Pub Date : 2024-01-01Epub Date: 2024-06-16DOI: 10.1080/02656736.2024.2365974
Yuchun He, Min Wu, Xu Guo, Feng Ran, Haiyan Li, Daibi Zhang, Yaqin Wang, Jin Zeng, Xuelian Chen, Linghui Zhai, Xiaohui Li, Tingting Lei
Purpose: To investigate the feasibility, safety and efficacy of high intensity focused ultrasound ablation (HIFU) as a preoperative treatment for challenging hysteroscopic myomectomies.
Materials and methods: A total of 75 patients diagnosed with types 0-III of uterine fibroids were enrolled. Based on the Size, Topography, Extension of the base, Penetration and lateral Wall position (STEPW) classification scoring system, 25 cases with a score ≥ 5 points were treated with HIFU followed by hysteroscopic myomectomy (HIFU + HM group), whereas 50 cases with a score < 5 points were treated with hysteroscopic myomectomy (HM group).
Results: The median preoperative STEPW score was 7 in the HIFU + HM group and 2 in the HM group. The average non-perfused volume (NPV) ratio achieved in fibroids after HIFU was 86.87%. Patients in the HIFU + HM group underwent hysteroscopic myomectomy one to four days after HIFU, and downgrading was observed in 81.81% of fibroids. The operation time for patients in the HIFU + HM group was 73 min and the success rate of myomectomy in a single attempt was 60%. The volume of distention medium used during the operation was greater in the HIFU + HM group than in the HM group (15,500 ml vs. 7500 ml). No significant difference was observed between the two groups in terms of intraoperative blood loss, the incidence of intraoperative and postoperative complications, menstrual volume score, or uterine fibroid quality of life score.
Conclusion: HIFU can be utilized as a preoperative treatment for large submucosal fibroids prior to hysteroscopic myomectomy. HIFU offers a novel approach in the management of this subset of patients.
{"title":"Feasibility, safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomy.","authors":"Yuchun He, Min Wu, Xu Guo, Feng Ran, Haiyan Li, Daibi Zhang, Yaqin Wang, Jin Zeng, Xuelian Chen, Linghui Zhai, Xiaohui Li, Tingting Lei","doi":"10.1080/02656736.2024.2365974","DOIUrl":"https://doi.org/10.1080/02656736.2024.2365974","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the feasibility, safety and efficacy of high intensity focused ultrasound ablation (HIFU) as a preoperative treatment for challenging hysteroscopic myomectomies.</p><p><strong>Materials and methods: </strong>A total of 75 patients diagnosed with types 0-III of uterine fibroids were enrolled. Based on the Size, Topography, Extension of the base, Penetration and lateral Wall position (STEPW) classification scoring system, 25 cases with a score ≥ 5 points were treated with HIFU followed by hysteroscopic myomectomy (HIFU + HM group), whereas 50 cases with a score < 5 points were treated with hysteroscopic myomectomy (HM group).</p><p><strong>Results: </strong>The median preoperative STEPW score was 7 in the HIFU + HM group and 2 in the HM group. The average non-perfused volume (NPV) ratio achieved in fibroids after HIFU was 86.87%. Patients in the HIFU + HM group underwent hysteroscopic myomectomy one to four days after HIFU, and downgrading was observed in 81.81% of fibroids. The operation time for patients in the HIFU + HM group was 73 min and the success rate of myomectomy in a single attempt was 60%. The volume of distention medium used during the operation was greater in the HIFU + HM group than in the HM group (15,500 ml vs. 7500 ml). No significant difference was observed between the two groups in terms of intraoperative blood loss, the incidence of intraoperative and postoperative complications, menstrual volume score, or uterine fibroid quality of life score.</p><p><strong>Conclusion: </strong>HIFU can be utilized as a preoperative treatment for large submucosal fibroids prior to hysteroscopic myomectomy. HIFU offers a novel approach in the management of this subset of patients.</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":"141330887","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}
Purpose: To explore the feasibility and safety of a microwave ablation (MWA) strategy involving intraductal chilled saline perfusion (ICSP) via percutaneous transhepatic cholangial drainage (PTCD) combined with ultrasound-magnetic resonance (US-MR) fusion imaging for liver tumors proximal to the hilar bile ducts (HBDs).
Methods: Patients with liver tumors proximal to the HBDs (≤5 mm) who underwent MWA at our hospital between June 2020 and April 2023 were retrospectively analyzed. The strategy of US-MR fusion imaging combined with PTCD-ICSP was used to assist the MWA procedures. The technical success, technique efficacy, local tumor progression, intrahepatic distant recurrence and complications were recorded and analyzed.
Results: In total, 12 patients with 12 liver tumors were retrospectively enrolled in this study. US-MR fusion imaging was utilized in all patients, and PTCD-ICSP assistance was successfully used for 4 nodules abutting HBDs (0 mm). The rates of technical success, technique efficacy, local tumor progression and intrahepatic distant recurrence were 91.7%, 83.3%, 0% and 8.3%, respectively. The major complication of biliary infection occurred in only one patient who had previously undergone left hemihepatectomy and bile-intestinal anastomosis.
Conclusions: MWA for liver tumors proximal to HBDs assisted by US-MR fusion imaging combined with PTCD-ICSP was feasible and safe. This strategy made MWA of liver tumors abutting HBDs possible.
