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Bachetta A, Cheung S, Moore ER, Nguyen D, Kiely MJ, Whiteley MS. Defining the Parameters for Endovenous Microwave Ablation to Achieve Equivalence With Endovenous Laser Ablation, Using the Porcine Liver Model. Vasc Endovascular Surg 2024; 58:491-497. [PMID: 38240500 DOI: 10.1177/15385744241229587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
AIMS Endovenous microwave ablation (EMWA) is an endovenous thermoablation (EVTA) system to ablate incompetent truncal veins. Early results suggest that EMWA uses more power than endovenous laser ablation (EVLA) to get the same results. We aimed to define the parameters for EMWA, which give the same tissue ablation as EVLA, using the validated porcine liver model. METHODS EVLA (1470 nm 600 micron radial fibre) treatments were performed at 6 W, 8 W and 10 W, at pullback speeds of 6, 7, 8 and 9 s/cm, giving Linear Endovenous Energy Densities (LEEDs) between 36 - 90 J/cm. Each combination of power and pullback was repeated 5 times. We then used EMWA in the same model. Powers of 35-75 W and pullback speeds of 4-9 s/cm were used (LEEDs 140-675 J/cm). Ablation tracts from both devices were analysed by 2 blinded observers, noting thermal spread and carbonisation. RESULTS For each commonly used parameter for EVLA, we identified a range of parameters for EMWA that produced similar tissue ablation in the porcine liver model. To keep the pullback speeds within the usual range, powers of 35-75 W were needed with EMWA, with mean EMWA LEEDs 3.9 - 5.8 times higher than EVLA LEEDs. We found the quicker the pullback speed, the higher the multiple of EMWA LEED we needed to get the same effect. CONCLUSION We have identified parameters for EMWA that gave equivalent tissue ablation in the porcine liver model to commonly used parameters used for EVLA. These need to be validated clinically, but as the model used has already been validated against clinical outcome in endovenous thermal ablation, there is little reason to suspect that these results would not be valid. As the power during EMWA is higher than EVLA, EVMA LEEDs are approximately 4-6 times higher than EVLA LEEDs to achieve the same thermal effect on the tissues.
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Affiliation(s)
| | - Simon Cheung
- Research Department, The Whiteley Clinic, Guildford, UK
| | - Emma R Moore
- Research Department, The Whiteley Clinic, Guildford, UK
| | - Danny Nguyen
- Research Department, The Whiteley Clinic, Guildford, UK
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Qian Y, Li Z, Fan C, Huang Y. Comparison of ultrasound-guided microwave ablation, laser ablation, and radiofrequency ablation for the treatment of elderly patients with benign thyroid nodules: A meta-analysis. Exp Gerontol 2024; 191:112425. [PMID: 38604254 DOI: 10.1016/j.exger.2024.112425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/27/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND A new minimally invasive technique, ultrasound-guided thermal ablation has become one of the treatment methods for benign thyroid nodules. This study aims to evaluate the efficacy and safety of laser ablation (LA), radiofrequency ablation (RFA), and microwave ablation (MWA) in the treatment of elderly patients with benign thyroid nodules. METHODS PubMed, Web of Science, and Cochrane Library were searched for qualified randomized controlled studies (RCTs) issued from establishing databases to March 2022. After screening and evaluating the article quality, the data on nodular volume reduction rate (VRR) and the incidence of complications after thermal ablation were extracted and analyzed by RevMan 5.3 and Stata l4.0. RESULTS The meta-analysis included seven articles with 3055 participants. We found that LA, RFA, and MWA could markedly reduce the volume of benign thyroid nodules. LA was superior to RFA and MWA in reducing the volume of benign thyroid nodules in 6 months of follow-up (all P < 0.05). LA, RFA, and MWA can be safely implemented in patients with benign thyroid nodules. The incidence of significant complications after the RFA group was enhanced compared with that in the MWA (P < 0.05), and the incidence of secondary complications after RFA was slightly higher than that of LA (P < 0.05). CONCLUSION LA, RFA, and MWA can markedly reduce the volume of benign thyroid nodules in elderly patients and can safely treat benign thyroid nodules.
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Affiliation(s)
- Ying Qian
- Department of Ultrasound, The People's Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu, China
| | - Zheng Li
- Department of Ultrasound, The People's Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu, China
| | - Chunyun Fan
- Department of Ultrasound, The People's Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu, China
| | - Yong Huang
- Department of Endocrinology, The People's Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu, China.
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Zhong X, Zhang X, Cao Y, Zhou P. Interaction Between Microbubbles and Microwave Ablation: A Phantom and Rabbit Model. J Ultrasound Med 2024; 43:1143-1151. [PMID: 38469913 DOI: 10.1002/jum.16443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/24/2024] [Accepted: 02/24/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES This study aimed to explore the interactions between microbubbles and microwave ablation (MWA). METHODS The study employed custom-made phantoms (in vitro) and white New Zealand rabbits (in vivo). MWA was performed with or without microbubbles in the phantoms (2 × 105 particles mL-1) and rabbit livers (intravenous injection of 0.05 mL/kg SonoVue). During the MWA, K-type thermocouple probes were used to monitor the MWA-induced temperature increase. Contrast-enhanced ultrasound imaging (CEUS) was used to monitor and analyze the microbubbles signal intensity. After MWA, the ablation-zone volumes were evaluated and compared between the groups with and without microbubbles. RESULTS In both the phantom models and rabbits, microbubbles showed no significant influence on MWA, including the ablation range and MWA-induced temperature increase. In phantoms and rabbit livers filled with microbubbles, MWA caused the formation of a gradually expanding microbubble-defect region over the ablation time. An increase in the temperature caused microbubble destruction. CONCLUSIONS Microbubbles had no significant influence on MWA. However, MWA induced the destruction of microbubbles in a temperature-dependent manner. Thus, the poor thermotolerance of microbubbles is a non-negligible barrier when using CEUS to monitor the ablation range during MWA in real-time.
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Affiliation(s)
- Xinyu Zhong
- Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xinghao Zhang
- Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yuting Cao
- Institute of Ultrasound Imaging and Department of Ultrasound, Chongqing Key Laboratory of Ultrasound Molecular Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ping Zhou
- Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, China
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Della Corte A, Mori M, Calabrese F, Palumbo D, Ratti F, Palazzo G, Pellegrini A, Santangelo D, Ronzoni M, Spezi E, Del Vecchio A, Fiorino C, Aldrighetti L, De Cobelli F. Preoperative MRI radiomic analysis for predicting local tumor progression in colorectal liver metastases before microwave ablation. Int J Hyperthermia 2024; 41:2349059. [PMID: 38754994 DOI: 10.1080/02656736.2024.2349059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE Radiomics may aid in predicting prognosis in patients with colorectal liver metastases (CLM). Consistent data is available on CT, yet limited data is available on MRI. This study assesses the capability of MRI-derived radiomic features (RFs) to predict local tumor progression-free survival (LTPFS) in patients with CLMs treated with microwave ablation (MWA). METHODS All CLM patients with pre-operative Gadoxetic acid-MRI treated with MWA in a single institution between September 2015 and February 2022 were evaluated. Pre-procedural information was retrieved retrospectively. Two observers manually segmented CLMs on T2 and T1-Hepatobiliary phase (T1-HBP) scans. After inter-observer variability testing, 148/182 RFs showed robustness on T1-HBP, and 141/182 on T2 (ICC > 0.7).Cox multivariate analysis was run to establish clinical (CLIN-mod), radiomic (RAD-T1, RAD-T2), and combined (COMB-T1, COMB-T2) models for LTPFS prediction. RESULTS Seventy-six CLMs (43 patients) were assessed. Median follow-up was 14 months. LTP occurred in 19 lesions (25%).CLIN-mod was composed of minimal ablation margins (MAMs), intra-segment progression and primary tumor grade and exhibited moderately high discriminatory power in predicting LTPFS (AUC = 0.89, p = 0.0001). Both RAD-T1 and RAD-T2 were able to predict LTPFS: (RAD-T1: AUC = 0.83, p = 0.0003; RAD-T2: AUC = 0.79, p = 0.001). Combined models yielded the strongest performance (COMB-T1: AUC = 0.98, p = 0.0001; COMB-T2: AUC = 0.95, p = 0.0003). Both combined models included MAMs and tumor regression grade; COMB-T1 also featured 10th percentile of signal intensity, while tumor flatness was present in COMB-T2. CONCLUSION MRI-based radiomic evaluation of CLMs is feasible and potentially useful for LTP prediction. Combined models outperformed clinical or radiomic models alone for LTPFS prediction.
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Affiliation(s)
- Angelo Della Corte
- Department of Radiology, IRCCS San Raffaele Hospital, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Martina Mori
- Department of Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | | | - Diego Palumbo
- Department of Radiology, IRCCS San Raffaele Hospital, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Francesca Ratti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy
| | - Gabriele Palazzo
- Department of Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Monica Ronzoni
- Unit of Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emiliano Spezi
- School of Engineering, Cardiff University, Cardiff, UK
- Department of Medical Physics, Velindre Cancer Centre, Cardiff, UK
| | | | - Claudio Fiorino
- Department of Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | - Luca Aldrighetti
- University Vita-Salute San Raffaele, Milan, Italy
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy
| | - Francesco De Cobelli
- Department of Radiology, IRCCS San Raffaele Hospital, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
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Balaji P, Barry MA, Tran VT, Marschner S, Lu J, Nguyen DM, Mina A, Bandodkar S, Alvarez S, James V, Ronquillo J, Varikatt W, Kovoor P, McEwan A, Thiagalingam A, Thomas SP, Qian PC. Long-Term Safety and Efficacy of Transcatheter Microwave and Radiofrequency Denervation in a Chronic Ovine Model. J Am Heart Assoc 2024; 13:e031795. [PMID: 38664237 DOI: 10.1161/jaha.123.031795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 02/26/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Transcatheter renal denervation (RDN) has had inconsistent efficacy and concerns for durability of denervation. We aimed to investigate long-term safety and efficacy of transcatheter microwave RDN in vivo in normotensive sheep in comparison to conventional radiofrequency ablation. METHODS AND RESULTS Sheep underwent bilateral RDN, receiving 1 to 2 microwave ablations (maximum power of 80-120 W for 240 s-480 s) and 12 to 16 radiofrequency ablations (180 s-240 s) in the main renal artery in a paired fashion, alternating the side of treatment, euthanized at 2 weeks (acute N=15) or 5.5 months (chronic N=15), and compared with undenervated controls (N=4). Microwave RDN produced substantial circumferential perivascular injury compared with radiofrequency at both 2 weeks [area 239.8 (interquartile range [IQR] 152.0-343.4) mm2 versus 50.1 (IQR, 32.0-74.6) mm2, P <0.001; depth 16.4 (IQR, 13.9-18.9) mm versus 7.5 (IQR, 6.0-8.9) mm P <0.001] and 5.5 months [area 20.0 (IQR, 3.4-31.8) mm2 versus 5.0 (IQR, 1.4-7.3) mm2, P=0.025; depth 5.9 (IQR, 1.9-8.8) mm versus 3.1 (IQR, 1.2-4.1) mm, P=0.005] using mixed models. Renal denervation resulted in significant long-term reductions in viability of renal sympathetic nerves [58.9% reduction with microwave (P=0.01) and 45% reduction with radiofrequency (P=0.017)] and median cortical norepinephrine levels [71% reduction with microwave (P <0.001) and 72.9% reduction with radiofrequency (P <0.001)] at 5.5 months compared with undenervated controls. CONCLUSIONS Transcatheter microwave RDN produces deep circumferential perivascular ablations without significant arterial injury to provide effective and durable RDN at 5.5 months compared with radiofrequency RDN.
