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Obituary. 讣告
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2023-12-30 DOI: 10.1080/02656736.2023.2283909
Dennis B Leeper, Mark W Dewhirst
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引用次数: 0
Complications of microwave ablation in patients with persistent/recurrent hyperparathyroidism after surgical or ablative treatment. 手术或消融治疗后甲状旁腺功能亢进症持续/复发患者的微波消融并发症。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-05 DOI: 10.1080/02656736.2024.2308063
Ying Wei, Zhen-Long Zhao, Jie Wu, Shi-Liang Cao, Li-Li Peng, Yan Li, Ming-An Yu

Objective: To evaluate the complications associated with microwave ablation (MWA) in treating persistent/recurrent hyperparathyroidism (HPT) post-surgical or ablative treatments.

Materials and methods: From January 2015 to December 2022, 87 persistent/recurrent HPT patients (primary HPT [PHPT]: secondary HPT [SHPT] = 13:74) who underwent MWA after surgical or ablative treatment were studied. Grouping was based on ablation order (initial vs. re-MWA), prior treatment (parathyroidectomy [PTX] vs. MWA), and etiology (PHPT vs. SHPT). The study focused on documenting and comparing treatment complications and analyzing major complication risk factors.

Result: Among the 87 patients, the overall complication rate was 17.6% (15/87), with major complications at 13.8% (12/87) and minor complications at 3.4% (3/87). Major complications included recurrent laryngeal nerve (RLN) palsy (12.6%) and Horner syndrome (1.1%), while minor complications were limited to hematoma (3.4%). Severe hypocalcemia noted in 21.6% of SHPT patients. No significant differences in major complication rates were observed between initial and re-MWA groups (10.7% vs. 13.8%, p = 0.455), PTX and MWA groups (12.5% vs. 15.4%, p = 0.770), or PHPT and SHPT groups (15.4% vs. 13.5%, p > 0.999). Risk factors for RLN palsy included ablation of superior and large parathyroid glands (>1.7 cm). All patients recovered spontaneously except for one with permanent RLN palsy in the PTX group (2.1%).

Conclusion: Complication rates for MWA post-surgical or ablative treatments were comparable to initial MWA rates. Most complications were transient, indicating MWA as a viable and safe treatment option for persistent/recurrent HPT patients.

目的:评估微波消融治疗甲状旁腺功能亢进症(HPT)的并发症:评估微波消融术(MWA)治疗手术或消融治疗后顽固性/复发性甲状旁腺功能亢进症(HPT)的相关并发症:从2015年1月至2022年12月,对87名在手术或消融治疗后接受微波消融术的顽固性/复发性甲状旁腺功能亢进症患者(原发性甲状旁腺功能亢进症[PHPT]:继发性甲状旁腺功能亢进症[SHPT]=13:74)进行了研究。根据消融顺序(初次与再次MWA)、先前治疗(甲状旁腺切除术 [PTX] 与 MWA)和病因(PHPT 与 SHPT)进行分组。研究重点是记录和比较治疗并发症,分析主要并发症风险因素:87名患者中,总并发症发生率为17.6%(15/87),其中主要并发症为13.8%(12/87),次要并发症为3.4%(3/87)。主要并发症包括喉返神经(RLN)麻痹(12.6%)和霍纳综合征(1.1%),而轻微并发症仅限于血肿(3.4%)。21.6%的 SHPT 患者出现严重低钙血症。初次和再次MWA组(10.7% vs. 13.8%,P = 0.455)、PTX和MWA组(12.5% vs. 15.4%,P = 0.770)或PHPT和SHPT组(15.4% vs. 13.5%,P > 0.999)之间的主要并发症发生率无明显差异。RLN麻痹的风险因素包括上甲状旁腺和大甲状旁腺(>1.7厘米)的消融。除了PTX组的一名永久性RLN麻痹患者(2.1%)外,所有患者均可自行康复:结论:手术或消融治疗后的MWA并发症发生率与最初的MWA发生率相当。大多数并发症都是一过性的,这表明 MWA 是针对顽固性/复发性 HPT 患者的一种可行且安全的治疗方案。
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引用次数: 0
Theoretical evaluation of the impact of diverse treatment conditions by calculation of the tumor control probability (TCP) of simulated cervical cancer Hyperthermia-Radiotherapy (HT-RT) treatments in-silico. 通过计算模拟宫颈癌热疗-放疗(HT-RT)治疗的肿瘤控制概率(TCP),对不同治疗条件的影响进行理论评估。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-03-11 DOI: 10.1080/02656736.2024.2320852
Sergio Mingo Barba, Adela Ademaj, Dietmar Marder, Oliver Riesterer, Marco Lattuada, Rudolf M Füchslin, Alke Petri-Fink, Stephan Scheidegger

Introduction: Hyperthermia (HT) induces various cellular biological processes, such as repair impairment and direct HT cell killing. In this context, in-silico biophysical models that translate deviations in the treatment conditions into clinical outcome variations may be used to study the extent of such processes and their influence on combined hyperthermia plus radiotherapy (HT + RT) treatments under varying conditions.