{"title":"Ultrasound-MR fusion imaging combined with intraductal cooling via PTCD during microwave ablation of perihilar liver tumors: a retrospective pilot study.","authors":"Jiangyu Guo, Shuang Liang, Huahui Liu, Liping Luo, Shanshan Wu, Sainan Guan, Ying Liu, Yongyan He, Erjiao Xu, Ronghua Yan","doi":"10.1080/02656736.2024.2361708","DOIUrl":"https://doi.org/10.1080/02656736.2024.2361708","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the feasibility and safety of a microwave ablation (MWA) strategy involving intraductal chilled saline perfusion (ICSP) via percutaneous transhepatic cholangial drainage (PTCD) combined with ultrasound-magnetic resonance (US-MR) fusion imaging for liver tumors proximal to the hilar bile ducts (HBDs).</p><p><strong>Methods: </strong>Patients with liver tumors proximal to the HBDs (≤5 mm) who underwent MWA at our hospital between June 2020 and April 2023 were retrospectively analyzed. The strategy of US-MR fusion imaging combined with PTCD-ICSP was used to assist the MWA procedures. The technical success, technique efficacy, local tumor progression, intrahepatic distant recurrence and complications were recorded and analyzed.</p><p><strong>Results: </strong>In total, 12 patients with 12 liver tumors were retrospectively enrolled in this study. US-MR fusion imaging was utilized in all patients, and PTCD-ICSP assistance was successfully used for 4 nodules abutting HBDs (0 mm). The rates of technical success, technique efficacy, local tumor progression and intrahepatic distant recurrence were 91.7%, 83.3%, 0% and 8.3%, respectively. The major complication of biliary infection occurred in only one patient who had previously undergone left hemihepatectomy and bile-intestinal anastomosis.</p><p><strong>Conclusions: </strong>MWA for liver tumors proximal to HBDs assisted by US-MR fusion imaging combined with PTCD-ICSP was feasible and safe. This strategy made MWA of liver tumors abutting HBDs possible.</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":"141758590","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: 2024-06-23DOI: 10.1080/02656736.2024.2359496
Shufang Xiang, Juan Li, Mei Zhang
Background: Microwave ablation (MWA) is a widely adopted treatment technique for hepatocellular carcinoma (HCC). However, MWA alone is of limited use and has a high recurrence rate. Transforming growth factor-β1 (TGF-β1) is recognized as a potential therapeutic target for HCC patients. Therefore, this study was designed to investigate whether the TGF-β1 inhibitor could increase the efficacy of MWA therapy for HCC treatment.
Methods: In vitro, HCC cells challenged with TGF-β1 inhibitor (SB-525334), or normal saline were then heated by microwave. Methyl tetrazolium assays were performed to detect cell survival rate and half-maximal drug inhibitory concentration (IC50). Cell viability and apoptosis were detected by cell counting kit-8 assays, flow cytometry and western blotting. In vivo, the mice injected with HepG2 cells received oral gavage of SB-525334 (20 mg/kg) or normal saline and MWA at a power of 15 W. Tumor volume was recorded. Expression of Ki67 and apoptosis-related proteins were detected by immunohistochemistry and western blotting. TUNEL assays were used to detect cell death ratio. Histopathological changes were examined by hematoxylin and eosin staining. The mechanisms associated with the function of MWA combined with TGF-β1 inhibitor in HCC development were explored by western blotting.
Results: Combination of MWA and SB-525334 decreased the survival rate and promoted the apoptosis of HCC cells compared with MWA alone. SB-525334 enhanced the suppressive effect of MWA on tumor growth and amplified cell apoptosis. Mechanistically, MWA collaborated with SB-525334 inhibitor inactivated the TGF-β1/Smad2/Smad3 pathway.
Conclusion: TGF-β1 inhibitor enhances the therapeutic effect of MWA on HCC.
背景:微波消融(MWA)是一种广泛采用的肝细胞癌(HCC)治疗技术。然而,单用微波消融术的作用有限,而且复发率较高。转化生长因子-β1(TGF-β1)被认为是 HCC 患者的潜在治疗靶点。因此,本研究旨在探讨 TGF-β1 抑制剂能否提高 MWA 治疗 HCC 的疗效:方法:在体外,用 TGF-β1 抑制剂(SB-525334)或生理盐水处理 HCC 细胞,然后用微波加热。用甲基四氮唑试验检测细胞存活率和半最大药物抑制浓度(IC50)。细胞活力和细胞凋亡通过细胞计数试剂盒-8测定法、流式细胞术和免疫印迹法进行检测。在体内,注射 HepG2 细胞的小鼠口服 SB-525334(20 毫克/千克)或生理盐水和功率为 15 瓦的 MWA。记录肿瘤体积。通过免疫组化和免疫印迹检测 Ki67 和凋亡相关蛋白的表达。TUNEL检测法用于检测细胞死亡比率。组织病理学变化通过苏木精和伊红染色进行检测。通过免疫印迹法探讨了 MWA 与 TGF-β1 抑制剂联合作用于 HCC 的相关机制:结果:与单独使用 MWA 相比,MWA 与 SB-525334 联合使用可降低 HCC 细胞的存活率并促进其凋亡。SB-525334增强了MWA对肿瘤生长的抑制作用,并扩大了细胞凋亡。从机理上讲,MWA与SB-525334抑制剂共同作用,使TGF-β1/Smad2/Smad3通路失活:结论:TGF-β1 抑制剂增强了 MWA 对 HCC 的治疗效果。
