UFs). The aim of this study is to develop a machine learning model that can accurately predict the efficacy of HIFU ablation for UFs, assisting the preoperative selection of suitable patients with UFs.

Methods: This study collected data from 1,000 patients with UFs who underwent ultrasound-guided high-intensity focused ultrasound. The least absolute shrinkage and selection operator (LASSO) regression was used for multidimensional feature screening. Five machine learning algorithms such as logistic regression, random forest, extreme gradient boosting (XGBoost), artificial neural network, and gradient boosting decision tree were utilized to predict ablation efficacy. The efficacy was quantified by the non-perfused volume ratio (NPVR), which was classified into two categories: NPVR <80% and NPVR ≥80%.

Results: The XGBoost model proved to be the most effective, showing the highest AUC of 0.692 (95% CI: 0.622-0.762) in the testing data set. The four key predictors were T2 weighted image, the distance from ventral side of UFs to skin, platelet count, and contrast-enhanced T1 weighted image.

Conclusions: The machine learning prediction model in this study showed significant potential for accurately predicting the preoperative efficacy of HIFU ablation for UFs. These insights were important for clinicians in the preoperative assessment and selection of patients, which could enhance the precision of treatment planning.