Methods: An extended linear-quadratic model calibrated for SiHa and HeLa cell lines (cervical cancer) was used to theoretically study the impact of varying HT treatment conditions on radiosensitization and direct HT cell killing effect. Simulated patients were generated to compute the Tumor Control Probability (TCP) under different HT conditions (number of HT sessions, temperature and time interval), which were randomly selected within margins based on reported patient data.

Results: Under the studied conditions, model-based simulations suggested a treatment improvement with a total CEM43 thermal dose of approximately 10 min. Additionally, for a given thermal dose, TCP increased with the number of HT sessions. Furthermore, in the simulations, we showed that the TCP dependence on the temperature/time interval is more correlated with the mean value than with the minimum/maximum value and that comparing the treatment outcome with the mean temperature can be an excellent strategy for studying the time interval effect.

Conclusion: The use of thermoradiobiological models allows us to theoretically study the impact of varying thermal conditions on HT + RT treatment outcomes. This approach can be used to optimize HT treatments, design clinical trials, and interpret patient data.

导言热疗(HT)会诱发各种细胞生物学过程,如修复受损和直接杀伤热疗细胞。在这种情况下,将治疗条件的偏差转化为临床结果变化的in-silico生物物理模型可用于研究这些过程的程度及其在不同条件下对热疗+放疗(HT + RT)联合治疗的影响:方法:使用针对 SiHa 和 HeLa 细胞系(宫颈癌)校准的扩展线性二次模型,从理论上研究不同热疗治疗条件对放射增敏和直接热疗细胞杀伤效应的影响。根据报告的患者数据,在边际范围内随机选择患者,生成模拟患者,计算不同热疗条件(热疗次数、温度和时间间隔)下的肿瘤控制概率(TCP):结果:在所研究的条件下,基于模型的模拟结果表明,CEM43的总热剂量约为10分钟,治疗效果有所改善。此外,在给定的热剂量下,TCP 随 HT 治疗次数的增加而增加。此外,在模拟中,我们发现 TCP 对温度/时间间隔的依赖性与平均值的相关性比与最小/最大值的相关性更高,将治疗结果与平均温度进行比较是研究时间间隔效应的绝佳策略:热放射生物学模型的使用使我们能够从理论上研究不同热条件对 HT + RT 治疗效果的影响。这种方法可用于优化热疗治疗、设计临床试验和解释患者数据。
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引用次数: 0
Regional hyperthermia for soft tissue sarcoma - a survey on current practice, controversies and consensus among 12 European centers. 软组织肉瘤区域热疗--12 个欧洲中心对当前做法、争议和共识的调查。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-04-23 DOI: 10.1080/02656736.2024.2342348
Siyer Roohani, Felix Ehret, Marcus Beck, Danai P Veltsista, Jacek Nadobny, Sebastian Zschaeck, Sultan Abdel-Rahman, Franziska Eckert, Anne Flörcken, Rolf D Issels, Stephan Klöck, Robert Krempien, Lars H Lindner, Markus Notter, Oliver J Ott, Daniel Pink, Vlatko Potkrajcic, Peter Reichardt, Oliver Riesterer, Mateusz Jacek Spałek, Emanuel Stutz, Rüdiger Wessalowski, Thomas Zilli, Daniel Zips, Pirus Ghadjar, David Kaul

Purpose: To analyze the current practice of regional hyperthermia (RHT) for soft tissue sarcoma (STS) at 12 European centers to provide an overview, find consensuses and identify controversies necessary for future guidelines and clinical trials.

Methods: In this cross-sectional survey study, a 27-item questionnaire assessing clinical subjects and procedural details on RHT for STS was distributed to 12 European cancer centers for RHT.