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Affiliation(s)
- Poornima Balaji
- Cardiology Department Westmead Hospital Sydney NSW Australia
- Westmead Applied Research Centre University of Sydney NSW Australia
| | - Michael A Barry
- Cardiology Department Westmead Hospital Sydney NSW Australia
| | - Vu Toan Tran
- Cardiology Department Westmead Hospital Sydney NSW Australia
| | - Simone Marschner
- Westmead Applied Research Centre University of Sydney NSW Australia
| | - Juntang Lu
- Cardiology Department Westmead Hospital Sydney NSW Australia
| | - Duc Minh Nguyen
- Cardiology Department Westmead Hospital Sydney NSW Australia
- Westmead Applied Research Centre University of Sydney NSW Australia
| | - Ashraf Mina
- NSW Health Pathology Institute of Clinical Pathology and Medical Research, Westmead Hospital Sydney NSW Australia
| | - Sushil Bandodkar
- Biochemistry Department, Faculty of Medicine and Health University of Sydney Children's Hospital at Westmead Clinical School Sydney NSW Australia
| | - Shirley Alvarez
- Biochemistry Department, Faculty of Medicine and Health University of Sydney Children's Hospital at Westmead Clinical School Sydney NSW Australia
| | - Virginia James
- The Westmead Institute of Medical Research Sydney NSW Australia
| | - John Ronquillo
- Department of Anatomical Pathology Institute of Clinical Pathology and Medical Research, Westmead Hospital Sydney NSW Australia
| | - Winny Varikatt
- Department of Anatomical Pathology Institute of Clinical Pathology and Medical Research, Westmead Hospital Sydney NSW Australia
| | - Pramesh Kovoor
- Cardiology Department Westmead Hospital Sydney NSW Australia
- Westmead Applied Research Centre University of Sydney NSW Australia
- Sydney Medical School University of Sydney NSW Australia
| | - Alistair McEwan
- Westmead Applied Research Centre University of Sydney NSW Australia
- School of Electrical and Information Engineering University of Sydney NSW Australia
| | - Aravinda Thiagalingam
- Cardiology Department Westmead Hospital Sydney NSW Australia
- Westmead Applied Research Centre University of Sydney NSW Australia
- Sydney Medical School University of Sydney NSW Australia
| | - Stuart P Thomas
- Cardiology Department Westmead Hospital Sydney NSW Australia
- Westmead Applied Research Centre University of Sydney NSW Australia
- Sydney Medical School University of Sydney NSW Australia
| | - Pierre C Qian
- Cardiology Department Westmead Hospital Sydney NSW Australia
- Westmead Applied Research Centre University of Sydney NSW Australia
- Sydney Medical School University of Sydney NSW Australia
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Wei Y, Zhang L, Zhang S, Song M, Ji C. Laparoscopic-assisted microwave ablation in treatment of small hepatocellular carcinoma: safety and efficacy in comparison with laparoscopic hepatectomy. BMC Surg 2024; 24:138. [PMID: 38715071 PMCID: PMC11075224 DOI: 10.1186/s12893-024-02432-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
Laparoscopic-assisted microwave ablation (LAMWA), as one of the locoregional therapies, has been employed to treat hepatocellular carcinoma (HCC). This study aims to compare the efficacy and safety of LAMWA and laparoscopic hepatectomy in the treatment of small HCC.This study included 140 patients who met the inclusion criteria. Among them, 68 patients received LAMWA and 72 patients underwent laparoscopic hepatectomy. The perioperative condition, liver function recovery, the alpha fetoprotein (AFP) level, morbidities, hospitalization time, overall survival (OS), disease-free survival (DFS) and recurrence rate between the two groups were compared. The rate of complete elimination of tumor tissue was 100% and the AFP level was returned to normal within 3 months after surgery in both groups (P > 0.05). The mean alanine transaminase (ALT) and aspartate transaminase (AST) peak in the LAMWA group was lower than that in the laparoscopic hepatectomy group (259.51 ± 188.75 VS 388.9 ± 173.65, P = 0.000) and (267.34 ± 190.65 VS 393.1 ± 185.67, P = 0.000), respectively. The mean operation time in the LAMWA group was shorter than that in the laparoscopic hepatectomy group (89 ± 31 min VS 259 ± 48 min, P = 0.000). The blood loss in the LAMWA group was less than that in the laparoscopic hepatectomy group (58.4 ± 64.0 ml VS 213.0 ± 108.2 ml, P = 0.000). Compared with the laparoscopic hepatectomy group, patients in the LAMWA group had lower mean hospital stay (4.8 ± 1.2d VS 11.5 ± 2.9d, P = 0.000). The morbidities of the LAMWA group and the hepatectomy group were 14.7%(10/68) and 34.7%(25/72), respectively (P = 0.006). The one-, three-, and five-year OS rates were 88.2%, 69.9%, 45.6% for the LAMWA group and 86.1%, 72.9%, 51.4% for the laparoscopic hepatectomy group (P = 0.693). The corresponding DFS rates for the two groups were 76.3%, 48.1%, 27.9% and 73.2%, 56.7%, 32.0% (P = 0.958). Laparoscopic-assisted microwave ablation is a safe and effective therapeutic option for selected small HCC.
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Affiliation(s)
- Youping Wei
- Department of imaging, Aviation General Hospital, China Medical University, Beijing, 100012, China
| | - Lihong Zhang
- Department of hepatobiliary surgery, Affiliated Hospital of Yangzhou University, Yangzhou, 225012, China
| | - Shun Zhang
- Department of imaging, Aviation General Hospital, China Medical University, Beijing, 100012, China
| | - Meina Song
- Department of imaging, Aviation General Hospital, China Medical University, Beijing, 100012, China
| | - Changhui Ji
- Department of general surgery, Taixing Peoplès Hospital of Yangzhou University, No. 1, Changzheng Road, Taixing City, 225400, China.
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Xu Y, Padley SPG, Devaraj A, Desai SR, Ridge CA. Discrepancy Between Achieved and Vendor-Predicted Ablation Zones in the Lung: Contributing Factors. Cardiovasc Intervent Radiol 2024; 47:613-620. [PMID: 38361010 DOI: 10.1007/s00270-024-03667-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE Several factors are known to affect lung ablation zones. Questions remain as to why there are discrepancies between achieved and vendor-predicted ablation zones and what contributing factors can be modified to balance therapeutic effects with avoidance of complications. This retrospective study of lung tumour microwave ablation analyses day 1 post-treatment CT to assess the effects of lesion-specific and operator-dependent factors on ablation zones. METHODS AND MATERIALS Consecutive patients treated at a tertiary centre from 2018 to 2021 were included. All ablations were performed using a single microwave ablation device under lung isolation. The lung tumours were categorised as primary or secondary, and their "resistance" to ablation was graded according to their locations. Intraprocedural pulmonary inflation was assessed as equal to or less than the contralateral non-isolated lung. Ablation energy was categorised as high, medium, or low. Ablation zone dimensions were measured on day 1 CT and compared to vendor reference charts. Ablations with multiple needle positions or indeterminate boundaries were excluded. RESULTS A total of 47 lesions in 31 patients were analysed. Achieved long axes are longer than predicted by 5 mm or 14% (p < 0.01) without overall short axis discrepancy. Secondary tumours (p = 0.020), low-resistance location (p < 0.01), good lung inflation (p < 0.01), low (p = 0.003) and medium (p = 0.038) total energy produce lengthened long axes by 4-6 mm or 10-19%. High total energy results in shorter than predicated short axes by 6 mm or 18% (p = 0.010). CONCLUSION We identified several factors affecting ablation zone dimensions which may have implications for ablation planning and the avoidance of complications.
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Affiliation(s)
- Yiwang Xu
- Department of Radiology, Royal Brompton Hospital, London, UK.
| | - Simon P G Padley
- Department of Radiology, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Anand Devaraj
- Department of Radiology, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sujal R Desai
- Department of Radiology, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Carole A Ridge
- Department of Radiology, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
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Foret A, Haaga CB, Jain S, Baumgartner CO, Escott M, Henderson BR, O'Brien ST, Delacroix SE, Gills JRR, Westerman ME. Clinical safety and efficacy of microwave ablation for small renal masses. Int Braz J Urol 2024; 50:277-286. [PMID: 38598830 DOI: 10.1590/s1677-5538.ibju.2024.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/04/2024] [Indexed: 04/12/2024] Open
Abstract
PURPOSE CT-guided MWA is a safe and effective tool that should be utilized in the treatment of small renal masses (SRMs). We aim to clarify the utility of CT-guided MWA by examining patient outcomes such as recurrence, treatment success, changes in renal function, and complications. METHODS A retrospective review of consecutive patients with SRMs who underwent same day renal mass biopsy (RMB) and CT-guided MWA between 2015 and 2022 was performed. Treatment safety was assessed by 30-day complications according to the Clavien-Dindo system and change in eGFR >30 days post-procedure. Treatment efficacy was defined by local recurrence and incomplete treatment rates and calculated using the Kaplan-Meier method. RESULTS A total of 108 renal masses were found in 104 patients. The overall complication rate was 7.4% (8/108), of which 4 were major complications (3.7%). For those with renal function available >30 days post ablation, the median eGFR was 47.2 (IQR: 36.0, 57), compared to 52.3 (IQR: 43.7, 61.5) pre-ablation, p<0.0001. 5-year local recurrence free survival was 86%. Among those with biopsy proven malignancy (n= 66), there were five local recurrences (7.54%) occurring at a median of 25.1 months (IQR 19.9, 36.2) and one case (1.5%) of incomplete treatment. CONCLUSIONS As the medical field continues to evolve towards less invasive interventions, MWA offers a valuable tool in the management of renal masses. With low major complication and recurrence rates, our findings support the utility of CT-guided MWA as a tool for treatment of SRMs.
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Affiliation(s)
- Ashley Foret
- School of Medicine, LSU Health Science Center New Orleans, New Orleans, Louisiana, USA
| | - Christopher B Haaga
- School of Medicine, LSU Health Science Center New Orleans, New Orleans, Louisiana, USA
| | - Shivani Jain
- School of Medicine, LSU Health Science Center New Orleans, New Orleans, Louisiana, USA
| | | | - Megan Escott
- School of Medicine, LSU Health Science Center New Orleans, New Orleans, Louisiana, USA
- Department of Urology, Wake Forest, Winston-Salem, NC, USA
| | - Benjamin R Henderson
- Department of Radiology, East Jefferson General Hospital, Metairie, Louisiana, USA
| | - Sean T O'Brien
- Department of Radiology, East Jefferson General Hospital, Metairie, Louisiana, USA
| | - Scott E Delacroix
- Department of Urology, LSU Health Science Center, New Orleans, Louisiana, USA
- LSU - LCMC Cancer Center, New Orleans, Louisiana, USA
| | - Jessie R R Gills
- Department of Urology, LSU Health Science Center, New Orleans, Louisiana, USA
- LSU - LCMC Cancer Center, New Orleans, Louisiana, USA
| | - Mary E Westerman
- Department of Radiology, East Jefferson General Hospital, Metairie, Louisiana, USA
- LSU - LCMC Cancer Center, New Orleans, Louisiana, USA
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Santhaveesuk P, Saenthaveesuk P, Holland JN, Kiat-Amnuay S. Microwave disinfection of facial silicone prostheses, Part 1: Color stability. J Prosthet Dent 2024; 131:980.e1-980.e8. [PMID: 38448355 DOI: 10.1016/j.prosdent.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/08/2024]
Abstract
STATEMENT OF PROBLEM The choice of cleaning method is an important consideration for lengthening the serviceable time of facial prostheses as microbial organisms and biofilms could degrade facial prostheses and cause skin irritation. Whether microwave disinfection is a suitable cleaning method without degradation of the properties of a prosthesis is unclear. PURPOSE The purpose of this in vitro study was to measure the color stability of 6 commonly used facial silicone elastomers after microwave disinfection over a simulated 1.5-year period. MATERIAL AND METHODS Six different facial silicone elastomers: MDX4-4210, MDX4-4210/Type A, M511, A-2186, VST-50, and A-2000 were mixed with intrinsic silicone white opacifier (except for the control group) and subsequently combined with 4 silicone intrinsic pigment color groups: red (R), yellow (Y), burnt sienna (B), and a mixture of R+Y+B (M). The control group was a silicone elastomer without opacifier or pigment. Each of the 30 experimental groups consisted of 5 specimens (N=150). Five specimens were placed in a 250-mL Erlenmeyer flask filled with 160 mL of tap water. Seven flasks were then placed in a 660-W microwave oven. An exposure of 6 minutes was used according to the antimicrobial efficacy of microwave disinfection protocol on facial silicone prostheses with a final water temperature of 60 °C for 18 times (simulating 1.5 years of microwave disinfection with one 6-minute exposure monthly). A spectrophotometer was used to measure reflectance color change values (∆E). Color differences were calculated following CIELab (∆E*ab) and CIEDE2000 (∆E00) formulae. ∆E*ab and ∆E00 were statistically analyzed by a linear mixed effects model with 3 factors (silicone type, color shade, and time) using the R Statistical software program (α=.05). RESULTS Both ∆E*ab and ∆E00 of all silicone elastomers studied were less than the visual perceptibility thresholds (∆E*ab<1.1 and E00<0.7) and were considered clinically acceptable (∆E*ab<3.0 and E00<2.1) after the 1.5-year simulation of microwave disinfection. Yellow and blue pigments had more effect on MDX4-4210 and M511, while red pigment had more effect on MDX4-4210, MDX4-4210/Type A, and M511 (P<.05). Nevertheless, the values were still below the perceptibility threshold (∆E*ab≤1.0 and E00<0.6). CONCLUSIONS All 6 facial silicone elastomers maintained clinically acceptable color after 18 months of exposure to microwave disinfection.
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Affiliation(s)
- Penchanok Santhaveesuk
- Former Prosthodontic Resident, Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; and Former AEGD Preceptor, University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas
| | - Pensiri Saenthaveesuk
- Lecturer, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand; and Former AEGD Resident, University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas
| | - Julian Nathaniel Holland
- Senior Statistician, Office of Research, University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas
| | - Sudarat Kiat-Amnuay
- Professor and Section Head, Department of General Practice and Dental Public Health, Houston Center for Biomaterials and Biomimetics, University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas.
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10
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Zhuang M, Lu M, Jiang Z, Liang Y, Wang S, Wang L, Li J. Comparison of Micro-flow Imaging and Contrast-Enhanced Ultrasound in Ultrasound-Guided Microwave Ablation of Benign Thyroid Nodules. Ultrasound Med Biol 2024; 50:729-734. [PMID: 38355362 DOI: 10.1016/j.ultrasmedbio.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/02/2024] [Accepted: 01/22/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE The study described here was aimed at ascertaining the utility of micro-flow imaging (MFI) during ultrasound (US)-guided microwave ablation (MWA) of thyroid nodules by contrasting its effectiveness with that of contrast-enhanced ultrasound (CEUS). METHODS Seventy-three patients with eighty-eight thyroid nodules who underwent US-guided MWA were included in our study from January 2020 to June 2023. Thirty-five patients underwent CEUS during the MWA process, and thirty-eight patients underwent MFI during the MWA process. We compared the two groups' baseline characteristics, tumor volume (V), volume reduction rate (VRR), complications and clinical characteristics. RESULTS Both groups exhibited similar outcomes with respect to V and VRR at 1, 3, 6, 12 and 18 mo after MWA (p > 0.05). Consistency was observed with respect to post-operative complications, supplementary ablation times and surgical duration (p > 0.05). It is worth noting that the MFI group had lower treatment costs compared with the CEUS group (11,337.64 ± 80.93 yuan for the MFI group versus 12,971.23 ± 254.89 yuan for the CEUS group, p < 0.05). CONCLUSION In the MWA procedure for thyroid nodules, MFI is similar to CEUS with respect to safety and efficacy. Simultaneously, it offers the advantage of reducing surgical expenses, which lessens the economic burden for patients.