{"title":"TGF-β1 inhibitor enhances the therapeutic effect of microwave ablation on hepatocellular carcinoma.","authors":"Shufang Xiang, Juan Li, Mei Zhang","doi":"10.1080/02656736.2024.2359496","DOIUrl":"10.1080/02656736.2024.2359496","url":null,"abstract":"<p><strong>Background: </strong>Microwave ablation (MWA) is a widely adopted treatment technique for hepatocellular carcinoma (HCC). However, MWA alone is of limited use and has a high recurrence rate. Transforming growth factor-β1 (TGF-β1) is recognized as a potential therapeutic target for HCC patients. Therefore, this study was designed to investigate whether the TGF-β1 inhibitor could increase the efficacy of MWA therapy for HCC treatment.</p><p><strong>Methods: </strong>In vitro, HCC cells challenged with TGF-β1 inhibitor (SB-525334), or normal saline were then heated by microwave. Methyl tetrazolium assays were performed to detect cell survival rate and half-maximal drug inhibitory concentration (IC50). Cell viability and apoptosis were detected by cell counting kit-8 assays, flow cytometry and western blotting. In vivo, the mice injected with HepG2 cells received oral gavage of SB-525334 (20 mg/kg) or normal saline and MWA at a power of 15 W. Tumor volume was recorded. Expression of Ki67 and apoptosis-related proteins were detected by immunohistochemistry and western blotting. TUNEL assays were used to detect cell death ratio. Histopathological changes were examined by hematoxylin and eosin staining. The mechanisms associated with the function of MWA combined with TGF-β1 inhibitor in HCC development were explored by western blotting.</p><p><strong>Results: </strong>Combination of MWA and SB-525334 decreased the survival rate and promoted the apoptosis of HCC cells compared with MWA alone. SB-525334 enhanced the suppressive effect of MWA on tumor growth and amplified cell apoptosis. Mechanistically, MWA collaborated with SB-525334 inhibitor inactivated the TGF-β1/Smad2/Smad3 pathway.</p><p><strong>Conclusion: </strong>TGF-β1 inhibitor enhances the therapeutic effect of MWA on HCC.</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":"141442658","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: 2024-07-16DOI: 10.1080/02656736.2024.2379983
Yan Hu, Wei Zhou, Shangyan Xu, Wanru Jia, Guiping Zhang, Yuan Cao, Qianru Zhang, Lu Zhang, Weiwei Zhan
As the utilization of high-resolution imaging modalities, such as ultrasound, becomes increasingly prevalent, there has been a swift rise in the detection rates of malignant thyroid nodules (MTC). Surgery remains the cornerstone of standard treatment for these nodules. However, the advent and evolution of thermal ablation (TA) techniques, encompassing radiofrequency ablation, laser ablation, and microwave ablation, have emerged as a novel therapeutic avenue for patients with MTC, particularly for those deemed unsuitable for surgery due to high risks or for those who refuse surgery. Presently, TA has been validated as an efficacious and safe intervention for both benign thyroid nodules and a subset of MTC. An expanding body of research has been dedicated to broadening the applicability of TA, initially from recurrent thyroid cancer and lymph nodes to now encompass isolated papillary thyroid microcarcinomas (PTMC) alongside a comprehensive exploration into the expanded parameters such as size, number, and location of PTMC, and its applicability in other types of thyroid cancer. This review provides a detailed synthesis of the clinical evidence about the use of TA in the management of MTC, as endorsed by current guidelines. It further delves into the ongoing research efforts aimed at extending its indications and discusses the prospective implications and challenges of integrating TA into the clinical management paradigms for MTC.
随着超声等高分辨率成像模式的日益普及,恶性甲状腺结节(MTC)的检出率也迅速上升。手术仍然是治疗这些结节的标准基石。然而,随着热消融(TA)技术的出现和发展,包括射频消融、激光消融和微波消融在内的热消融技术已成为 MTC 患者的一种新的治疗途径,尤其适用于那些因高风险而不适合手术或拒绝手术的患者。目前,TA已被证实是一种对良性甲状腺结节和部分MTC有效且安全的干预方法。越来越多的研究致力于扩大TA的适用范围,从最初的复发性甲状腺癌和淋巴结到现在的孤立性甲状腺乳头状微癌(PTMC),同时还对PTMC的大小、数量和位置等扩展参数及其在其他类型甲状腺癌中的适用性进行了全面探索。本综述详细综述了有关在 MTC 治疗中使用 TA 的临床证据,并得到了现行指南的认可。它进一步深入探讨了目前旨在扩大TA适应症的研究工作,并讨论了将TA纳入MTC临床管理范例的前瞻性意义和挑战。
{"title":"Thermal ablation for the treatment of malignant thyroid nodules: present and future.","authors":"Yan Hu, Wei Zhou, Shangyan Xu, Wanru Jia, Guiping Zhang, Yuan Cao, Qianru Zhang, Lu Zhang, Weiwei Zhan","doi":"10.1080/02656736.2024.2379983","DOIUrl":"https://doi.org/10.1080/02656736.2024.2379983","url":null,"abstract":"<p><p>As the utilization of high-resolution imaging modalities, such as ultrasound, becomes increasingly prevalent, there has been a swift rise in the detection rates of malignant thyroid nodules (MTC). Surgery remains the cornerstone of standard treatment for these nodules. However, the advent and evolution of thermal ablation (TA) techniques, encompassing radiofrequency ablation, laser ablation, and microwave ablation, have emerged as a novel therapeutic avenue for patients with MTC, particularly for those deemed unsuitable for surgery due to high risks or for those who refuse surgery. Presently, TA has been validated as an efficacious and safe intervention for both benign thyroid nodules and a subset of MTC. An expanding body of research has been dedicated to broadening the applicability of TA, initially from recurrent thyroid cancer and lymph nodes to now encompass isolated papillary thyroid microcarcinomas (PTMC) alongside a comprehensive exploration into the expanded parameters such as size, number, and location of PTMC, and its applicability in other types of thyroid cancer. This review provides a detailed synthesis of the clinical evidence about the use of TA in the management of MTC, as endorsed by current guidelines. It further delves into the ongoing research efforts aimed at extending its indications and discusses the prospective implications and challenges of integrating TA into the clinical management paradigms for MTC.</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":"141626687","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: 2024-07-11DOI: 10.1080/02656736.2024.2352545