Results: We have identified seven controversies and five consensus points. Of 12 centers, 6 offer both, RHT with chemotherapy (CTX) or with radiotherapy (RT). Two centers only offer RHT with CTX and four centers only offer RHT with RT. All 12 centers apply RHT for localized, high-risk STS of the extremities, trunk wall and retroperitoneum. However, eight centers also use RHT in metastatic STS, five in palliative STS, eight for superficial STS and six for low-grade STS. Pretherapeutic imaging for RHT treatment planning is used by 10 centers, 9 centers set 40-43 °C as the intratumoral target temperature, and all centers use skin detectors or probes in body orifices for thermometry.

Discussion: There is disagreement regarding the integration of RHT in contemporary interdisciplinary care of STS patients. Many clinical controversies exist that require a standardized consensus guideline and innovative study ideas. At the same time, our data has shown that existing guidelines and decades of experience with the technique of RHT have mostly standardized procedural aspects.

Conclusions: The provided results may serve as a basis for future guidelines and inform future clinical trials for RHT in STS patients.

目的:分析12个欧洲中心目前对软组织肉瘤(STS)进行区域热疗(RHT)的实践情况,为未来的指南和临床试验提供一个概览,找到共识并找出必要的争议点:在这项横断面调查研究中,我们向 12 个欧洲癌症中心的 RHT 患者发放了一份 27 个项目的调查问卷,评估 STS RHT 的临床对象和手术细节:结果:我们发现了七个争议点和五个共识点。在 12 个中心中,有 6 个中心同时提供 RHT 和化疗 (CTX) 或放疗 (RT)。有两家中心只提供结合 CTX 的 RHT,有四家中心只提供结合 RT 的 RHT。所有 12 个中心都将 RHT 用于四肢、躯干壁和腹膜后的局部高危 STS。不过,也有 8 个中心将 RHT 用于转移性 STS,5 个中心用于姑息性 STS,8 个中心用于浅表性 STS,6 个中心用于低级别 STS。10个中心使用治疗前成像来制定RHT治疗计划,9个中心将40-43 °C作为瘤内目标温度,所有中心都使用皮肤探测器或体腔探头进行测温:讨论:对于将 RHT 纳入 STS 患者的跨学科治疗,目前还存在分歧。许多临床争议需要标准化的共识指南和创新的研究理念。与此同时,我们的数据显示,现有的指南和数十年的 RHT 技术经验已基本实现了程序方面的标准化:所提供的结果可作为未来指南的依据,并为未来 STS 患者 RHT 的临床试验提供参考。
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引用次数: 0
Insights from in vivo preclinical cancer studies with histotripsy. 利用组旋技术进行活体临床前癌症研究的启示
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-01-12 DOI: 10.1080/02656736.2023.2297650
Tejaswi Worlikar, Timothy Hall, Man Zhang, Mishal Mendiratta-Lala, Michael Green, Clifford S Cho, Zhen Xu

Histotripsy is the first noninvasive, non-ionizing, and non-thermal ablation technique that mechanically fractionates target tissue into acellular homogenate via controlled acoustic cavitation. Histotripsy has been evaluated for various preclinical applications requiring noninvasive tissue removal including cancer, brain surgery, blood clot and hematoma liquefaction, and correction of neonatal congenital heart defects. Promising preclinical results including local tumor suppression, improved survival outcomes, local and systemic anti-tumor immune responses, and histotripsy-induced abscopal effects have been reported in various animal tumor models. Histotripsy is also being investigated in veterinary patients with spontaneously arising tumors. Research is underway to combine histotripsy with immunotherapy and chemotherapy to improve therapeutic outcomes. In addition to preclinical cancer research, human clinical trials are ongoing for the treatment of liver tumors and renal tumors. Histotripsy has been recently approved by the FDA for noninvasive treatment of liver tumors. This review highlights key learnings from in vivo shock-scattering histotripsy, intrinsic threshold histotripsy, and boiling histotripsy cancer studies treating cancers of different anatomic locations and discusses the major considerations in planning in vivo histotripsy studies regarding instrumentation, tumor model, study design, treatment dose, and post-treatment tumor monitoring.