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Affiliation(s)
- Min Zhuang
- Ultrasonography Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Man Lu
- Ultrasonography Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.
| | - Zirui Jiang
- School of Health Science of Purdue University, West Lafayette, IN, USA
| | - Yin Liang
- Ultrasonography Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Shishi Wang
- Ultrasonography Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Lu Wang
- Ultrasonography Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Jiami Li
- Ultrasonography Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
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11
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Chlorogiannis DD, Kratiras Z, Efthymiou E, Moulavasilis N, Kelekis N, Chrisofos M, Stravodimos K, Filippiadis DK. Percutaneous Microwave Ablation Versus Robot-Assisted Partial Nephrectomy for Stage I Renal Cell Carcinoma: A Propensity-Matched Cohort Study Focusing Upon Long-Term Follow-Up of Oncologic Outcomes. Cardiovasc Intervent Radiol 2024; 47:573-582. [PMID: 38561521 DOI: 10.1007/s00270-024-03695-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/22/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE To retrospectively compare long-term oncologic outcomes of percutaneous computed tomography-guided microwave ablation (MWA) and robot-assisted partial nephrectomy (RAPN) for the treatment of stage 1 (T1a and T1b) renal cell carcinoma (RCC) patients. MATERIALS AND METHODS Institutional database research identified all T1 RCC patients who underwent either MWA or RAPN. Models were adjusted with propensity score matching. Kaplan-Meier log-rank test analyses and Cox proportional hazard regression models were used to compare the oncologic outcomes. Patient and tumor characteristics, technical success as well as oncologic outcomes were evaluated and compared between the 2 groups. RESULTS After propensity score matching, a total of 71 patients underwent percutaneous MWA (mean age 70 ± 10 years) and 71 underwent RAPN (mean age 60 ± 9 years). At 8-year follow-up, the estimated survival rates for MWA cohort were 98% (95% confidence interval [CI] 95-100%) for overall survival, 97% (95% CI 93-100%) for recurrence-free survival, and 97% (95% CI 93-100%) for metastasis-free survival. The matched cohort that underwent RAPN exhibited survival rates of 100% (95% CI 100-100%) for overall survival, 98% (95% CI 94-100%) for recurrence-free survival, and 98% (95% CI 94-100%) for metastasis-free survival. After performing log-rank testing, these rates were not significantly different (p values of 0.44, 0.67, and 0.67, respectively). CONCLUSION The results of the present study suggest that both MWA and RAPN are equally effective in terms of oncologic outcome for the treatment of T1 RCC.
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Affiliation(s)
| | - Zisis Kratiras
- 3rd Department of Urology, University General Hospital "ATTIKON," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evgenia Efthymiou
- 2nd Department of Radiology, University General Hospital "ATTIKON," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Napoleon Moulavasilis
- 1st Department of Urology, "Laiko" General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Kelekis
- 2nd Department of Radiology, University General Hospital "ATTIKON," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Michail Chrisofos
- 3rd Department of Urology, University General Hospital "ATTIKON," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstandinos Stravodimos
- 1st Department of Urology, "Laiko" General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris K Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON," Medical School, National and Kapodistrian University of Athens, Athens, Greece
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12
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Huang XY, Lu QS, Wu SP, Huang HM, Zhang YF. Changes in liver and kidney function, red blood cell count and hemoglobin levels 1 day after ultrasound-guided percutaneous microwave ablation for uterine fibroids. Int J Hyperthermia 2024; 41:2338542. [PMID: 38684224 DOI: 10.1080/02656736.2024.2338542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/31/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE To investigate the changes in liver and kidney function, red blood cell (RBC) count and hemoglobin (HGB) levels in patients undergoing ultrasound-guided percutaneous microwave ablation (UPMWA) for uterine fibroids on postoperative day 1. METHODS The changes in liver and kidney function, RBC count and HGB levels in 181 patients who underwent selective UPMWA in the Second Affiliated Hospital of Shantou University Medical College, China, between August 2017 and January 2023 were retrospectively analyzed. RESULTS All patients underwent UPMWA for uterine fibroids; 179 patients had multiple uterine fibroids and 2 patients had single uterine fibroids. The maximum fibroid diameter ranged from 18 to 140 mm, with an average of 68.3 mm. Ultrasound imaging was used to confirm that the blood flow signal within the mass had disappeared in all patients, indicating that the ablation was effective. Within 24 h, compared with before UPMWA, levels of total bilirubin, direct bilirubin, indirect bilirubin and aspartate aminotransferase had significantly increased (p < 0.01), whereas levels of total protein, albumin, globulin, alanine aminotransferase, creatinine and urea had significantly decreased (p < 0.01). Acute kidney injury (AKI) occurred in 1 of the 181 patients. The RBC count and HGB levels decreased significantly after UPMWA (p < 0.01). CONCLUSION Ultrasound-guided percutaneous microwave ablation for uterine fibroids can impose a higher detoxification load on the liver and cause thermal damage to and the destruction of RBCs within local circulation, potentially leading to AKI. Protein levels significantly decreased after UPMWA. Therefore, perioperative organ function protection measures and treatment should be actively integrated into clinical practice to improve prognosis and enhance recovery.
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Affiliation(s)
- Xiao-Yu Huang
- Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Qin-Sheng Lu
- Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Shao-Ping Wu
- Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Han-Ming Huang
- Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Yong-Fa Zhang
- Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
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13
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Wang X, Xi Z, Ye K, Gong Z, Chen Y, Wang X. Improvement of Phased Antenna Array Applied in Focused Microwave Breast Hyperthermia. Sensors (Basel) 2024; 24:2682. [PMID: 38732788 PMCID: PMC11085649 DOI: 10.3390/s24092682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024]
Abstract
Focused microwave breast hyperthermia (FMBH) employs a phased antenna array to perform beamforming that can focus microwave energy at targeted breast tumors. Selective heating of the tumor endows the hyperthermia treatment with high accuracy and low side effects. The effect of FMBH is highly dependent on the applied phased antenna array. This work investigates the effect of polarizations of antenna elements on the microwave-focusing results by simulations. We explore two kinds of antenna arrays with the same number of elements using different digital realistic human breast phantoms. The first array has all the elements' polarization in the vertical plane of the breast, while the second array has half of the elements' polarization in the vertical plane and the other half in the transverse plane, i.e., cross polarization. In total, 96 sets of different simulations are performed, and the results show that the second array leads to a better focusing effect in dense breasts than the first array. This work is very meaningful for the potential improvement of the antenna array for FMBH, which is of great significance for the future clinical applications of FMBH. The antenna array with cross polarization can also be applied in microwave imaging and sensing for biomedical applications.
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Affiliation(s)
- Xuanyu Wang
- School of Information Science and Technology, Shanghai Tech University, Shanghai 201210, China; (X.W.); (Z.X.); (K.Y.)
| | - Zijun Xi
- School of Information Science and Technology, Shanghai Tech University, Shanghai 201210, China; (X.W.); (Z.X.); (K.Y.)
| | - Ke Ye
- School of Information Science and Technology, Shanghai Tech University, Shanghai 201210, China; (X.W.); (Z.X.); (K.Y.)
| | - Zheng Gong
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou 324003, China;
| | - Yifan Chen
- School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China;
| | - Xiong Wang
- School of Information Science and Technology, Shanghai Tech University, Shanghai 201210, China; (X.W.); (Z.X.); (K.Y.)
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14
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Fang Z, Wu C, Cao L, Wang T, Hong X, Moser MAJ, Zhang W, Zhang B. Development of non-invasive flexible directional microwave ablation for central lung cancer: a simulation study. Phys Med Biol 2024; 69:09NT04. [PMID: 38527368 DOI: 10.1088/1361-6560/ad3795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/25/2024] [Indexed: 03/27/2024]
Abstract
Transbronchial microwave ablation (MWA) with flexible antennas has gradually become an attractive alternative to percutaneous MWA for lung cancer due to its characteristic of non-invasiveness. However, flexible antennas for the precision ablation of lung tumors that are adjacent to critical bronchial structures are still not available. In this study, a non-invasive flexible directional (FD) antenna for early stage central lung tumors surrounding the bronchia was proposed. A comprehensive numerical MWA model with the FD antenna was developed in a real human-sized left lung model. The structure of the antenna and the treatment protocol were optimized by a generic algorithm for the precision ablation of two cases of early stage central lung cancer (i.e. spherical-like and ellipsoidal tumors). The electromagnetic efficiency of the optimized antenna was also improved by implementing an optimizedπ-matching network for impedance matching. The results indicate that the electromagnetic energy of MWA can be restricted to a particular area for precision ablation of specific lung tumors using the FD antenna. This study contributes to the field of lung cancer management with MWA.
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Affiliation(s)
- Zheng Fang
- Intelligent Energy-based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, People's Republic of China
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, Canada
| | - Chen Wu
- Intelligent Energy-based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, People's Republic of China
| | - Lin Cao
- Department of Automatic Control and Systems Engineering, the University of Sheffield, Sheffield, United Kingdom
| | - Tao Wang
- Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xiaowu Hong
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, People's Republic of China
- Research Institute of Fudan University, Ningbo, People's Republic of China
| | - Michael A J Moser
- Department of Surgery, University of Saskatchewan, Saskatoon, Canada
| | - Wenjun Zhang
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, Canada
| | - Bing Zhang
- Intelligent Energy-based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, People's Republic of China
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15
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Luo YC, Lang ML, Cai WJ, Han ZY, Liu FY, Cheng ZG, Yu XL, Dou JP, Li X, Tan SL, Dong XJ, Liang P, Yu J. [Curative effect of percutaneous microwave ablation therapy on hepatocellular carcinoma survival: a 15-year real-world study]. Zhonghua Gan Zang Bing Za Zhi 2024; 32:332-339. [PMID: 38733188 DOI: 10.3760/cma.j.cn501113-20231124-00223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Abstract
Objective: To evaluate the long-term efficacy of percutaneous microwave ablation (MWA) therapy for hepatocellular carcinoma. Methods: 2054 cases with Barcelona Clinic Liver Cancer (BCLC) stage 0~B at the Fifth Medical Center of the Chinese People's Liberation Army General Hospital from January 2006 to September 2020 were retrospectively collected. All patients were followed up for at least 2 years. The primary endpoint of overall survival and secondary endpoints (tumor-related survival, disease-free survival, and postoperative complications) of patients treated with ultrasound-guided percutaneous MWA were analyzed. Kaplan-Meier method was used for stratified survival rate analysis. Fine-and-Gray competing risk model was used to analyze overall survival. Results: A total of 5 503 HCC nodules [mean tumor diameter (2.6±1.6) cm] underwent 3 908 MWAs between January 2006 and September 2020, with a median follow-up time of 45.6 (24.0 -79.2) months.The technical effectiveness rate of 5 375 tumor nodules was 97.5%. The overall survival rates at 5, 10, and 15-years were 61.6%, 38.8%, and 27.0%, respectively. The tumor-specific survival rates were 67.1%, 47.2%, and 37.7%, respectively. The free tumor survival rates were 25.8%, 15.7%, and 9.9%, respectively. The incidence rate of severe complications was 2.8% (108/3 908). Further analysis showed that the technical effectiveness and survival rate over the passing three time periods from January 2006-2010, 2011-2015, and 2016-September 2020 were significantly increased, with P < 0.001, especially for liver cancer 3.1~5.0 cm (P < 0.001). Conclusion: Microwave ablation therapy is a safe and effective method for BCLC stage 0-B, with significantly enhanced technical efficacy and survival rate over time.
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Affiliation(s)
- Y C Luo
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - M L Lang
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - W J Cai
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - Z Y Han
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - F Y Liu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - Z G Cheng
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - X L Yu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - J P Dou
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - X Li
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - S L Tan
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - X J Dong
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - P Liang
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - J Yu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
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16
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Li H, Zhang G, Wang H, Chen H, Liu X, Zheng C, Lin L, Li L. Ultrasound-guided microwave ablation for the treatment of idiopathic granulomatous mastitis: comparison with surgical excision. BMC Womens Health 2024; 24:248. [PMID: 38637788 PMCID: PMC11025156 DOI: 10.1186/s12905-024-03070-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 04/02/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Idiopathic granulomatous mastitis (IGM) results in notable clinical symptoms and breast deformity. This study aimed to evaluate the clinical feasibility of microwave ablation (MWA) for the treatment of IGM through comparison with surgical excision. METHODS From June 2016 to December 2020, a total of 234 consecutive patients admitted to the hospital were retrospectively included in this study. IGM was pathologically confirmed via breast biopsy in all included patients. These patients were divided into the MWA group (n = 91) and surgical group (n = 143) based on the type of treatment. Patients in both groups received oral prednisone prior to intervention. The clinical remission rate, recurrence rate, operative pain, complications, and BREAST Q score were compared between the two groups. RESULTS There were 340 lesions in the MWA group, and 201 lesions in the surgical group were ultimately included. Significant differences in the complete remission rate (96.7% vs. 86.7%, p = 0.020), recurrence rate (3.3% vs. 13.3%, p = 0.020), operation time (48.7±14.6 min vs. 68.1±36.4 min, p < 0.001), postoperative pain (p < 0.001) and postoperative BREAST Q score (p < 0.001) were observed between the MWA and surgical groups. CONCLUSIONS Microwave ablation is feasible for the treatment of IGM, due to its high curative rate and low recurrence rate. Because of the minimal invasiveness of MWA and sufficient preservation of the gland and contour of the breast, patients are more satisfied with the appearance of the breast. Therefore, for patients with complex conditions requiring surgery, MWA is a good alternative treatment.