Theresa V Feddersen, Juan A Hernandez-Tamames, Margarethus M Paulides, Michiel Kroesen, Gerard C van Rhoon, Dirk H J Poot
Magnetic resonance thermometry (MRT) can measure in-vivo 3D-temperature changes in real-time and noninvasively. However, for the oropharynx region and the entire head and neck, motion potentially introduces large artifacts. Considering long treatment times of 60-90 min, this study aims to evaluate whether MRT around the oropharynx is clinically feasible for hyperthermia treatments and quantify the effects of breathing and swallowing on MRT performance. A 3D-ME-FGRE sequence was used in a phantom cooling down and around the oropharynx of five volunteers over ∼75 min. The imaging protocol consisted of imaging with acceleration (ARC = 2), number of image averages (NEX = 1,2 and 3). For volunteers, the acquisitions included a breath-hold scan and scans with deliberate swallowing. MRT performance was quantified in neck muscle, spinal cord and masseter muscle, using mean average error (MAE), mean error (ME) and spatial standard deviation (SD). In phantom, an increase in NEX leads to a significant decrease in SD, but MAE and ME were unchanged. No significant difference was found in volunteers between the different scans. There was a significant difference between the regions evaluated: neck muscle had the best MAE (=1.96 °C) and SD (=0.82 °C), followed by spinal cord (MAE = 3.17 °C, SD = 0.92 °C) and masseter muscle (MAE = 4.53 °C, SD = 1.16 °C). Concerning the ME, spinal cord did best, then neck muscle and masseter muscle, with values of -0.64 °C, 1.15 °C and -3.05 °C respectively. Breathing, swallowing, and different ways of imaging (acceleration and NEX) do not significantly influence the MRT performance in the oropharynx region. The ROI selected however, leads to significant differences.
{"title":"Magnetic resonance thermometry for hyperthermia in the oropharynx region.","authors":"Theresa V Feddersen, Juan A Hernandez-Tamames, Margarethus M Paulides, Michiel Kroesen, Gerard C van Rhoon, Dirk H J Poot","doi":"10.1080/02656736.2024.2352545","DOIUrl":"https://doi.org/10.1080/02656736.2024.2352545","url":null,"abstract":"<p><p>Magnetic resonance thermometry (MRT) can measure in-vivo 3D-temperature changes in real-time and noninvasively. However, for the oropharynx region and the entire head and neck, motion potentially introduces large artifacts. Considering long treatment times of 60-90 min, this study aims to evaluate whether MRT around the oropharynx is clinically feasible for hyperthermia treatments and quantify the effects of breathing and swallowing on MRT performance. A 3D-ME-FGRE sequence was used in a phantom cooling down and around the oropharynx of five volunteers over ∼75 min. The imaging protocol consisted of imaging with acceleration (ARC = 2), number of image averages (NEX = 1,2 and 3). For volunteers, the acquisitions included a breath-hold scan and scans with deliberate swallowing. MRT performance was quantified in neck muscle, spinal cord and masseter muscle, using mean average error (MAE), mean error (ME) and spatial standard deviation (SD). In phantom, an increase in NEX leads to a significant decrease in SD, but MAE and ME were unchanged. No significant difference was found in volunteers between the different scans. There was a significant difference between the regions evaluated: neck muscle had the best MAE (=1.96 °C) and SD (=0.82 °C), followed by spinal cord (MAE = 3.17 °C, SD = 0.92 °C) and masseter muscle (MAE = 4.53 °C, SD = 1.16 °C). Concerning the ME, spinal cord did best, then neck muscle and masseter muscle, with values of -0.64 °C, 1.15 °C and -3.05 °C respectively. Breathing, swallowing, and different ways of imaging (acceleration and NEX) do not significantly influence the MRT performance in the oropharynx region. The ROI selected however, leads to significant differences.</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":"141590270","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}
Purpose: Caesarean scar pregnancy (CSP) presents a significant clinical challenge owing to the associated risks of uterine scar rupture, severe haemorrhage and adverse maternal outcomes. This study aimed to assess the safety and efficacy of combining high-intensity focused ultrasound (HIFU) with suction curettage for treating CSP.
Methods: We conducted a comprehensive search in four databases, namely PubMed, Web of Science, Embase and Cochrane Library, to identify published studies evaluating the use of HIFU combined with suction curettage to treat CSP. Intraoperative blood loss, treatment success rate, and reproductive results were the primary outcomes assessed.