组织切削术是第一种非侵入性、非电离、非热消融技术,它通过受控声空化作用将目标组织机械地分割成无细胞匀浆。组织切削术已被评估用于各种需要无创组织切除的临床前应用,包括癌症、脑外科手术、血凝块和血肿液化以及新生儿先天性心脏缺陷矫正。据报道,在各种动物肿瘤模型中,临床前研究取得了可喜的成果,包括局部肿瘤抑制、生存率提高、局部和全身抗肿瘤免疫反应以及组织胞浆诱导的脱落效应。目前还在对患有自发性肿瘤的兽医患者进行组织切碎术研究。目前正在研究如何将组织细胞震荡疗法与免疫疗法和化疗相结合,以提高治疗效果。除了临床前癌症研究外,治疗肝脏肿瘤和肾脏肿瘤的人体临床试验也在进行中。最近,美国食品及药物管理局已批准组织切片疗法用于肝脏肿瘤的无创治疗。本综述重点介绍了治疗不同解剖位置癌症的体内冲击散射组织切碎术、固有阈值组织切碎术和沸腾组织切碎术癌症研究的主要经验,并讨论了计划体内组织切碎术研究时在仪器、肿瘤模型、研究设计、治疗剂量和治疗后肿瘤监测方面的主要注意事项。
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引用次数: 0
Risk assessment and prediction of occult uterine sarcoma in patients with presumed uterine fibroids before high-intensity focused ultrasound treatment. 高强度聚焦超声治疗前对子宫肌瘤假定患者隐匿性子宫肉瘤的风险评估和预测。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-07-31 DOI: 10.1080/02656736.2024.2385600
Qian Wang, Zhenjiang Lin, Xiaogang Zhu, Yangyang Wang, Ying Zhang, Min He, Lian Zhang

Objective: To develop a diagnostic model for predicting occult uterine sarcoma in patients with presumed uterine fibroids.

Materials and methods: We retrospectively reviewed 41631 patients with presumed uterine fibroids who presented for HIFU treatment in 13 hospitals between November 2008 and October 2023. Of these patients, 27 with occult uterine sarcoma and 54 with uterine fibroids were enrolled. Univariate analysis and multivariate logistics regression analysis were used to determine the independent risk factors for the diagnosis of occult uterine sarcoma. A prediction model was constructed based on the coefficients of the risk factors.

Results: The multivariate analysis revealed abnormal vaginal bleeding, ill-defined boundary of tumor, hyperintensity on T2WI, and central unenhanced areas as independent risk factors. A scoring system was created to assess for occult uterine sarcoma risk. The score for abnormal vaginal bleeding was 56. The score for ill-defined lesion boundary was 90. The scores for lesions with hypointensity, isointensity signal/heterogeneous signal intensity, and hyperintensity on T2WI were 0, 42, and 93, respectively. The scores for lesions without enhancement on the mass margin, uniform enhancement of tumor, and no enhancement in the center of tumor were 0, 20, and 100, respectively. Patients with a higher total score implied a higher likelihood of a diagnosis of occult uterine sarcoma than that of patients with a lower score. The established model showed good predictive efficacy.

Conclusions: Our results demonstrated that the diagnostic prediction model can be used to evaluate the risk of uterine sarcoma in patients with presumed uterine fibroids.

目的:建立一个诊断模型,用于预测子宫肌瘤患者的隐匿性子宫肉瘤:建立一个诊断模型,用于预测假定子宫肌瘤患者的隐匿性子宫肉瘤:我们回顾性研究了 2008 年 11 月至 2023 年 10 月期间在 13 家医院接受 HIFU 治疗的 41631 例子宫肌瘤患者。其中,27 例为隐匿性子宫肉瘤患者,54 例为子宫肌瘤患者。采用单变量分析和多变量物流回归分析来确定隐匿性子宫肉瘤诊断的独立风险因素。根据风险因素的系数建立了预测模型:多变量分析显示,异常阴道出血、肿瘤边界不清晰、T2WI高密度和中心未增强区是独立的风险因素。我们建立了一个评分系统来评估隐匿性子宫肉瘤的风险。异常阴道出血的评分为 56 分。病灶边界不清的评分为 90 分。T2WI 低密度、等密度信号/异质信号强度和高密度病变的得分分别为 0、42 和 93 分。肿块边缘无强化、肿瘤均匀强化和肿瘤中心无强化的病灶得分分别为 0、20 和 100。总分较高的患者被诊断为隐匿性子宫肉瘤的可能性高于总分较低的患者。所建立的模型具有良好的预测效果:我们的研究结果表明,诊断预测模型可用于评估子宫肌瘤患者罹患子宫肉瘤的风险。
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引用次数: 0
In vivo electrical properties of the healthy liver and the hepatic tumor in a mouse model between 1 Hz and 1 MHz during a thermal treatment. 在热处理过程中,健康肝脏和肝肿瘤小鼠模型在 1 赫兹和 1 兆赫之间的体内电特性。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-09-01 DOI: 10.1080/02656736.2024.2396122
Yitong Guo, Weice Wang, Weichen Li, Junyao Li, Mingxu Zhu, Ruteng Song, Wenjing Zhu, Lei Wang, Zhenyu Ji, Xuetao Shi