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Affiliation(s)
- Hang Li
- The School of Clinical Medicine, Fujian Medical University, Fujian, 350000, China
- Department of Breast Surgery, Affiliated Hospital of Putian University, Fujian, 351100, China
| | - Guoliang Zhang
- Department of Thyroid Surgery, Affiliated Hospital of Putian University, Fujian, 351100, China
| | - Hongling Wang
- Department of General Surgery, Xiamen Xinkaiyuan Hospital, Fujian, 361000, China
| | - Haiying Chen
- The School of Clinical Medicine, Fujian Medical University, Fujian, 350000, China
| | - Xiaoli Liu
- Department of Pathology, Affiliated Hospital of Putian University, Fujian, 351100, China
| | - Chuansheng Zheng
- The School of Clinical Medicine, Fujian Medical University, Fujian, 350000, China
| | - Lisheng Lin
- Department of Breast Surgery, Affiliated Hospital of Putian University, Fujian, 351100, China
| | - Lihong Li
- The School of Clinical Medicine, Fujian Medical University, Fujian, 350000, China.
- Department of Breast Surgery, Affiliated Hospital of Putian University, Fujian, 351100, China.
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17
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Zhou M, Li Z, Liu Y, Fang Y, Qin L, Yang W, Yan F, Zhao Q. Transapical intramyocardial septal microwave ablation in treatment of hypertrophic obstructive cardiomyopathy: 12-month outcomes of a swine model. J Cardiothorac Surg 2024; 19:205. [PMID: 38615019 PMCID: PMC11015544 DOI: 10.1186/s13019-024-02677-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 03/23/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND To date, the extended Morrow procedure is considered the gold standard treatment for patients with obstructive hypertrophic cardiomyopathy who experience severe symptoms and are unresponsive to medication treatment. We therefore aimed to perform transapical intramyocardial septal microwave ablation to reduce the thickness of the interventricular septum myocardium in a minimally invasive method. METHODS Fourteen swine were divided to form either a microwave ablation group (n = 7) or a sham group (n = 7). In the microwave ablation group, a transapical microwave antenna was inserted into the septum to ablate each myocardial segment at 40 W for 1 min, while in the sham group, the same operation was performed but without power output. We used echocardiography, electrocardiogram, during the operation. And added computerized tomography, cardiac nuclear magnetic resonance during follow-up. RESULTS Segment hypokinesis was observed in all swine immediately following ablation. Compared with the sham group, the thickness of ablated segments in the ablation group decreased significantly 1 month post-operation (ablation group, 5.53 ± 1.00 mm vs. 8.03 ± 1.15 mm, respectively, P < 0.01; sham group, 8.40 ± 0.94 mm vs. 8.21 ± 1.09 mm, respectively, P = 0.081), and the outcome was still observed 1 year post-operation (ablation group, 3.36 ± 0.85 mm vs. 8.03 ± 1.15 mm, respectively, P < 0.01). No perforation of the septum was observed during the procedure or follow-up, and no heart failure or sudden cardiac death occurred during postoperative feeding. CONCLUSIONS Transapical intramyocardial septal microwave ablation can effectively and safely produce a large region of necrosis. This technique can potentially mimic surgical myectomy while avoiding cardiopulmonary bypass and median sternotomy in high-risk hypertrophic obstructive cardiomyopathy patients.
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Affiliation(s)
- Mi Zhou
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Zhaolong Li
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yun Liu
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yuehua Fang
- Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Le Qin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wenjie Yang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Qiang Zhao
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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18
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Xiao YL, Wu SY, Jiang YZ. Thermo-immune synergy: Camrelizumab plus microwave ablation in preoperative early-stage breast cancer. Med 2024; 5:278-280. [PMID: 38614071 DOI: 10.1016/j.medj.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 04/15/2024]
Abstract
Immunotherapy has enhanced breast cancer outcomes, but optimizing combination therapies is crucial. Integrating additional treatment modalities, like physical therapies, holds promise for optimizing efficacy. Pan et al. recently reported that combining preoperative immunotherapy with microwave ablation is safe and feasible in early-stage breast cancer, effectively sensitizing peripheral CD8+ T cells.1.
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Affiliation(s)
- Yu-Ling Xiao
- Key Laboratory of Breast Cancer in Shanghai, Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Song-Yang Wu
- Key Laboratory of Breast Cancer in Shanghai, Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yi-Zhou Jiang
- Key Laboratory of Breast Cancer in Shanghai, Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
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19
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Pan H, Yu M, Tang X, Mao X, Liu M, Zhang K, Qian C, Wang J, Xie H, Qiu W, Ding Q, Wang S, Zhou W. Preoperative single-dose camrelizumab and/or microwave ablation in women with early-stage breast cancer: A window-of-opportunity trial. Med 2024; 5:291-310.e5. [PMID: 38417440 DOI: 10.1016/j.medj.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Immune checkpoint blockade has shown low response rates for advanced breast cancer, and combination strategies are needed. Microwave ablation (MWA) may be a trigger of antitumor immunity. This window-of-opportunity trial (ClinicalTrials.gov: NCT04805736) was conducted to determine the safety and feasibility of preoperative camrelizumab (an anti-PD-1 antibody) combined with MWA in the treatment of early-stage breast cancer. METHODS Sixty participants were randomized to preoperatively receive single-dose camrelizumab alone (n = 20), MWA alone (n = 20), or camrelizumab+MWA (n = 20). A random number table was used to allocate interventions. The primary outcome was the safety and feasibility of MWA combined with camrelizumab. FINDINGS Camrelizumab and MWA were well tolerated alone and in combination without delays in prescheduled surgery. No treatment-related grade III/IV adverse events were observed. Different from in the single-dose camrelizumab or MWA group, participants showed stable counts of blood cells after combination therapy. After combination therapy, peripheral CD8+ T cells showed enhanced cytotoxic and effect-memory functions. Clonal expansional CD8+ T cells showed higher cytotoxic activity and effector memory- and tumor-specific signatures than emergent clones after combination therapy. Enhanced interactions between clonal expansional CD8+ T cells and monocytes were observed, suggesting that monocytes contributed to the enhanced functions of clonal expansional CD8+ T cells. Major histocompatibility complex (MHC) class I-related pathways and interferon signaling pathways were activated in monocytes by combination therapy. CONCLUSIONS Camrelizumab combined with MWA was feasible for early-stage breast cancer. Peripheral CD8+ T cells were activated after combination therapy, dependent on monocytes with activated MHC class I pathways. FUNDING This study was supported by the Natural Science Foundation of Jiangsu Province (BK20230017).
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Affiliation(s)
- Hong Pan
- Department of Breast Surgery & General Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Muxin Yu
- Department of Breast Surgery & General Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xinyu Tang
- Department of Breast Surgery & General Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xinrui Mao
- Department of Breast Surgery & General Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Mingduo Liu
- Department of Breast Surgery & General Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Kai Zhang
- Pancreas Center & Department of General Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China; Pancreas Institute of Nanjing Medical University, Nanjing 210029, China
| | - Chao Qian
- Department of General Surgery, Sir Run Run Hospital, Nanjing Medical University, Nanjing 211112, China
| | - Ji Wang
- Department of Breast Surgery & General Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Hui Xie
- Department of Breast Surgery & General Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Wen Qiu
- Department of Immunology, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Antibody Technology of the Ministry of Health, Nanjing Medical University, Nanjing 211166, China
| | - Qiang Ding
- Department of Breast Surgery & General Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Shui Wang
- Department of Breast Surgery & General Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Wenbin Zhou
- Department of Breast Surgery & General Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
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Torralba EJ, Fisher G, Fursmidt R, Gilbert M, Nystrom P, Malcom A, Mathis J, Short R. BPI24-013: Microwave Ablation Versus Resection Versus Stereotactic Body Radiation Therapy of Stage IA Non-Small Cell Lung Cancer in US Veterans. J Natl Compr Canc Netw 2024; 22:BPI24-013. [PMID: 38579882 DOI: 10.6004/jnccn.2023.7132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Affiliation(s)
| | - Garrett Fisher
- 1Wright State University Boonshoft School of Medicine, Dayton, OH
| | - Reid Fursmidt
- 1Wright State University Boonshoft School of Medicine, Dayton, OH
| | - Michael Gilbert
- 1Wright State University Boonshoft School of Medicine, Dayton, OH
| | - Perry Nystrom
- 1Wright State University Boonshoft School of Medicine, Dayton, OH
| | - Albert Malcom
- 1Wright State University Boonshoft School of Medicine, Dayton, OH
| | - John Mathis
- 1Wright State University Boonshoft School of Medicine, Dayton, OH
| | - Robert Short
- 2Dayton Veteran Affairs Medical Center, Dayton, OH
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21
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Yang X, Zhao W, Chen S, Yang J. Microwave ablation for diffuse adenomyosis leading to multiple complications after hysterectomy: A case report and literature review. Medicine (Baltimore) 2024; 103:e37701. [PMID: 38579043 PMCID: PMC10994439 DOI: 10.1097/md.0000000000037701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/04/2024] [Indexed: 04/07/2024] Open
Abstract
RATIONALE Hysterectomy after microwave ablation (MWA) is more difficult than conventional surgery which increases the probability of postoperative complications due to MWA's collateral thermal damage to nearby intestines. Here we report a case of multiple postoperative complications after hysterectomy following MWA. PATIENT CONCERNS A 44-year-old female was admitted due to progressive abdominal pain during menstruation for 30 years and no relief 1 year after MWA. Hysterectomy was performed. Intraoperative findings: pelvic inflammatory exudation; the uterus and the left adnexa were extensively and densely adhered to the intestine, bladder, pelvic wall and surrounding tissues; the local tissue of the uterus was brittle and dark yellow. Intestinal obstruction, abdominal infection and urinary fistula occurred after hysterectomy. DIAGNOSES 1. Adenomyosis. 2. Endometrial polyps. 3. Left chocolate cyst of ovary. 4. Pelvic adhesions. 5. Pelvic inflammation. INTERVENTIONS The patient underwent intestinal obstruction catheter implantation, ultrasound-guided pelvic fluid mass puncture drainage, right kidney puncture and fistula drainage, right ureteral bladder replantation, and right ureteral stent implantation. OUTCOMES After 48 days of comprehensive treatment, the patient was cured and discharged. LESSONS Microwave ablation has a poor therapeutic effect on diffuse adenomyosis, and should avoid excessive ablation during the ablation process.
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Affiliation(s)
- Xiuchun Yang
- School of Nursing, Weifang Medical University, Weifang, People’s Republic of China
- Gynecology Ward, Yidu Central Hospital, Weifang, People’s Republic of China
| | - Wenhui Zhao
- Gynecology Ward, Yidu Central Hospital, Weifang, People’s Republic of China
| | - Shujuan Chen
- School of Nursing, Weifang Medical University, Weifang, People’s Republic of China
| | - Jinhong Yang
- Department of Oncology, Weifang People’s Hospital, Weifang, People’s Republic of China
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22
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Liu S, Zhou P, Shen Q, Qian G. Efficacy of microwave ablation with parallel acupuncture guided by ultrasound in treating single hepatocellular carcinoma in high-risk areas: A retrospective analysis of 155 patients. J Cancer Res Ther 2024; 20:547-554. [PMID: 38687924 DOI: 10.4103/jcrt.jcrt_1246_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/02/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To investigate the safety and short- and long-term efficacy of ultrasound-guided microwave ablation (MWA) with parallel acupuncture for treating single hepatocellular carcinoma (HCC) in high-risk areas. METHODS Retrospective analysis was performed on 155 patients with single hepatocellular carcinoma who underwent microwave ablation in our hospital between December 2015 and September 2016. Patients with a tumor distance of ≤5 mm from the risk area were included in the observation group. Patients with a tumor distance of >5 mm from the risk area were placed in the control group. The patients' preoperative general health status, tumor site, tumor size, follow-up data, disease-free survival rate, overall survival rates, local tumor progression, and intrahepatic distant recurrence rate were collected and analyzed. RESULTS The 1-, 3-, and 5-year overall survival rates for the observation group were 91.8%, 75.5%, and 59.2%, respectively. The 1-, 3-, and 5-year overall survival rates for the control group were 97.2%, 84.0%, and 66.0%, respectively. There were no significant differences between the two groups (P = 0.522). A tumor size of ≤20 mm (HR = 0.488, 95% CI = 0.254-0.940, P = 0.032) was an independent risk factor affecting the overall survival of patients with solitary HCC treated with MWA. The 1-, 3-, and 5-year recurrence-free survival rates for the observation group were 59.2%, 28.6%, and 18.4%, respectively, and those for the control group were 79.2%, 43.4%, and 31.1%, respectively. There was a statistical difference between the two groups (P = 0.007). Tumor size ≤20 mm (HR = 0.468, 95% CI = 0.303-0.723, P = 0.001), tumor location in a risk area (HR = 1.662, 95% CI = 1.121-2.465, P = 0.011), and an α-fetoprotein (AFP) level of <200 ug/L (HR = 0.612, 95% CI = 0.386-0.970, P = 0.036) are independent factors affecting the recurrence-free survival of MWA treatment for HCC. CONCLUSION Microwave ablation with parallel acupuncture guided by ultrasound is a safe and effective treatment for single hepatocellular carcinoma in high-risk areas.