Results: A total of 18 studies involving 1251 patients with CSP, all of whom received preoperative HIFU therapy were included. The average hospital stay was 6.22 days, the intraoperative blood loss was 26.29 ml and the incidence of adverse events was 15.60%, including abdominal or lower limb pain, fever, vaginal bleeding, haematuria and vomiting. Furthermore, post-treatment follow-up showed that serum β-human chorionic gonadotropin levels were rapidly normalized (average of 25.48 days) and menstruation returned (average of 33.03 days). The treatment had a remarkable success rate of 97.60% and a subsequent pregnancy rate of 68.70%.
Conclusion: While the combination of HIFU and suction-curettage may induce common adverse effects such as lower abdominal or limb pain, these reactions typically do not necessitate therapeutic intervention. Additionally, the size of the gestational sac is a determinant of the procedure's success. In conclusion, HIFU combined with suction curettage demonstrates promising clinical efficacy, safety and favourable reproductive outcomes in managing CSP.
{"title":"Efficacy and safety of high-intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy: a systematic review and single-arm meta-analysis.","authors":"Yu Jiang, Yang Liu, Nian Liu, Shize Qin, Shuting Zhong, Xiaohua Huang","doi":"10.1080/02656736.2024.2310019","DOIUrl":"10.1080/02656736.2024.2310019","url":null,"abstract":"<p><strong>Purpose: </strong>Caesarean scar pregnancy (CSP) presents a significant clinical challenge owing to the associated risks of uterine scar rupture, severe haemorrhage and adverse maternal outcomes. This study aimed to assess the safety and efficacy of combining high-intensity focused ultrasound (HIFU) with suction curettage for treating CSP.</p><p><strong>Methods: </strong>We conducted a comprehensive search in four databases, namely PubMed, Web of Science, Embase and Cochrane Library, to identify published studies evaluating the use of HIFU combined with suction curettage to treat CSP. Intraoperative blood loss, treatment success rate, and reproductive results were the primary outcomes assessed.</p><p><strong>Results: </strong>A total of 18 studies involving 1251 patients with CSP, all of whom received preoperative HIFU therapy were included. The average hospital stay was 6.22 days, the intraoperative blood loss was 26.29 ml and the incidence of adverse events was 15.60%, including abdominal or lower limb pain, fever, vaginal bleeding, haematuria and vomiting. Furthermore, post-treatment follow-up showed that serum β-human chorionic gonadotropin levels were rapidly normalized (average of 25.48 days) and menstruation returned (average of 33.03 days). The treatment had a remarkable success rate of 97.60% and a subsequent pregnancy rate of 68.70%.</p><p><strong>Conclusion: </strong>While the combination of HIFU and suction-curettage may induce common adverse effects such as lower abdominal or limb pain, these reactions typically do not necessitate therapeutic intervention. Additionally, the size of the gestational sac is a determinant of the procedure's success. In conclusion, HIFU combined with suction curettage demonstrates promising clinical efficacy, safety and favourable reproductive outcomes in managing CSP.</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":"139702495","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}
Objective: Long-term re-intervention after ultrasound-guided high intensity focused ultrasound (USgHIFU) ablation was reported, and the prediction of non-perfusion volume ratio (NPVR) in differently aged patients with uterine fibroids (UFs) was explored.
Materials and methods: Patients with UFs who underwent USgHIFU ablation from January 2012 to December 2019 were enrolled and divided into < 40-year-old and ≥ 40-year-old groups. Cox regression was used to analyze the influencing factors of re-intervention rate, and receiver operating characteristic (ROC) curve was used to analyze the correlation between NPVR and re-intervention rate.
Results: A total of 2141 patients were enrolled, and 1558 patients were successfully followed up. The 10-year cumulative re-intervention rate was 21.9%, and the < 40-year-old group had a significantly higher rate than the ≥ 40-year-old group (30.8% vs. 19.1%, p < 0.001). NPVR was an independent risk factor in both two groups. When the NPVR reached 80.5% in the < 40-year-old group and 75.5% in the ≥ 40-year-old group, the risk of long-term re-intervention was satisfactory.
Conclusion: The long-term outcome of USgHIFU is promising. The re-intervention rate is related to NPVR in differently aged patients. Young patients need a high NPVR to reduce re-intervention risk.