Objective: Understansding the changing patterns of in vivo electrical properties for the target tissue is crucial for the accurate temperature monitoring and the treatment efficacy in thermal therapy. Our research aims to investigate the changing patterns and the reversibility of in vivo electrical properties for both healthy livers and liver tumors in a mouse model over a frequency range of 1 Hz to 1 MHz at temperatures between 30 °C to 90 °C.

Methods and materials: The mice were anesthetized and the target organ was exposed. An 808-nm near-infrared laser was employed as the heating source to heat the organ in vivo. The four-needle electrode, connected to an impedance analyzer, was utilized to obtain the impedance at varying temperatures, which were monitored by a thermocouple.

Results: The findings indicated a gradual decline in impedance with an increase in temperature. Furthermore, the impedance was normalized to that at 30 °C, and the real part of the normalized impedance was defined as the k-values, which range from 0 to 1. The results demonstrated a linear correlation between k-values and temperatures (R2 > 0.9 for livers and R2 > 0.8 for tumors). Significant differences were observed between livers and tumors at 1, 10 and 50 kHz (p < 0.05). Additionally, it was demonstrated that the electrical properties could be reversed when the temperature was below or equal to 45 °C.

Conclusion: We believe that these results will contribute to the advancement of radiofrequency ablation systems and the development of techniques for temperature monitoring during liver thermal treatment.

目的:了解目标组织体内电特性的变化规律对于准确监测温度和热疗疗效至关重要。我们的研究旨在研究小鼠模型中健康肝脏和肝脏肿瘤在 30 °C 至 90 °C 温度下,在 1 Hz 至 1 MHz 频率范围内体内电特性的变化规律和可逆性:麻醉小鼠并暴露靶器官。采用波长为 808 纳米的近红外激光作为加热源,对体内器官进行加热。利用连接阻抗分析仪的四针电极获得不同温度下的阻抗,并通过热电偶进行监测:结果:研究结果表明,随着温度的升高,阻抗逐渐下降。此外,阻抗被归一化为 30 °C 时的阻抗,归一化阻抗的实部被定义为 k 值,范围在 0 至 1 之间。结果表明,k 值与温度呈线性相关(肝脏的 R2 > 0.9,肿瘤的 R2 > 0.8)。在 1、10 和 50 kHz 频率下,肝脏和肿瘤之间存在显著差异(p):我们相信,这些结果将有助于射频消融系统的进步和肝脏热处理期间温度监测技术的发展。
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引用次数: 0
Time series analysis combined with transcriptome sequencing to explore characteristic genes and potential molecular mechanisms associated with ultrasound-guided microwave ablation of glioma. 时间序列分析与转录组测序相结合,探索与胶质瘤超声引导下微波消融相关的特征基因和潜在分子机制。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-09-24 DOI: 10.1080/02656736.2024.2406889
Qian Zhang, Guangfei Yang, Ruijiao Chang, Fuxia Wang, Tao Han, Jin Tian, Wen Wang

Objective: This study aimed to explore marker genes and their potential molecular mechanisms involved in US-guided MWA for glioma in mice.

Method: The differentially expressed genes (DEGs1 and DEGs2) and lncRNAs (DELs1 and DELs2) were obtained between Non (glioma tissues without MWA) and T0 groups (0h after MWA), as well as between Non and T24 groups (24h after MWA). The down-regulation cluster genes (CONDOWNDEGs) and upregulation cluster genes (CONUPDEGs) were identified by time series analysis. Candidate genes were obtained by overlapping CONDOWNDEGs with downregulation DEGs (DOWNDEGs)1 and DOWNDEGs2, as well as CONUPDEGs with up-regulation DEGs (UPDEGs)1 and UPDEGs2. The expressions of immune checkpoints and inflammatory factors, gene set enrichment analysis (GSEA), and protein subcellular localization were performed. The eXpression2Kinases (X2K), GeneMANIA, transcription factor (TF), and competing endogenous (ce) RNA regulatory networks were conducted. The expression of marker genes was validated by quantitative real-time polymerase chain reaction (qRT-PCR).