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Affiliation(s)
- Sheng Liu
- Department of Interventional Ultrasound, Eastern Hepatobiliary Surgery Hospital, Third Affiliated Hospital of China Naval Medical University, Shanghai, China
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23
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Lau KK, Lau RW, Baranowski R, Krzykowski J, Ng CS. Transbronchial Microwave Ablation of Peripheral Lung Tumors: The NAVABLATE Study. J Bronchology Interv Pulmonol 2024; 31:165-174. [PMID: 37747275 PMCID: PMC10984635 DOI: 10.1097/lbr.0000000000000950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Image-guided thermal ablation is a minimally invasive local therapy for lung malignancies. NAVABLATE characterized the safety and performance of transbronchial microwave ablation (MWA) in the lung. METHODS The prospective, single-arm, 2-center NAVABLATE study (NCT03569111) evaluated transbronchial MWA in patients with histologically confirmed lung malignancies ≤30 mm in maximum diameter who were not candidates for, or who declined, both surgery and stereotactic body radiation therapy. Ablation of 1 nodule was allowed per subject. The nodule was reached with electromagnetic navigation bronchoscopy. Cone-beam computed tomography was used to verify the ablation catheter position and to evaluate the ablation zone postprocedure. The primary end point was composite adverse events related to the transbronchial MWA device through 1-month follow-up. Secondary end points included technical success (nodule reached and ablated according to the study protocol) and technique efficacy (satisfactory ablation based on 1-month follow-up imaging). RESULTS Thirty subjects (30 nodules; 66.7% primary lung, 33.3% oligometastatic) were enrolled from February 2019 to September 2020. The pre-procedure median nodule size was 12.5 mm (range 5 to 27 mm). Procedure-day technical success was 100% (30/30), with a mean ablative margin of 9.9±2.7 mm. One-month imaging showed 100% (30/30) technique efficacy. The composite adverse event rate related to the transbronchial MWA device through 1-month follow-up was 3.3% (1 subject, mild hemoptysis). No deaths or pneumothoraces occurred. Four subjects (13.3%) experienced grade 3 complications; none had grade 4 or 5. CONCLUSION Transbronchial microwave ablation is an alternative treatment modality for malignant lung nodules ≤30 mm. There were no deaths or pneumothorax. In all, 13.3% of patients developed grade 3 or above complications.
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Affiliation(s)
- Kelvin K.W. Lau
- Department of Thoracic Surgery, Barts Thorax Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
| | - Rainbow W.H. Lau
- Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Ralitsa Baranowski
- Department of Thoracic Surgery, Barts Thorax Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
| | | | - Calvin S.H. Ng
- Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
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24
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Wu J, Lu W, Cheng G, Hu Q, Jiang B, Liao S. Assessing postoperative wound infection rates in ultrasound-guided microwave ablation versus conventional surgery for varicose veins. Int Wound J 2024; 21:e14584. [PMID: 38112035 PMCID: PMC10961856 DOI: 10.1111/iwj.14584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/20/2023] Open
Abstract
Varicose veins are the prevalent vascular disorder that has conventionally been managed via risky postoperative wound infections and conventional surgery. While ultrasound-guided microwave ablation (UMA) has gained attention as a minimally invasive alternative, there is still a lack of research examining its comparative effectiveness. A prospective comparative investigation was undertaken in the Zhejiang region of China from January to November 2023, involving 140 patients who had received the diagnosis of primary varicose veins. An equal number of 70 patients underwent UMA and conventional surgery. Exclusion criteria for the study encompassed adult patients aged 18-65, with the exception of those who had undergone prior venous surgery, deep vein thrombosis or peripheral arterial disease. The demographical characteristics, procedural details and complication profiles of patients who developed postoperative wound infections within 30 days were analysed statistically. The outcomes demonstrated that postoperative wound infections were significantly diminished (5.7%) with UMA in comparison to conventional surgery (17.1%). In addition, the average duration of procedures and length of hospital stay for UMA patients were both reduced, although neither of these differences was found to be statistically significant (p > 0.05). Infection management, age and gender distribution of varicose veins were comparable between the two groups (p > 0.05). A significant inverse correlation was observed between the severity of varicose veins and postoperative outcomes, as determined by the regression analysis (p < 0.05). Using UMA to treat varicose veins showed promise as an alternative to conventional surgery, specifically in minimizing the incidence of postoperative wound infections. Additional research and clinical consideration are needed regarding the potential transition toward minimally invasive techniques in treatment of varicose veins, as suggested by these results.
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Affiliation(s)
- Jiawen Wu
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
| | - Wei Lu
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
| | - Guobing Cheng
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
| | - Qiang Hu
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
| | - Buping Jiang
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
| | - Sheng Liao
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
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25
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Zhao ZL, Wang SR, Dong G, Liu Y, He JF, Shi LL, Guo JQ, Wang ZH, Cong ZB, Liu LH, Yang BB, Qu CP, Niu WQ, Wei Y, Peng LL, Li Y, Lu NC, Wu J, Yu MA. Microwave Ablation versus Surgical Resection for US-detected Multifocal T1N0M0 Papillary Thyroid Carcinoma: A 10-Center Study. Radiology 2024; 311:e230459. [PMID: 38563669 DOI: 10.1148/radiol.230459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background Microwave ablation (MWA) is currently under preliminary investigation for the treatment of multifocal papillary thyroid carcinoma (PTC) and has shown promising treatment efficacy. Compared with surgical resection (SR), MWA is minimally invasive and could preserve thyroid function. However, a comparative analysis between MWA and SR is warranted to draw definitive conclusions. Purpose To compare MWA and SR for preoperative US-detected T1N0M0 multifocal PTC in terms of overall and 1-, 3-, and 5-year progression-free survival rates and complication rates. Materials and Methods In this retrospective study, 775 patients with preoperative US-detected T1N0M0 multifocal PTC treated with MWA or SR across 10 centers between May 2015 and December 2021 were included. Propensity score matching (PSM) was performed for patients in the MWA and SR groups, followed by comparisons between the two groups. The primary outcomes were overall and 1-, 3-, and 5-year progression-free survival (PFS) rates and complication rates. Results After PSM, 229 patients (median age, 44 years [IQR 36.5-50.5 years]; 179 female) in the MWA group and 453 patients (median age, 45 years [IQR 37-53 years]; 367 female) in the SR group were observed for a median of 20 months (range, 12-74 months) and 26 months (range, 12-64 months), respectively. MWA resulted in less blood loss, shorter incision length, and shorter procedure and hospitalization durations (all P < .001). There was no evidence of differences in overall and 1-, 3-, or 5-year PFS rates (all P > .05) between MWA and SR (5-year rate, 77.2% vs 83.1%; P = .36) groups. Permanent hoarseness (2.2%, P = .05) and hypoparathyroidism (4.0%, P = .005) were encountered only in the SR group. Conclusion There was no evidence of a significant difference in PFS rates between MWA and SR for US-detected multifocal T1N0M0 PTC, and MWA resulted in fewer complications. Therefore, MWA is a feasible option for selected patients with multifocal T1N0M0 PTC. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Georgiades in this issue.
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Affiliation(s)
- Zhen-Long Zhao
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Shu-Rong Wang
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Gang Dong
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Ying Liu
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Jun-Feng He
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Li-Li Shi
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Jian-Qin Guo
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Zhong-Hua Wang
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Zhi-Bin Cong
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Li-Hong Liu
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Bei-Bei Yang
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Chun-Ping Qu
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Wen-Quan Niu
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Ying Wei
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Li-Li Peng
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Yan Li
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Nai-Cong Lu
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Jie Wu
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
| | - Ming-An Yu
- From the Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Z.L.Z., Y.W., L.L.P., Y. Li, N.C.L., J.W., M.A.Y.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics and Traumatology, Yantai, China (S.R.W., Y. Liu); Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (G.D.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China (J.F.H.); Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.); Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou, China (J.Q.G.); Department of Special Inspection, Wendeng District People's Hospital, Weihai, China (Z.H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (L.H.L., B.B.Y.); Department of Special Inspection, Muping Zhongyi Hospital, Yantai, China (C.P.Q.); Department of Clinical Medical Sciences, Capital Institute of Pediatrics, Beijing, China (W.Q.N.)
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Zeinali N, Sebek J, Fallahi H, Pfannenstiel A, Prakash P. Transmission Coefficient-Based Monitoring of Microwave Ablation: Development and Experimental Evaluation in Ex Vivo Tissue. IEEE Trans Biomed Eng 2024; 71:1269-1280. [PMID: 37943642 DOI: 10.1109/tbme.2023.3331659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
OBJECTIVES To assess the feasibility of monitoring transient evolution of thermal ablation zones with a microwave transmission coefficient-based technique. METHODS Microwave ablation was performed in ex vivo bovine liver with two 2.45 GHz directional antennas. A custom apparatus was developed to enable periodic switching between "heating mode" when power from the generator was coupled to the antennas, and "monitoring mode", when antennas were coupled to a network analyzer for broadband transmission coefficient ( s21) measurements. Experiments were performed with applied powers ranging between 30-50 W per antenna for 53-1219 s. Transient s21 spectra over the course of ablations were analyzed to determine feasibility of predicting extent of ablation zones and compared against ground truth assessment from images of sectioned tissue. A linear regression-based mapping between the two datasets was derived to predict ablation extent. RESULTS Normalized average transmission coefficient initially rapidly decreased and then increased before asymptotically approaching steady state, with the transition time ranging between 53 s (45 W) and 109 s (30 W). Analysis of ground truth ablation zone images indicated time to complete ablation of 230-350 s. The relative prediction error for time to complete ablation derived from the s21 data was in the range of 1.6%-2.3% compared to ground truth. CONCLUSION We have demonstrated the feasibility of monitoring transient evolution of thermal ablation zones using microwave transmission coefficient measurements in ex vivo tissue. SIGNIFICANCE The presented technique has potential to contribute towards addressing the clinical need for a method of monitoring evolution of thermal ablation zones.
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Wang Z, Zuo T, Lin W, Liang Y, Jiang F, Li Y. Safety and clinical efficacy of microwave ablation combined with percutaneous vertebroplasty in the treatment of multisegmental spinal metastases. J Cancer Res Ther 2024; 20:712-717. [PMID: 38687944 DOI: 10.4103/jcrt.jcrt_558_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 12/26/2023] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To evaluate the safety and efficacy of microwave ablation (MWA) combined with percutaneous vertebroplasty (PVP) in the treatment of multisegmental (2-3 segments) osteolytic spinal metastases. MATERIALS AND METHODS This study comprised a retrospective analysis of data from 20 patients with multisegmental (2-3 segments) osteolytic spinal metastases who received MWA combined with PVP. The visual analog scale (VAS) score, Oswestry Disability Index (ODI) score, Quality of Life Questionnaire-Bone Metastases 22 (QLQ-BM22), and local recurrence before and after the operation were measured. The occurrence of complications was observed to evaluate safety. RESULTS All operations were completed successfully with no serious complications. Transient nerve injury occurred in two cases, but recovered after symptomatic treatment. The bone cement leakage rate was 13.9% (6/43). The mean baseline VAS scores were 7.25 ± 0.91 before treatment and 7.25 ± 0.91, 3.70 ± 1.12, 2.70 ± 0.73, 2.40 ± 0.68, 2.25 ± 0.71, and 2.70 ± 0.92 at 1 day, 1 week, 1, 3, and 6 months after treatment; all values were significantly lower (P < 0.001). The mean baseline ODI score decreased from 56.90 ± 9.74 before treatment to 41.90 ± 7.09, 38.10 ± 7.93, and 38.80 ± 10.59 at 1, 3, and 6 months after treatment, respectively; all values were significantly lower (P < 0.001). The average QLQ-BM22 baseline score decreased from 54.10 ± 5.36 before treatment to 44.65 ± 5.22, 43.05 ± 4.78, 42.30 ± 4.06, and 42.15 ± 5.47 at 1 week, 1, 3, and 6 months after treatment; all values were significantly lower (all P < 0.001). The postoperative survival time of all patients was >6 months. In three patients, four vertebral segments recurred 6 months after operation. CONCLUSION MWA combined with PVP is a safe and effective treatment for multisegmental osteolytic vertebral metastases that can effectively relieve pain, improve spinal function, improve quality of life, and delay tumor progression. However, it is a long operation, necessitating good preoperative preparation and effective intraoperative pain relief measures.