目的:报告了超声引导下高强度聚焦超声(USgHIFU)消融术后的长期再干预情况,并探讨了不同年龄子宫肌瘤(UFs)患者非灌注容积比(NPVR)的预测:入选2012年1月至2019年12月接受USgHIFU消融术的子宫肌瘤患者,分为<40岁组、≥40岁组。采用Cox回归分析再介入率的影响因素,并采用接收者操作特征曲线(ROC)分析NPVR与再介入率的相关性:共有2141名患者入组,1558名患者成功接受了随访。10年累计再介入率为21.9%,年龄小于40岁组的再介入率明显高于年龄≥40岁组(30.8% vs. 19.1%,P 结论:USgHIFT的远期疗效优于NPVR:USgHIFU 的长期疗效令人乐观。不同年龄患者的再次介入率与 NPVR 有关。年轻患者需要较高的 NPVR 以降低再介入风险。
{"title":"Long-term re-intervention after USgHIFU and prediction of NPVR in different ages of patients with uterine fibroids.","authors":"Shuang Li, Wang-Wa Ma, Mei-Jie Yang, Yong-Bin Deng, Liang Hu, Jin-Yun Chen","doi":"10.1080/02656736.2024.2304264","DOIUrl":"10.1080/02656736.2024.2304264","url":null,"abstract":"<p><strong>Objective: </strong>Long-term re-intervention after ultrasound-guided high intensity focused ultrasound (USgHIFU) ablation was reported, and the prediction of non-perfusion volume ratio (NPVR) in differently aged patients with uterine fibroids (UFs) was explored.</p><p><strong>Materials and methods: </strong>Patients with UFs who underwent USgHIFU ablation from January 2012 to December 2019 were enrolled and divided into < 40-year-old and ≥ 40-year-old groups. Cox regression was used to analyze the influencing factors of re-intervention rate, and receiver operating characteristic (ROC) curve was used to analyze the correlation between NPVR and re-intervention rate.</p><p><strong>Results: </strong>A total of 2141 patients were enrolled, and 1558 patients were successfully followed up. The 10-year cumulative re-intervention rate was 21.9%, and the < 40-year-old group had a significantly higher rate than the ≥ 40-year-old group (30.8% vs. 19.1%, <i>p</i> < 0.001). NPVR was an independent risk factor in both two groups. When the NPVR reached 80.5% in the < 40-year-old group and 75.5% in the ≥ 40-year-old group, the risk of long-term re-intervention was satisfactory.</p><p><strong>Conclusion: </strong>The long-term outcome of USgHIFU is promising. The re-intervention rate is related to NPVR in differently aged patients. Young patients need a high NPVR to reduce re-intervention risk.</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":"139520761","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: 2024-01-08DOI: 10.1080/02656736.2023.2299480
Rogier van Oossanen, Alexandra Maier, Jérémy Godart, Jean-Philippe Pignol, Antonia G Denkova, Gerard C van Rhoon, Kristina Djanashvili
Objective: To investigate the potential of hybrid Pd/Fe-oxide magnetic nanoparticles designed for thermo-brachytherapy of breast cancer, considering their specific loss power (SLP) and clinical constraints in the applied magnetic field.
Methods: Hybrid nanoparticles consisting of palladium-core and iron oxide shell of increasing thickness, were suspended in water and their SLPs were measured at varying magnetic fields (12-26 mT peak) and frequencies (50-730 kHz) with a commercial alternating magnetic field generator (magneTherm™ Digital, nanoTherics Ltd.).
Results: Validation of the heating device used in this study with commercial HyperMag-C nanoparticles showed a small deviation (±4%) over a period of 1 year, confirming the reliability of the method. The integration of dual thermometers, one in the center and one at the bottom of the sample vial, allowed monitoring of homogeneity of the sample suspensions. SLPs measurements on a series of nanoparticles of increasing sizes showed the highest heating for the diameter of 21 nm (SLP = 225 W/g) at the applied frequencies of 346 and 730 kHz. No heating was observed for the nanoparticles with the size <14 nm, confirming the importance of the size-parameter. The heating ability of the best performing Pd/Fe-oxide-21 was calculated to be sufficient to ablate tumors with a radius ±4 and 12 mm using 10 and 1 mg/mL nanoparticle concentration, respectively.
Conclusions: Nanoparticles consisting of non-magnetic palladium-core and magnetic iron oxide shell are suitable for magnetic hyperthermia/thermal ablation under clinically safe conditions of 346 kHz and 19.1 mT, with minimal eddy current effects in combination with maximum SLP.
{"title":"Magnetic hybrid Pd/Fe-oxide nanoparticles meet the demands for ablative thermo-brachytherapy.","authors":"Rogier van Oossanen, Alexandra Maier, Jérémy Godart, Jean-Philippe Pignol, Antonia G Denkova, Gerard C van Rhoon, Kristina Djanashvili","doi":"10.1080/02656736.2023.2299480","DOIUrl":"10.1080/02656736.2023.2299480","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the potential of hybrid Pd/Fe-oxide magnetic nanoparticles designed for thermo-brachytherapy of breast cancer, considering their specific loss power (<i>SLP</i>) and clinical constraints in the applied magnetic field.</p><p><strong>Methods: </strong>Hybrid nanoparticles consisting of palladium-core and iron oxide shell of increasing thickness, were suspended in water and their <i>SLPs</i> were measured at varying magnetic fields (12-26 mT peak) and frequencies (50-730 kHz) with a commercial alternating magnetic field generator (magneTherm™ Digital, nanoTherics Ltd.).</p><p><strong>Results: </strong>Validation of the heating device used in this study with commercial HyperMag-C nanoparticles showed a small deviation (±4%) over a period of 1 year, confirming the reliability of the method. The integration of dual thermometers, one in the center and one at the bottom of the sample vial, allowed monitoring of homogeneity of the sample suspensions. <i>SLP</i>s measurements on a series of nanoparticles of increasing sizes showed the highest heating for the diameter of 21 nm (<i>SLP</i> = 225 W/g) at the applied frequencies of 346 and 730 kHz. No heating was observed for the nanoparticles with the size <14 nm, confirming the importance of the size-parameter. The heating ability of the best performing Pd/Fe-oxide-21 was calculated to be sufficient to ablate tumors with a radius ±4 and 12 mm using 10 and 1 mg/mL nanoparticle concentration, respectively.</p><p><strong>Conclusions: </strong>Nanoparticles consisting of non-magnetic palladium-core and magnetic iron oxide shell are suitable for magnetic hyperthermia/thermal ablation under clinically safe conditions of 346 kHz and 19.1 mT, with minimal eddy current effects in combination with maximum <i>SLP</i>.</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":"139377562","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: 2024-01-12DOI: 10.1080/02656736.2023.2270671
Haoyu Jing, Lin Yan, Jing Xiao, Xinyang Li, Bo Jiang, Zhen Yang, Yingying Li, Bin Sun, Mingbo Zhang, Yukun Luo
Objective: To evaluate the outcomes of radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) adjacent to the trachea and compare them with those of PTMC distant from the trachea.