Results: Five marker genes (IL32, VCAM1, IL34, NFKB1 and CXCL13) were identified, which were connected with immune-related functions. Two immune checkpoints (CD96 and TIGIT) and six inflammatory factors played key roles in US-guided MWA for glioma. ceRNA regulatory networks revealed that miR-625-5p, miR-625-3p, miR-31-5p and miR-671-5p were associated with target genes. qRT-PCR indicated both IL32, VCAM1, and NFKB1 were potential markers under US-guided MWA-related time series analysis.

Conclusion: The use of US-guided MWA might be a practical method for influencing the function of target genes, regulating time frames to decrease inflammation, and stimulating immune responses in glioma therapy.

研究目的本研究旨在探索小鼠脑胶质瘤US-guided MWA的标记基因及其潜在的分子机制:方法:研究小鼠神经胶质瘤组织中的差异表达基因(DEGs1和DEGs2)和lncRNAs(DELs1和DELs2)。通过时间序列分析确定了下调集群基因(CONDOWNDEGs)和上调集群基因(CONUPDEGs)。通过将 CONDOWNDEGs 与下调 DEGs(DOWNDEGs)1 和 DOWNDEGs2 重叠,以及 CONUPDEGs 与上调 DEGs(UPDEGs)1 和 UPDEGs2 重叠,得到候选基因。对免疫检查点和炎症因子的表达、基因组富集分析(GSEA)和蛋白质亚细胞定位进行了分析。还进行了eXpression2Kinases(X2K)、GeneMANIA、转录因子(TF)和竞争性内源性(ce)RNA调控网络的分析。通过实时定量聚合酶链反应(qRT-PCR)验证了标记基因的表达:结果:发现了五个标记基因(IL32、VCAM1、IL34、NFKB1 和 CXCL13)与免疫相关功能有关。ceRNA调控网络显示,miR-625-5p、miR-625-3p、miR-31-5p和miR-671-5p与靶基因相关;qRT-PCR显示,IL32、VCAM1和NFKB1是US-guided MWA相关时间序列分析的潜在标记物:结论:在胶质瘤治疗中,使用 US 引导的 MWA 可能是影响靶基因功能、调节时间框架以减少炎症和刺激免疫反应的一种实用方法。
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引用次数: 0
Investigating the optimal maximum diameter of benign thyroid nodules for thermal ablation on the basis of complete disappearance rate. 以完全消失率为基础,研究热消融良性甲状腺结节的最佳最大直径。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-09-26 DOI: 10.1080/02656736.2024.2408374
Shi-Liang Cao, Wan-Ying Shi, Zhen-Long Zhao, Ying Wei, Na Yu, Jie Wu, Li-Li Peng, Yan Li, Ming-An Yu

Objective: Thermal ablation (TA) is a safe and effective treatment for benign thyroid nodules (BTNs). However, there has been no consensus on the optimal maximum diameter (MD) of BTNs for TA. This study aimed to identify the optimal MD of BTNs for TA based on complete disappearance rate after TA.

Materials and methods: This retrospective study included 639 BTNs treated with TA from June 2014 to January 2022. The complete disappearance rate of BTNs after TA was summarized, related influencing factors were explored, and the optimal MD of BTNs for TA was identified.

Results: At the final follow-up (median: 40 months, range: 24-95 months), the overall volume reduction rate was 95.4 ± 9.0%, and 50.5% of the BTNs (323/639) completely disappeared. The MD was significantly negatively correlated with complete disappearance (odds ratio 0.89, 95% confidence interval 0.87-0.92; p < 0.001). Calcification, comet-tail artifacts, multilocular cysts, and composition of BTNs, as well as diabetes were negatively correlated with complete disappearance. Restricted cubic spline indicated that an MD of 25.0 mm was the optimal threshold of BTNs for TA, which was confirmed by subgroup logistic regression analysis. Compared with BTNs with MD ≤ 25.0 mm, those with MD > 25.0 mm had a greater complication rate (6.5% vs. 2.4%, p = 0.012).

Conclusions: The MD of BTNs was negatively correlated with complete disappearance after TA; an MD > 25.0 mm indicated a reduced likelihood of complete disappearance compared with an MD ≤ 25.0 mm. An MD of 25.0 mm is an appropriate threshold of BTNs for TA on the basis of complete disappearance rate.