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Affiliation(s)
- Zhilong Wang
- Department of Oncology Intervention, Central Hospital Affiliated to Shandong First Medical University, 105 Jiefang Road, Jinan, Shangdong Province, China
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Han L, Wu XL, Guo F, Xi YN, Chang XY, Zhang CZ, Zhang JF, Ma PC. [Clinical Application of Microwave Ablation in Potentially Resectable Colorectal Cancer With Simultaneously Multiple Liver Metastases]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2024; 46:161-168. [PMID: 38686711 DOI: 10.3881/j.issn.1000-503x.15900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Objective To analyze the clinical efficacy of microwave ablation in the colorectal cancer with simultaneously multiple liver metastases that was initially evaluated as potentially resectable. Methods The patients with potentially resectable colorectal cancer with simultaneous multiple liver metastases treated in the Department of General Surgery of the First Affiliated Hospital of Hebei North University,the Center of Minimally Invasive Therapy in Oncology of Traditional Chinese and Western Medicine in Dongzhimen Hospital of Beijing University of Chinese Medicine,and the Second Department of General Surgery in the Fourth Hospital of Hebei Medical University from October 1,2018 to October 1,2020 were selected in this study.The general data,pathological features,treatment methods,and clinical efficacy of the patients were collected.According to the treatment methods,the patients were assigned into a surgical resection group(conversion therapy+laparoscopic primary resection+hepatectomy)and a microwave ablation group(conversion therapy+laparoscopic primary resection+microwave ablation).The surgical indicators(operation duration,time to first postoperative anal exhaust,hospital stay,etc.)and postoperative complications(anastomotic stenosis,anastomotic hemorrhage,incision infection,etc.)were compared between the two groups.The survival period was followed up,including the overall survival period and disease-free survival period,and the survival curves were drawn to analyze the clinical efficacy of the two treatment regimens. Results A total of 198 patients with potentially resectable colorectal cancer with simultaneous multiple liver metastases were included in this study.Sixty-six patients were cured by neoadjuvant chemotherapy(FOLFOX or FOLFIRI),including 30 patients in the surgical resection group and 36 patients in the microwave ablation group(with 57 tumors ablated).After the first ablation,54(94.74%)tumors achieved complete ablation,and all of them reached no evidence of disease status after re-ablation.The microwave ablation group had shorter operation duration,less intraoperative blood loss,shorter time to first postoperative anal exhaust,shorter time of taking a liquid diet,shorter hospital stay,and lower hospitalization cost than the surgical resection group(all P<0.001).In addition,the microwave ablation group had lower visual analogue scale score(P<0.001)than the surgical resection group.The incidences of complications such as incision infection(P=0.740),anastomotic fistula(P=1.000),and anastomotic stenosis(P=1.000),the overall survival period(P=0.191),and the disease-free survival period(P=0.934)showed no significant differences between the two groups. Conclusions For patients with colorectal cancer with simultaneous multiple liver metastases initially assessed as potentially resectable,laparoscopic primary resection+surgical resection/microwave ablation after conversion therapy was safe,effective,and had similar survival outcomes.Microwave ablation outperformed surgical resection in postoperative recovery,economy,and tolerability,being worthy of clinical promotion.
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Affiliation(s)
- Lei Han
- 1 Department of General Surgery,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China
| | - Xue-Liang Wu
- 1 Department of General Surgery,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China
- 2 Insistute of Oncology,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China
| | - Fei Guo
- 1 Department of General Surgery,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China
| | - Yu-Ning Xi
- 1 Department of General Surgery,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China
| | - Xiao-Yan Chang
- 3 Center of Minimally Invasive Therapy in Oncology of Traditional Chinese and Western Medicine,Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100029,China
| | - Chun-Ze Zhang
- 4 Department of Anus and Intestine Surgery,People's Hospital of Tianjin,Tianjin 300000,China
| | - Jian-Feng Zhang
- 5 Second Department of General Surgery,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050000,China
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Ren J, Qiao Y, Jin L, Mao C, Wang C, Wu S, Zheng Y, Li Z, Cui Z, Jiang H, Zhu S, Liu X. A Smart Bacteria-Capture-Killing Vector for Effectively Treating Osteomyelitis Through Synergy Under Microwave Therapy. Small 2024; 20:e2307406. [PMID: 38009734 DOI: 10.1002/smll.202307406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/03/2023] [Indexed: 11/29/2023]
Abstract
Osteomyelitis caused by deep tissue infections is difficult to cure through phototherapy due to the poor penetration depth of the light. Herein, Cu/C/Fe3O4-COOH nanorod composites (Cu/C/Fe3O4-COOH) with nanoscale tip convex structures are successfully fabricated as a microwave-responsive smart bacteria-capture-killing vector. Cu/C/Fe3O4-COOH exhibited excellent magnetic targeting and bacteria-capturing ability due to its magnetism and high selectivity affinity to the amino groups on the surface of Staphylococcus aureus (S. aureus). Under microwave irradiation, Cu/C/Fe3O4-COOH efficiently treated S. aureus-infected osteomyelitis through the synergistic effects of microwave thermal therapy, microwave dynamic therapy, and copper ion therapy. It is calculated the electric field intensity in various regions of Cu/C/Fe3O4-COOH under microwave irradiation, demonstrating that it obtained the highest electric field intensity on the surface of copper nanoparticles of Cu/C/Fe3O4-COOH due to its high-curvature tips and metallic properties. This led to copper nanoparticles attracted more charged particles compared with other areas in Cu/C/Fe3O4-COOH. These charges are easier to escape from the high curvature surface of Cu/C/Fe3O4-COOH, and captured by adsorbed oxygen, resulting in the generation of reactive oxygen species. The Cu/C/Fe3O4-COOH designed in this study is expected to provide insight into the treatment of deep tissue infections under the irradiation of microwave.
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Affiliation(s)
- Jinzhi Ren
- School of Materials Science and Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Yaguan Road 135#, Tianjin, 300072, China
- Biomedical Materials Engineering Research Center, Hubei Key Laboratory of Polymer Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science and Engineering, State Key Laboratory of Biocatalysis and Enzyme Engineering, Hubei University, Wuhan, 430062, China
- School of Materials Science and Engineering, Peking University, Yi-He-Yuan Road 5#, Beijing, 100871, China
| | - Yuqian Qiao
- School of Materials Science and Engineering, Peking University, Yi-He-Yuan Road 5#, Beijing, 100871, China
| | - Liguo Jin
- School of Materials Science and Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Yaguan Road 135#, Tianjin, 300072, China
- Biomedical Materials Engineering Research Center, Hubei Key Laboratory of Polymer Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science and Engineering, State Key Laboratory of Biocatalysis and Enzyme Engineering, Hubei University, Wuhan, 430062, China
- School of Materials Science and Engineering, Peking University, Yi-He-Yuan Road 5#, Beijing, 100871, China
| | - Congyang Mao
- Biomedical Materials Engineering Research Center, Hubei Key Laboratory of Polymer Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science and Engineering, State Key Laboratory of Biocatalysis and Enzyme Engineering, Hubei University, Wuhan, 430062, China
| | - Chaofeng Wang
- School of Health Science and Biomedical Engineering, Hebei University of Technology, Xiping Avenue 5340#, Tianjin, 300401, China
| | - Shuilin Wu
- School of Materials Science and Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Yaguan Road 135#, Tianjin, 300072, China
- Biomedical Materials Engineering Research Center, Hubei Key Laboratory of Polymer Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science and Engineering, State Key Laboratory of Biocatalysis and Enzyme Engineering, Hubei University, Wuhan, 430062, China
- School of Materials Science and Engineering, Peking University, Yi-He-Yuan Road 5#, Beijing, 100871, China
| | - Yufeng Zheng
- School of Materials Science and Engineering, Peking University, Yi-He-Yuan Road 5#, Beijing, 100871, China
| | - Zhaoyang Li
- School of Materials Science and Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Yaguan Road 135#, Tianjin, 300072, China
| | - Zhenduo Cui
- School of Materials Science and Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Yaguan Road 135#, Tianjin, 300072, China
| | - Hui Jiang
- School of Materials Science and Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Yaguan Road 135#, Tianjin, 300072, China
| | - Shengli Zhu
- School of Materials Science and Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Yaguan Road 135#, Tianjin, 300072, China
| | - Xiangmei Liu
- Biomedical Materials Engineering Research Center, Hubei Key Laboratory of Polymer Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science and Engineering, State Key Laboratory of Biocatalysis and Enzyme Engineering, Hubei University, Wuhan, 430062, China
- School of Health Science and Biomedical Engineering, Hebei University of Technology, Xiping Avenue 5340#, Tianjin, 300401, China
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Alhasan AS, Daqqaq TS, Alhasan MS, Ghunaim HA, Aboualkheir M. Complication Rates and Risk of Recurrence After Percutaneous Radiofrequency Ablation and Microwave Ablation for the Treatment of Liver Tumors: a Meta-analysis. Acad Radiol 2024; 31:1288-1301. [PMID: 38087720 DOI: 10.1016/j.acra.2023.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 04/14/2024]
Abstract
RATIONALE AND OBJECTIVES The rate of complications and risk of local recurrence following percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) for liver tumors varies significantly between investigations. This meta-analysis aimed to assess complication rates and risk of local recurrence after percutaneous RFA and MWA. MATERIALS AND METHODS PubMed, Medline, Web of Science, the Cochrane Library, Embase, Google Scholar, and CINAHL were systematically searched from database inception until August 2022 to retrieve articles reporting the complication rates and risk of recurrence after percutaneous RFA and MWA for the treatment of liver tumors. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated and displayed by forest plots. To measure heterogeneity, Cochran Q and I2 statistics were also applied. Egger's test and funnel plots were also performed to assess any potential publication bias. Additionally, subgroup analysis was done to investigate the source of heterogeneity. RESULTS 26 studies including 2026 and 1974 patients for RFA and MWA, respectively, were included. The rate of minor complications was significantly higher after MWA compared to RFA, yielding an overall OR of 0.688 (95% CI: 0.549-0.862, P = 0.001). Similarly, the rate of major complications was significantly higher after MWA than RFA (P = 0.012), yielding an overall OR of 0.639 (95% CI: 0.450-0.907). No significant difference was found between RFA and MWA in terms of local recurrence after ablation (P > 0.05). In addition, there was no statistical evidence of publication bias. CONCLUSION When most factors are considered equally, percutaneous RFA and MWA can be considered safe modalities for the treatment of liver tumors, with RFA superior in terms of the incidence of minor and major complications.
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Affiliation(s)
- Ayman S Alhasan
- Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah, Saudi Arabia (A.S.A., T.S.D., M.S.A., H.A.G., M.A.); Department of Radiology, King Faisal Specialist Hospital and Research Centre, Madinah, Saudi Arabia (A.S.A.).
| | - Tareef S Daqqaq
- Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah, Saudi Arabia (A.S.A., T.S.D., M.S.A., H.A.G., M.A.)
| | - Mustafa S Alhasan
- Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah, Saudi Arabia (A.S.A., T.S.D., M.S.A., H.A.G., M.A.)
| | - Hadeel A Ghunaim
- Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah, Saudi Arabia (A.S.A., T.S.D., M.S.A., H.A.G., M.A.)
| | - Mervat Aboualkheir
- Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah, Saudi Arabia (A.S.A., T.S.D., M.S.A., H.A.G., M.A.); Department of Clinical Science /College of Medicine/Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia (M.A.)
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Zhou Y, Shu G, Luo Y, Wang F, Jing X, Pan J, Sun SK. Achieving Complete Tumor Clearance: A Minimalist Manganese Hydrogel for Magnetic Resonance Imaging-Guided Synergetic Microwave Ablation and Chemodynamic Therapy. Adv Healthc Mater 2024; 13:e2303268. [PMID: 38140916 DOI: 10.1002/adhm.202303268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/29/2023] [Indexed: 12/24/2023]
Abstract
The combination of microwave ablation (MWA) and chemodynamic therapy (CDT) presents a promising strategy for complete eradication of residual tumor after MWA. However, it remains challenging and urgent to develop a facile, biocompatible, and imaging-guided platform for the achievement of this goal. Herein, a minimalist manganese hydrogel (ALG-Mn hydrogel) is proposed for synergistic MWA and CDT to completely eradicate tumor in vivo. The ALG-Mn hydrogel is prepared using a simple mixing method and exhibits excellent syringeability, remarkable microwave sensitivity, and potent Fenton-like activity. By assisting in MWA procedures, the ALG-Mn hydrogel enables both elimination of primary tumor mass through enhanced MWA efficacy and eradication of potential residual tumor tissues via robust CDT. This approach achieves complete tumor clearance without additional drug loading. Furthermore, the paramagnetic Mn2+ component allows real-time dynamic visualization of the ALG-Mn hydrogel at the tumor site via magnetic resonance imaging. To the best of knowledge, the proposed ALG-Mn hydrogel represents the minimalist biocompatible platform for imaging-guided synergistic MWA and CDT toward achieving complete tumor clearance.
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Affiliation(s)
- Yan Zhou
- School of Medicine, Nankai University, Tianjin, 300071, China
- Department of Ultrasound, Tianjin Third Central Hospital, Tianjin, 300170, China
| | - Gang Shu
- School of Medical Imaging, Tianjin Medical University, Tianjin, 300203, China
- Department of Radiology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Ying Luo
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary Disease, Tianjin Third Central Hospital, Tianjin, 300170, China
| | - Fengmei Wang
- School of Medicine, Nankai University, Tianjin, 300071, China
- Department of Ultrasound, Tianjin Third Central Hospital, Tianjin, 300170, China
- Tianjin Key Laboratory of Molecular Diagnosis and Treatment of Liver Cancer, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Xiang Jing
- Department of Ultrasound, Tianjin Third Central Hospital, Tianjin, 300170, China
| | - Jinbin Pan
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Shao-Kai Sun
- School of Medical Imaging, Tianjin Medical University, Tianjin, 300203, China
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Peng H, Wang M, Lu S, Liu J, Zhang Y, Fu Z, Li C, Huang Y, Guo J, Xu Z, Yang N. Enhanced recovery after surgery for percutaneous CT-guided microwave ablation of lung tumors: A single-center retrospective cohort study. J Cancer Res Ther 2024; 20:651-657. [PMID: 38687936 DOI: 10.4103/jcrt.jcrt_2017_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/24/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The feasibility and safety of enhanced recovery after surgery (ERAS) for percutaneous computed tomography (CT)-guided microwave ablation (MWA) for treating lung nodules remain unclear. METHODS AND MATERIALS A total of 409 patients with lung tumors treated at the Department of Thoracic Surgery, First Affiliated Hospital of Guangxi Medical University from August 2020 to May 2023 were enrolled. Perioperative data, including baseline characteristics, operation time, postoperative pain score (visual analog scale [VAS]), hospitalization expenses, postoperative complications, total hospital stay, and patient satisfaction, were observed and recorded. RESULTS No perioperative mortality occurred in either group and complete ablation was achieved in all patients. Patients in the ERAS group had significantly shorter hospital stays (P < 0.001), reduced operation times (P = 0.047), lower hospitalization expenses (P < 0.001), lower VAS scores (P < 0.001), and fewer complications (P = 0.047) compared with the traditional group. CONCLUSIONS ERAS for percutaneous CT-guided MWA (ERAA) is safe, effective, and feasible for the treatment of lung nodules.