Methods: Patients who received RFA for solitary low-risk PTMC between June 2014 and July 2020 were reviewed and classified into adjacent and distant groups. To balance between-group confounders, the propensity score matching approach was employed. Volume, volume reduction ratio (VRR), tumor disappearance, complications, and disease progression were assessed and compared between the groups. Furthermore, factors affecting disease progression were evaluated.
Results: A total of 122 and 470 patients were included in the adjacent and distant groups, respectively. Overall VRR was 99.5% ± 3.1 and cumulative tumor disappearance rate was 99.4% after a mean follow-up time of 40.1 months ± 16.2. Overall disease progression and complications incidence were 3.7% and 1.0%, respectively. No substantial differences were observed between the two groups in the latest volume (0.8 mm3 ± 4.1 vs. 0.9 mm3 ± 4.2, p = .77), VRR (99.7% ± 1.6 vs. 99.5% ± 2.7, p = .75), cumulative tumor disappearance rate (92.6% vs. 94.2%, p = .58), and incidence of disease progression (4.1% vs. 4.5%, p = .70) and complication (1.7% vs. 0.8%, p = .86) after 1:2 matching. Additionally, tracheal adjacency exhibited no association with disease progression in multivariate Cox regression analysis (p = .73).
Conclusion: For eligible patients with PTMC located adjacent to or distant from the trachea, RFA may offer a safe and effective alternative treatment method.
目的评估邻近气管的甲状腺乳头状微小癌(PTMC)射频消融术(RFA)的疗效,并与远离气管的PTMC的疗效进行比较:对2014年6月至2020年7月期间因单发低危PTMC接受RFA治疗的患者进行回顾性研究,并将其分为邻近组和远处组。为平衡组间混杂因素,采用了倾向得分匹配法。对各组的体积、体积缩小比(VRR)、肿瘤消失、并发症和疾病进展情况进行了评估和比较。此外,还对影响疾病进展的因素进行了评估:邻近组和远处组分别共有 122 名和 470 名患者。平均随访时间为40.1个月(±16.2)个月,总VRR为99.5%±3.1,累积肿瘤消失率为99.4%。总体疾病进展率和并发症发生率分别为3.7%和1.0%。两组患者的最新体积(0.8 mm3 ± 4.1 vs. 0.9 mm3 ± 4.2,p = .77)、VRR(99.7% ± 1.6 vs. 99.5% ± 2.7,p = .75)、累积肿瘤消失率(99.4%)均无显著差异。75)、累积肿瘤消失率(92.6% vs. 94.2%,p = .58)、1:2 匹配后疾病进展发生率(4.1% vs. 4.5%,p = .70)和并发症发生率(1.7% vs. 0.8%,p = .86)。此外,在多变量考克斯回归分析中,气管邻近性与疾病进展无关(p = .73):结论:对于符合条件的气管邻近或远离气管的 PTMC 患者,RFA 可能是一种安全有效的替代治疗方法。
{"title":"Radiofrequency ablation for papillary thyroid microcarcinoma with a trachea-adjacent versus trachea-distant location.","authors":"Haoyu Jing, Lin Yan, Jing Xiao, Xinyang Li, Bo Jiang, Zhen Yang, Yingying Li, Bin Sun, Mingbo Zhang, Yukun Luo","doi":"10.1080/02656736.2023.2270671","DOIUrl":"10.1080/02656736.2023.2270671","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the outcomes of radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) adjacent to the trachea and compare them with those of PTMC distant from the trachea.</p><p><strong>Methods: </strong>Patients who received RFA for solitary low-risk PTMC between June 2014 and July 2020 were reviewed and classified into adjacent and distant groups. To balance between-group confounders, the propensity score matching approach was employed. Volume, volume reduction ratio (VRR), tumor disappearance, complications, and disease progression were assessed and compared between the groups. Furthermore, factors affecting disease progression were evaluated.</p><p><strong>Results: </strong>A total of 122 and 470 patients were included in the adjacent and distant groups, respectively. Overall VRR was 99.5% ± 3.1 and cumulative tumor disappearance rate was 99.4% after a mean follow-up time of 40.1 months ± 16.2. Overall disease progression and complications incidence were 3.7% and 1.0%, respectively. No substantial differences were observed between the two groups in the latest volume (0.8 mm<sup>3</sup> ± 4.1 vs. 0.9 mm<sup>3</sup> ± 4.2, <i>p</i> = .77), VRR (99.7% ± 1.6 vs. 99.5% ± 2.7, <i>p</i> = .75), cumulative tumor disappearance rate (92.6% vs. 94.2%, <i>p</i> = .58), and incidence of disease progression (4.1% vs. 4.5%, <i>p</i> = .70) and complication (1.7% vs. 0.8%, <i>p</i> = .86) after 1:2 matching. Additionally, tracheal adjacency exhibited no association with disease progression in multivariate Cox regression analysis (<i>p</i> = .73).</p><p><strong>Conclusion: </strong>For eligible patients with PTMC located adjacent to or distant from the trachea, RFA may offer a safe and effective alternative treatment method.</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":"139424641","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: 10.1080/02656736.2024.2398558
Xin-Yi Zhou, Xin-Yu Yu, Ying Wei, Zhen-Long Zhao, Li-Li Peng, Yan Li, Jie Wu, Shi-Liang Cao, Ming-An Yu
Objective: To assess the feasibility, efficacy, and safety of microwave ablation in treating follicular thyroid neoplasms and suspicious follicular thyroid neoplasms.