目的:热消融(TA)是治疗甲状腺良性结节(BTN)的一种安全有效的方法。然而,关于热消融治疗甲状腺良性结节的最佳最大直径(MD)尚未达成共识。本研究旨在根据TA术后完全消失率确定TA治疗BTN的最佳最大直径:这项回顾性研究纳入了 2014 年 6 月至 2022 年 1 月期间接受 TA 治疗的 639 例 BTN。总结了TA术后BTN的完全消失率,探讨了相关影响因素,并确定了TA术后BTN的最佳MD:最终随访(中位数:40 个月,范围:24-95 个月)时,总体体积缩小率为 95.4 ± 9.0%,50.5% 的 BTNs(323/639)完全消失。MD 与完全消失呈明显负相关(几率比 0.89,95% 置信区间 0.87-0.92;P 25.0 mm 的并发症发生率更高(6.5% 对 2.4%,P = 0.012):结论:BTN的MD与TA术后完全消失呈负相关;与MD≤25.0毫米相比,MD>25.0毫米表明完全消失的可能性降低。根据完全消失率,25.0 毫米的 MD 是 BTN 进行 TA 的合适阈值。
{"title":"Investigating the optimal maximum diameter of benign thyroid nodules for thermal ablation on the basis of complete disappearance rate.","authors":"Shi-Liang Cao, Wan-Ying Shi, Zhen-Long Zhao, Ying Wei, Na Yu, Jie Wu, Li-Li Peng, Yan Li, Ming-An Yu","doi":"10.1080/02656736.2024.2408374","DOIUrl":"https://doi.org/10.1080/02656736.2024.2408374","url":null,"abstract":"<p><strong>Objective: </strong>Thermal ablation (TA) is a safe and effective treatment for benign thyroid nodules (BTNs). However, there has been no consensus on the optimal maximum diameter (MD) of BTNs for TA. This study aimed to identify the optimal MD of BTNs for TA based on complete disappearance rate after TA.</p><p><strong>Materials and methods: </strong>This retrospective study included 639 BTNs treated with TA from June 2014 to January 2022. The complete disappearance rate of BTNs after TA was summarized, related influencing factors were explored, and the optimal MD of BTNs for TA was identified.</p><p><strong>Results: </strong>At the final follow-up (median: 40 months, range: 24-95 months), the overall volume reduction rate was 95.4 ± 9.0%, and 50.5% of the BTNs (323/639) completely disappeared. The MD was significantly negatively correlated with complete disappearance (odds ratio 0.89, 95% confidence interval 0.87-0.92; <i>p</i> < 0.001). Calcification, comet-tail artifacts, multilocular cysts, and composition of BTNs, as well as diabetes were negatively correlated with complete disappearance. Restricted cubic spline indicated that an MD of 25.0 mm was the optimal threshold of BTNs for TA, which was confirmed by subgroup logistic regression analysis. Compared with BTNs with MD ≤ 25.0 mm, those with MD > 25.0 mm had a greater complication rate (6.5% vs. 2.4%, <i>p</i> = 0.012).</p><p><strong>Conclusions: </strong>The MD of BTNs was negatively correlated with complete disappearance after TA; an MD > 25.0 mm indicated a reduced likelihood of complete disappearance compared with an MD ≤ 25.0 mm. An MD of 25.0 mm is an appropriate threshold of BTNs for TA on the basis of complete disappearance rate.</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":"142346204","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
A novel scoring system based on magnetic resonance imaging for the prediction of the difficulty of ultrasound-guided high-intensity focused ultrasound ablation for uterine fibroids. 基于磁共振成像的新型评分系统,用于预测超声引导下高强度聚焦超声消融治疗子宫肌瘤的难度。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-08-04 DOI: 10.1080/02656736.2024.2386098
Ying Zhang, Qian Wang, Yangyang Wang, Rong Ma, Min He, Lian Zhang

Objective: To develop a novel scoring system based on magnetic resonance imaging (MRI) for predicting the difficulty of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for uterine fibroids.

Materials and methods: A total of 637 patients with uterine fibroids were enrolled. Sonication time, non-perfused volume ratio (NPVR), and ultrasound energy delivered for ablating 1 mm3 of fibroid tissue volume (E/V) were each classified as three levels and assigned scores from 0 to 2, respectively. Treatment difficulty level was then assessed by adding up the scores of sonication time, NPVR and E/V for each patient. The patients with score lower than 3 were categorized into low difficulty group, with score equal to or greater than 3 were categorized into high difficulty group. The potential predictors for treatment difficulty were compared between the two groups. Multifactorial logistic regression analysis model was created by analyzing the variables. The difficulty score system was developed using the beta coefficients of the logistic model.