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Affiliation(s)
- Huajian Peng
- Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
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Lucignani G, De Lorenzis E, Ierardi AM, Silvani C, Marmiroli A, Nizzardo M, Albo G, Carrafiello G, Montanari E, Boeri L. Perioperative and Survival Outcomes of Patients Treated With Robot-Assisted Partial Nephrectomy and Percutaneous Microwave Ablation for Small Renal Masses: A Single Center Experience. Clin Genitourin Cancer 2024; 22:237-243. [PMID: 38065718 DOI: 10.1016/j.clgc.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Robot assisted partial nephrectomy (RAPN) and microwave ablation (MWA) are 2 of the most advanced techniques for the management of localized small renal masses. PURPOSE To compare the perioperative, functional and oncological results of RAPN and MWA. MATERIALS AND METHODS Data from 171 consecutive patients undergoing either RAPN or MWA for a localized small renal mass at a single academic center was retrospectively collected. Baseline features included patients' demographics and masses' characteristics. Procedures were compared in terms of perioperative outcomes and renal function variation Progression of a persistent lesion or local recurrence after a complete treatment defined local tumor progression. Descriptive statistics and survival analysis tested the association between predictors and local tumor progression. RESULTS Of all, 109 and 62 patients underwent RAPN and MWA. Patients in the MWA group were older (P = .002) had higher Charlson Comorbidity Index (CCI) (P < .001) and higher frequency of preoperative chronic kidney disease (P < .001). MWA led to a shorter postoperative hospitalization time (P < .001) and lower incidence of medical complications (6.5% vs. 22.9%, P = .02) than RAPN. GFR decline was similar between groups both at discharge (P = .39) and at the time of last follow up (P = 1.00). A lower rate of secondary interventions (11.7% vs. 2.8%, P = .037) and a better disease-free survival (83.2% vs. 96.5%, P = .027) were reported after RAPN. Conversely, cancer specific and overall survival were comparable (P > .05). At univariate regression analysis, MWA was associated with local tumor progression (HR 3.46, P = .040). CONCLUSION MWA displayed a lower perioperative impact, while functional outcomes were similar after each intervention. RAPN resulted superior in terms of tumor eradication, but no difference was noted regarding cancer specific survival. Thus, MWA represents a valid alternative in frail patients, though less radical than RAPN.
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Affiliation(s)
- Gianpaolo Lucignani
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa De Lorenzis
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Maria Ierardi
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Silvani
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Marmiroli
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Nizzardo
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giancarlo Albo
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gianpaolo Carrafiello
- Department of Radiology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Emanuele Montanari
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Luca Boeri
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Wu L, Hu M, Li P, Man Q, Yuan Q, Zhang X, Qiu Y, Chen L, Fan J, Zhang K. Microwave ablation combined with percutaneous vertebroplasty for treating painful non-small cell lung cancer with spinal metastases under real-time temperature monitoring. J Cancer Res Ther 2024; 20:540-546. [PMID: 38687923 DOI: 10.4103/jcrt.jcrt_1074_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 12/01/2023] [Indexed: 05/02/2024]
Abstract
PURPOSE To retrospectively study the therapeutic effect and safety performance of the combination strategies of the computed tomography (CT)-guided microwave ablation (MWA) and percutaneous vertebroplasty (PVP) as a treatment for painful non-small cell lung cancer (NSCLC) with spinal metastases. MATERIALS AND METHODS A retrospective review included 71 patients with 109 vertebral metastases who underwent microwave ablation combined with percutaneous vertebroplasty by the image-guided and real-time temperature monitoring. Treatment efficacy was determined by comparing visual analog scale (VAS) scores, daily morphine equivalent opioid consumption, and Oswestry Disability Index (ODI) scores before treatment and during the follow-up period. RESULTS Technical success was achieved in all patients. The mean pre-procedure VAS score and morphine doses were 6.6 ± 1.8 (4-10) and 137.2 ± 38.7 (40-200) mg, respectively. The mean VAS scores and daily morphine doses at 24 h and 1, 4, 12, and 24 weeks postoperatively were 3.3 ± 1.9 and 73.5 ± 39.4 mg; 2.2 ± 1.5 and 40.2 ± 29.8 mg; 1.7 ± 1.2 and 31.3 ± 23.6 mg; 1.4 ± 1.1 and 27.3 ± 21.4 mg; and 1.3 ± 1.1 and 24.8 ± 21.0 mg, respectively (all P < 0.001). ODI scores significantly decreased (P < 0.05). Minor cement leakage occurred in 51 cases (46.8%), with one patient having a grade 3 neural injury. No local tumor progression was observed by follow-up imaging. CONCLUSIONS MWA combined with PVP can significantly relieve pain and improve patients' quality of life, which implied this is an effective treatment option for painful NSCLC with spinal metastases. Additionally, its efficacy should be further verified through the mid- and long-term studies.
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Affiliation(s)
- Linlin Wu
- Department of Oncology, Tengzhou Central People's Hospital Affiliated Xuzhou Medical University, Tengzhou City, Shandong Province, China
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Tehrani MHH, Moradi Kashkooli F, Soltani M. Spatiotemporal modeling of nano-delivered chemotherapeutics for synergistic microwave ablation cancer therapy. Comput Methods Programs Biomed 2024; 247:108102. [PMID: 38447317 DOI: 10.1016/j.cmpb.2024.108102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/25/2024] [Accepted: 02/25/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND AND OBJECTIVE The effectiveness of current microwave ablation (MWA) therapies is limited. Administration of thermosensitive liposomes (TSLs) which release drugs in response to heat has presented a significant potential for enhancing the efficacy of thermal ablation treatment, and the benefits of targeted drug delivery. However, a complete knowledge of the mechanobiological processes underlying the drug release process, especially the intravascular drug release mechanism and its distribution in response to MWA needs to be improved. Multiscale computational-based modeling frameworks, integrating different biophysical phenomena, have recently emerged as promising tools to decipher the mechanobiological events in combo therapies. The present study aims to develop a novel multiscale computational model of TSLs delivery following MWA implantation. METHODS Due to the complex interplay between the heating procedure and the drug concentration maps, a computational model is developed to determine the intravascular release of doxorubicin from TSL, its transvascular transport into the interstitium, transport in the interstitium, and cell uptake. Computational models can estimate the interplays among liposome and drug properties, tumor perfusion, and heating regimen to examine the impact of essential parameters and to optimize a targeted drug delivery platform. RESULTS Results indicated that the synergy of TSLs with MWA allows more localized drug delivery with lower side effects. The drug release rate and tumor permeability play crucial roles in the efficacy of TSLs during MWA treatment. The computational model predicted an unencapsulated drug lime around the ablated zone, which can destroy more cancer cells compared to MWA alone by 40%. Administration of TSLs with a high release rate capacity can improve the percentage of killed cancer cells by 24%. Since the heating duration in MWA is less than 15 min, the presented combination therapy showed better performance for highly permeable tumors. CONCLUSION This study highlights the potential of the proposed computational framework to address complex and realistic scenarios in cancer treatment, which can serve as the future research foundation, including advancements in nanomedicine and optimizing the pair of TSL and MWA for both preclinical and clinical studies. The present model could be as a valuable tool for patient-specific calibration of essential parameters.
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Affiliation(s)
- Masoud H H Tehrani
- Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran Iran
| | | | - M Soltani
- Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran Iran; Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, Canada; Centre for Biotechnology and Bioengineering, University of Waterloo, Waterloo, ON, Canada.
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McCloskey C, Jacques A, McCloskey D, Tibballs J. Percutaneous microwave ablation of T1a renal cell carcinomas: A 10-year single-center retrospective review. J Med Imaging Radiat Oncol 2024; 68:297-302. [PMID: 38477383 DOI: 10.1111/1754-9485.13638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Partial nephrectomy is currently the preferred treatment option for T1a renal cell carcinomas (RCC), with nephron-sparing techniques, including microwave ablation, becoming more common in select patients. Primary aims are to document outcomes of microwave ablation for T1a RCCs in an Australian tertiary centre to add to the evidence for its safety and efficacy. METHODS The prospectively maintained Sir Charles Gairdner Hospital Interventional Radiology database was retrospectively searched for all Renal Microwave ablations completed between June 2012 and February 2022. This database and a combination of hospital programmes including Agfa Impax PACS, Bossnet digital medical record and iSoft Clinical Manager were used to extract the relevant data which was anonymized and entered into an Excel spreadsheet for analysis. RESULTS Forty-eight patients underwent microwave ablation for 50 tumours. Of these, there were two local and two distant recurrences. A fifth patient had metastases on presentation. Higher local recurrence rates were associated with larger tumour size (P = 0.043). Tumour proximity to the collecting system <4 mm was associated with higher rates of complications (P = 0.020). RENAL scores did not show statistically significant correlation with complications (P = 0.092) or local or distant recurrence. Notably, the study follow-up time was longer than many comparative studies (mean = 2796, ~7.66 years censoring for death and mean = 832 days, ~2.28 years not censoring for death). CONCLUSION Consistent with the literature, this study further demonstrates that microwave ablation is a safe and efficacious option for treatment of T1a RCC.
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Affiliation(s)
- Cassie McCloskey
- Medical Imaging Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Angela Jacques
- Institute for Health Research, The University of Notre Dame, Perth, Western Australia, Australia
- Department of Research, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Dylan McCloskey
- St John of God Health Care, Perth, Western Australia, Australia
| | - Jonathan Tibballs
- Medical Imaging Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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Wei Z, Ye X. Enhanced recovery after surgery for microwave ablation of lung tumors: Icing on the cake. J Cancer Res Ther 2024; 20:507-508. [PMID: 38687919 DOI: 10.4103/jcrt.jcrt_435_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/19/2024] [Indexed: 05/02/2024]
Affiliation(s)
- Zhigang Wei
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Institute of Lung Cancer, Jinan, China
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Storman D, Swierz MJ, Mitus JW, Pedziwiatr M, Liang N, Wolff R, Bala MM. Microwave coagulation for liver metastases. Cochrane Database Syst Rev 2024; 3:CD010163. [PMID: 38534000 PMCID: PMC10966940 DOI: 10.1002/14651858.cd010163.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Liver metastases (i.e. secondary hepatic malignancies) are significantly more common than primary liver cancer. Long-term survival after radical surgical treatment is approximately 50%. For people in whom resection for cure is not feasible, other treatments must be considered. One treatment option is microwave coagulation utilising electromagnetic waves. It involves placing an electrode into a lesion under ultrasound or computed tomography guidance. OBJECTIVES To evaluate the beneficial and harmful effects of microwave coagulation versus no intervention, other ablation methods, or systemic treatments in people with liver metastases regardless of the location of the primary tumour. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest date of search was 14 April 2023. SELECTION CRITERIA Randomised clinical trials assessing beneficial or harmful effects of microwave coagulation and its comparators in people with liver metastases, irrespective of the location of the primary tumour. We included trials no matter the outcomes reported. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methodological procedures. Our primary outcomes were: all-cause mortality at the last follow-up and time to mortality; health-related quality of life (HRQoL); and any adverse events or complications. Our secondary outcomes were: cancer mortality; disease-free survival; failure to clear liver metastases; recurrence of liver metastases; time to progression of liver metastases; and tumour response measures. We used risk ratios (RR) and hazard ratios (HR) with 95% confidence intervals (CI) to present the results. Two review authors independently extracted data and assessed the risk of bias using the Cochrane RoB 1 tool. We used GRADE methodology to assess the certainty of the evidence. MAIN RESULTS Three randomised clinical trials fulfilled the inclusion criteria. The control interventions differed in the three trials; therefore, meta-analyses were not possible. The trials were at high risk of bias. The certainty of evidence of the assessed outcomes in the three comparisons was very low. Data on our prespecified outcomes were either missing or not reported. Microwave coagulation plus conventional transarterial chemoembolisation (TACE) versus conventional TACE alone One trial, conducted in China, randomised 50 participants (mean age 60 years, 76% males) with liver metastases from various primary sites. Authors reported that the follow-up period was at least one month. The trial reported adverse events or complications in the experimental group only and for tumour response measures. There were no dropouts in the trial. The trial did not report on any other outcomes. Microwave ablation versus conventional surgery One trial, conducted in Japan, randomised 40 participants (mean age 61 years, 53% males) with multiple liver metastases of colorectal cancer. Ten participants were excluded after randomisation (six from the experimental and four from the control group); thus, the trial analyses included 30 participants. Follow-up was three years. The reported number of deaths from all causes was 9/14 included participants in the microwave group versus 12/16 included participants in the conventional surgery group. The mean overall survival was 27 months in the microwave ablation and 25 months in the conventional surgery group. The three-year overall survival was 14% with microwave ablation and 23% with conventional surgery, resulting in an HR of 0.91 (95% CI 0.39 to 2.15). The reported frequency of adverse events or complications was comparable between the two groups, except for the required blood transfusion, which was more common in the conventional surgery group. There was no intervention-related mortality. Disease-free survival was 11.3 months in the microwave ablationgroup and 13.3 months in the conventional surgery group. The trial did not report on HRQoL. Microwave ablation versus radiofrequency ablation One trial, conducted in Germany, randomised 50 participants (mean age 62.8 years, 46% males) who were followed for 24 months. Two-year mortality showed an RR of 0.62 (95% CI 0.26 to 1.47). The trial reported that, by two years, 76.9% of participants in the microwave ablationgroup and 62.5% of participants in the radiofrequency ablation group survived (HR 0.63, 95% CI 0.23 to 1.73). The trial reported no deaths or major complications during the procedures in either group. There were two minor complications only in the radiofrequency ablation group (RR 0.19, 95% CI 0.01 to 3.67). The trial reported technical efficacy in 100% of procedures in both groups. Distant recurrence was reported for 10 participants in the microwave ablation group and nine participants in the radiofrequency ablation group (RR 1.03, 95% CI 0.50 to 2.08). No participant in the microwave ablation group demonstrated local progression at 12 months, while that occurred in two participants in the radiofrequency ablation group (RR 0.19, 95% CI 0.01 to 3.67). The trial did not report on HRQoL. One trial reported partial support by Medicor (MMS Medicor Medical Supplies GmbH, Kerpen, Germany) for statistical analysis. The remaining two trials did not provide information on funding. We identified four ongoing trials. AUTHORS' CONCLUSIONS The evidence is very uncertain about the effect of microwave ablation in addition to conventional TACE compared with conventional TACE alone on adverse events or complications. We do not know if microwave ablation compared with conventional surgery may have little to no effect on all-cause mortality. We do not know the effect of microwave ablation compared with radiofrequency ablation on all-cause mortality and adverse events or complications either. Data on all-cause mortality and time to mortality, HRQoL, adverse events or complications, cancer mortality, disease-free survival, failure to clear liver metastases, recurrence of liver metastases, time to progression of liver metastases, and tumour response measures were either insufficient or were lacking. In light of the current inconclusive evidence and the substantial gaps in data, the pursuit of additional good-quality, large randomised clinical trials is not only justified but also essential to elucidate the efficacy and comparative benefits of microwave ablation in relation to various interventions for liver metastases. The current version of the review, in comparison to the previous one, incorporates two new trials in two additional microwave ablation comparisons: 1. in addition to conventional TACE versus conventional TACE alone and 2. versus radiofrequency ablation.