Methods: In this retrospective study, the data of patients treated with microwave ablation for follicular neoplasms from December 2016 to January 2024 were summarized. The changes in nodule size, volume, technical success rate, disease progression, complete tumor resolution, thyroid function, and complications post-ablation were evaluated.
Results: Seventy-four patients (15 men, 59 women; mean age 46.3 ± 15.2 years) with follicular neoplasms were included. Over a median follow-up of 13 months, complete ablation was achieved, giving a 100% technical success rate. At the first month post-ablation, the maximum diameter of nodules showed no significant change (p = 0.287). From the third month, both maximum diameter and volume significantly decreased (p < 0.005 for all). Volume reduction rates remained stable at one and three months (p = 0.389 and 0.06, respectively) but increased significantly thereafter (p < 0.005 for all). By 24 months, the median maximum diameter had reduced from 2.3 cm to 0 cm, achieving a median volume reduction rate of 100%. Nodules disappeared completely in 20.3% (15/74). Local recurrence was noted in 2.7% of cases (2/74), with no metastasis or neoplasm-related deaths reported. Thyroid function remained unchanged post-treatment (p > 0.05). The complication and side effect rates were 8.1% and 4.1%, respectively.
Conclusions: Initial findings suggest microwave ablation is an effective and safe treatment for follicular neoplasms, with low incidences of disease progression and complications, while maintaining thyroid function.
目的评估微波消融治疗甲状腺滤泡性肿瘤和可疑甲状腺滤泡性肿瘤的可行性、有效性和安全性:在这项回顾性研究中,总结了2016年12月至2024年1月期间接受微波消融治疗的滤泡性肿瘤患者的数据。评估了消融术后结节大小、体积、技术成功率、疾病进展、肿瘤完全消退、甲状腺功能和并发症的变化:共纳入74名滤泡性肿瘤患者(男性15人,女性59人;平均年龄(46.3 ± 15.2)岁)。中位随访时间为 13 个月,均实现了完全消融,技术成功率为 100%。消融术后第一个月,结节的最大直径无明显变化(p = 0.287)。从第三个月开始,最大直径和体积都明显减小(p p = 0.389 和 0.06),但之后又明显增大(p p > 0.05)。并发症和副作用发生率分别为8.1%和4.1%:初步研究结果表明,微波消融是一种有效、安全的滤泡性肿瘤治疗方法,疾病进展和并发症发生率低,同时还能保持甲状腺功能。
{"title":"Efficacy and safety of microwave ablation for treatment of follicular thyroid neoplasms: a preliminary study.","authors":"Xin-Yi Zhou, Xin-Yu Yu, Ying Wei, Zhen-Long Zhao, Li-Li Peng, Yan Li, Jie Wu, Shi-Liang Cao, Ming-An Yu","doi":"10.1080/02656736.2024.2398558","DOIUrl":"https://doi.org/10.1080/02656736.2024.2398558","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility, efficacy, and safety of microwave ablation in treating follicular thyroid neoplasms and suspicious follicular thyroid neoplasms.</p><p><strong>Methods: </strong>In this retrospective study, the data of patients treated with microwave ablation for follicular neoplasms from December 2016 to January 2024 were summarized. The changes in nodule size, volume, technical success rate, disease progression, complete tumor resolution, thyroid function, and complications post-ablation were evaluated.</p><p><strong>Results: </strong>Seventy-four patients (15 men, 59 women; mean age 46.3 ± 15.2 years) with follicular neoplasms were included. Over a median follow-up of 13 months, complete ablation was achieved, giving a 100% technical success rate. At the first month post-ablation, the maximum diameter of nodules showed no significant change (<i>p</i> = 0.287). From the third month, both maximum diameter and volume significantly decreased (<i>p</i> < 0.005 for all). Volume reduction rates remained stable at one and three months (<i>p</i> = 0.389 and 0.06, respectively) but increased significantly thereafter (<i>p</i> < 0.005 for all). By 24 months, the median maximum diameter had reduced from 2.3 cm to 0 cm, achieving a median volume reduction rate of 100%. Nodules disappeared completely in 20.3% (15/74). Local recurrence was noted in 2.7% of cases (2/74), with no metastasis or neoplasm-related deaths reported. Thyroid function remained unchanged post-treatment (<i>p</i> > 0.05). The complication and side effect rates were 8.1% and 4.1%, respectively.</p><p><strong>Conclusions: </strong>Initial findings suggest microwave ablation is an effective and safe treatment for follicular neoplasms, with low incidences of disease progression and complications, while maintaining thyroid function.</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":"142154012","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}