Results: Signal intensity on T2WI, fibroid location index, largest diameter of fibroids, abdominal wall thickness, homogeneity of the signal of fibroids, and uterine position were independent influencing factors for the difficulty of USgHIFU for uterine fibroids. A prediction equation was obtained: difficulty score = 17 × uterine position (anteverted =0, retroverted =1)+71 × signal intensity (hypointense = 0, isointense/hyperintense = 1) +8 × enhancement (homogenous = 0, heterogeneous = 1)+25×(largest diameter of fibroids-20) +35 × (fibroid location index -0.2) +1×(abdominal wall thickness -5).

Conclusions: This scoring system established based on MRI findings can be used to reliably predict the difficulty level of USgHIFU treatment of uterine fibroids.

目的:开发一种基于磁共振成像(MRI)的新型评分系统,用于预测超声引导下高强度聚焦超声(USgHIFU)消融治疗子宫肌瘤的难度:共纳入 637 例子宫肌瘤患者。声波治疗时间、非灌注容积比(NPVR)和消融 1 mm3 子宫肌瘤组织容积所需的超声能量(E/V)被分为三个等级,并分别从 0 到 2 之间打分。然后将每位患者的超声时间、NPVR 和 E/V 分数相加,评估治疗难度。得分低于 3 分的患者被归为低难度组,得分等于或大于 3 分的患者被归为高难度组。比较两组患者治疗难度的潜在预测因素。通过分析这些变量,建立了多因素逻辑回归分析模型。利用逻辑模型的贝塔系数建立了难度评分系统:结果:T2WI信号强度、肌瘤位置指数、肌瘤最大直径、腹壁厚度、肌瘤信号均匀性和子宫位置是USgHIFU治疗子宫肌瘤难度的独立影响因素。得出的预测方程为:难度评分=17×子宫位置(前倾=0,后倾=1)+71×信号强度(低密度=0,等密度/高密度=1)+8×增强(同质=0,异质=1)+25×(肌瘤最大直径-20)+35×(肌瘤位置指数-0.2)+1×(腹壁厚度-5):根据核磁共振成像结果建立的这一评分系统可用于可靠地预测 USgHIFU 治疗子宫肌瘤的难度。
{"title":"A novel scoring system based on magnetic resonance imaging for the prediction of the difficulty of ultrasound-guided high-intensity focused ultrasound ablation for uterine fibroids.","authors":"Ying Zhang, Qian Wang, Yangyang Wang, Rong Ma, Min He, Lian Zhang","doi":"10.1080/02656736.2024.2386098","DOIUrl":"https://doi.org/10.1080/02656736.2024.2386098","url":null,"abstract":"<p><strong>Objective: </strong>To develop a novel scoring system based on magnetic resonance imaging (MRI) for predicting the difficulty of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for uterine fibroids.</p><p><strong>Materials and methods: </strong>A total of 637 patients with uterine fibroids were enrolled. Sonication time, non-perfused volume ratio (NPVR), and ultrasound energy delivered for ablating 1 mm<sup>3</sup> of fibroid tissue volume (E/V) were each classified as three levels and assigned scores from 0 to 2, respectively. Treatment difficulty level was then assessed by adding up the scores of sonication time, NPVR and E/V for each patient. The patients with score lower than 3 were categorized into low difficulty group, with score equal to or greater than 3 were categorized into high difficulty group. The potential predictors for treatment difficulty were compared between the two groups. Multifactorial logistic regression analysis model was created by analyzing the variables. The difficulty score system was developed using the beta coefficients of the logistic model.</p><p><strong>Results: </strong>Signal intensity on T2WI, fibroid location index, largest diameter of fibroids, abdominal wall thickness, homogeneity of the signal of fibroids, and uterine position were independent influencing factors for the difficulty of USgHIFU for uterine fibroids. A prediction equation was obtained: difficulty score = 17 × uterine position (anteverted =0, retroverted =1)+71 × signal intensity (hypointense = 0, isointense/hyperintense = 1) +8 × enhancement (homogenous = 0, heterogeneous = 1)+25×(largest diameter of fibroids-20) +35 × (fibroid location index -0.2) +1×(abdominal wall thickness -5).</p><p><strong>Conclusions: </strong>This scoring system established based on MRI findings can be used to reliably predict the difficulty level of USgHIFU treatment of uterine fibroids.</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":"141889186","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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