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Affiliation(s)
- Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz J Swierz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Jerzy W Mitus
- Department of Surgical Oncology, The Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch; Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Michal Pedziwiatr
- 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Ning Liang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | | | - Malgorzata M Bala
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
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Fan FY, Ding WZ, Liu FY, Cheng ZG, Han ZY, Yu XL, Liang P, Yu J. [Spatial distribution pattern of local tumor progression analysis after microwave ablation of hepatocellular carcinoma based on three-dimensional magnetic resonance imaging]. Zhonghua Gan Zang Bing Za Zhi 2024; 32:208-213. [PMID: 38584101 DOI: 10.3760/cma.j.cn501113-20231123-00219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Objective: To investigate the spatial distribution pattern of local tumor progression (LTP) for hepatocellular carcinoma (HCC) ≤5 cm after microwave ablation. Methods: A retrospective analysis was performed on 169 HCCs with matched MRI before and after ablation from December 2009 to December 2019. A tumor MRI was reconstructed using three-dimensional visualization technology. LTP was classified as contact or non-contact, early or late stage, according to whether LTP was in contact with the edge of the ablation zone and the occurrence time (24 months). The tumor-surrounded area was divided into eight quadrants by using the eight-quadrant map method. An analysis was conducted on the spatial correlation between the quadrant where the ablative margin (AM) safety boundary was located and the quadrant where different types of LTP occurred. The t-test, or rank-sum test, was used for the measurement data. 2-test for count data was used to compare the difference between the two groups. Results: The AM quadrant had a distribution of 54.4% LTP, 64.2% early LTP stage, and 69.1% contact LTP, suggesting this quadrant was much more concentrated than the other quadrants (P < 0.001). Additionally, the AM quadrant had only 15.2% of non-contact type LTP and 17.1% of late LTP, which was not significantly different from the average distribution probability of 12.5% (100/8%) among the eight quadrants (P = 0.667, 0.743). 46.6% of early contact type LTP was located at the ablation needle tip, 25.2% at the body, and 28.1% at the caudal, while the location distribution probabilities of non-early contact LTP were 34.8%, 31.8%, and 33.3%, respectively. Conclusion: LTP mostly occurs in areas where the ablation safety boundary is the shortest. However, non-contact LTP and late LTP stages exhibit the feature of uniform distribution. Thus, this type of LPT may result from an inadequate non-ablation safety boundary.
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Affiliation(s)
- F Y Fan
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - W Z Ding
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - F Y Liu
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - Z G Cheng
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - Z Y Han
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - X L Yu
- Chinese PLA Medical School, Beijing 100853, China
| | - P Liang
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - J Yu
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
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Vidjak K, Farina L, Challapalli RS, Quinn AM, O'Halloran M, Lowery A, Ruvio G, Cavagnaro M. Histology-validated electromagnetic characterization of ex-vivo ovine lung tissue for microwave-based medical applications. Sci Rep 2024; 14:5940. [PMID: 38467672 PMCID: PMC10928158 DOI: 10.1038/s41598-024-55035-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/19/2024] [Indexed: 03/13/2024] Open
Abstract
Microwave thermal ablation is an established therapeutic technique for treating malignant tissue in various organs. Its success greatly depends on the knowledge of dielectric properties of the targeted tissue and on how they change during the treatment. Innovation in lung navigation has recently increased the clinical interest in the transbronchial microwave ablation treatment of lung cancer. However, lung tissue is not largely characterized, thus its dielectric properties investigation prior and post ablation is key. In this work, dielectric properties of ex-vivo ovine lung parenchyma untreated and ablated at 2.45 GHz were recorded in the 0.5-8 GHz frequency range. The measured dielectric properties were fitted to 2-pole Cole-Cole relaxation model and the obtained model parameters were compared. Based on observed changes in the model parameters, the physical changes of the tissue post-ablation were discussed and validated through histology analysis. Additionally, to investigate the link of achieved results with the rate of heating, another two sets of samples, originating from both ovine and porcine tissues, were heated with a microwave oven for different times and at different powers. Dielectric properties were measured in the same frequency range. It was found that lung tissue experiences a different behavior according to heating rates: its dielectric properties increase post-ablation while a decrease is found for low rates of heating. It is hypothesized, and validated by histology, that during ablation, although the tissue is losing water, the air cavities deform, lowering air content and increasing the resulting tissue properties.
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Affiliation(s)
- Klementina Vidjak
- Department of Information Engineering, Electronics, and Telecommunications, Sapienza University of Rome, Rome, Italy
| | | | - Ritihaas Surya Challapalli
- Discipline of Surgery, Lambe Institute for Translational Research, University of Galway, Galway, Ireland
| | - Anne Marie Quinn
- Department of Anatomic Pathology, University Hospital Galway, Galway, Ireland
| | - Martin O'Halloran
- Translational Medical Device Lab, National University of Ireland Galway, Galway, Ireland
| | - Aoife Lowery
- Discipline of Surgery, Lambe Institute for Translational Research, University of Galway, Galway, Ireland
| | | | - Marta Cavagnaro
- Department of Information Engineering, Electronics, and Telecommunications, Sapienza University of Rome, Rome, Italy.
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Zhang J, Guo G, Li T, Guo C, Han Y, Zhou X. Long-term survival analysis of ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma conforming to the Milan criteria: primary versus recurrent HCC. Int J Hyperthermia 2024; 41:2318829. [PMID: 38467417 DOI: 10.1080/02656736.2024.2318829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/09/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND This study compared long-term outcomes between patients with initial hepatocellular carcinoma (IHCC) and those with recurrent HCC (RHCC) treated with microwave ablation (MWA). METHODS This retrospective study included 425 patients with HCCs (294 IHCCs and 131 RHCCs) within the Milan criteria who were treated with ultrasound-guided percutaneous MWA between January 2008 and November 2021. All patients with RHCC had previously undergone MWA for initial HCC. Overall survival (OS) and recurrence-free survival (RFS) rates were compared between the IHCC and RHCC groups before and after propensity score matching (PSM). RESULTS Before matching, the 1-, 3-, 5-, and 10-year OS rates in the IHCC group were 95.9%, 78.5%, 60.2%, and 42.5%, respectively, which were significantly higher than those in the RHCC group (93.8%, 70.0%, 42.0%, and 6.6%, respectively). This difference remained significant after PSM. However, subgroup analyses suggested that there were no significant differences in OS rates between IHCC and RHCC in patients with solitary HCC ≤3.0 cm, AFP ≤200 ng/mL, ablative margins ≥0.5 cm, or Albumin-Bilirubin (ALBI) grade 1. RFS was significantly higher in IHCC than in RHCC before and after PSM, as well as in subgroup analyses. ALBI grade (hazard ratio (HR), 2.38; 95% CI: 1.46-3.86; p < 0.001), serum AFP level (HR, 2.07; 95% CI: 1.19-3.62; p = 0.010) and ablative margins (HR, 0.18; 95% CI: 0.06-0.59; p = 0.005) were independent prognostic factors for OS of RHCC. Serum AFP(HR, 1.29; 95% CI: 1.02-1.63, p = 0.036) level was the only factor associated with RFS in RHCC. CONCLUSIONS MWA yielded comparable OS in IHCC and RHCC patients with solitary HCC ≤3.0 cm, AFP ≤200 ng/mL, ablative margins ≥0.5 cm, or ALBI grade 1.
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Affiliation(s)
- Jing Zhang
- State Key Laboratory of Cancer Biology & XiJing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China
| | - Guanya Guo
- State Key Laboratory of Cancer Biology & XiJing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China
| | - Tao Li
- State Key Laboratory of Cancer Biology & XiJing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China
| | - Changcun Guo
- State Key Laboratory of Cancer Biology & XiJing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China
| | - Ying Han
- State Key Laboratory of Cancer Biology & XiJing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China
| | - Xinmin Zhou
- State Key Laboratory of Cancer Biology & XiJing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China
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Wang G, Wei Z, Wang F, Han X, Jia H, Zhao D, Li C, Liu L, Yang X, Ye X. Clinical outcomes of percutaneous microwave ablation for pulmonary oligometastases from hepatocellular carcinoma: a retrospective, multicenter study. Cancer Imaging 2024; 24:34. [PMID: 38438879 PMCID: PMC10913397 DOI: 10.1186/s40644-024-00679-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/26/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Pulmonary oligometastases are common in hepatocellular carcinoma (HCC), however, the existing therapeutic options have several limitations. This study aimed to assess the safety and efficacy of microwave ablation (MWA) in the treatment of HCC-originating pulmonary oligometastases. METHODS A total of 83 patients, comprising 73 males and 10 females with a median age of 57 years, who had pulmonary oligometastases from HCC, underwent MWA treatment at four different medical institutions. Inclusion criteria for patients involved having primary HCC under control and having less than three oligometastases with a maximum diameter of ≤ 5 cm in the unilateral lung or less than five oligometastases with a maximum diameter of ≤ 3 cm in the bilateral lung. A total of 147 tumors were treated with MWA over 116 sessions. The primary endpoints assessed included technical success, treatment efficacy, and local progression rate, while secondary endpoints encompassed complications, clinical outcomes, overall survival (OS), local progression-free survival (LPFS), and prognostic factors. RESULTS The technical success rate for MWA was 100% (116/116 sessions), and the treatment efficacy rate was 82.3% (121/147 tumors). Six months after MWA, the local progression rate was 23.1% (18/147 tumors). Complications were observed in 10.3% (major) and 47.4% (minor) of the 116 sessions, with no cases of ablation-related deaths. The median follow-up period was 21.6 months (range: 5.7-87.8 months). Median OS was 22.0 months, and the 1-, 2-, and 3-year OS rates were 82.6%, 44.5%, and 25.2%, respectively. Median LPFS was 8.5 months. Multivariate Cox regression analysis identified α-fetoprotein (AFP) levels during initial diagnosis and the number of oligometastases as potential independent prognostic factors for OS (p = 0.017 and 0.045, respectively). CONCLUSION Percutaneous MWA is a safe and effective treatment modality for pulmonary oligometastases originating from HCC.
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Affiliation(s)
- Gang Wang
- Department of Oncology, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Lung Cancer Institute, 16766 Jingshi Road, 250021, Jinan, Shandong, China
| | - Zhigang Wei
- Department of Oncology, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Lung Cancer Institute, 16766 Jingshi Road, 250021, Jinan, Shandong, China
| | - Feihang Wang
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 200032, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
| | - Xiaoying Han
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250014, Jinan, Shandong, China
| | - Haipeng Jia
- Department of Radiology, Qilu Hospital of Shandong University, 250012, Jinan, China
| | - Danyang Zhao
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 200032, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
| | - Chunhai Li
- Department of Radiology, Qilu Hospital of Shandong University, 250012, Jinan, China.
| | - Lingxiao Liu
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 200032, Shanghai, China.
- National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China.
| | - Xia Yang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250014, Jinan, Shandong, China.
| | - Xin Ye
- Department of Oncology, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Lung Cancer Institute, 16766 Jingshi Road, 250021, Jinan, Shandong, China.
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Zufry H, Hariyanto TI. Comparative Efficacy and Safety of Radiofrequency Ablation and Microwave Ablation in the Treatment of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis. Korean J Radiol 2024; 25:301-313. [PMID: 38413114 PMCID: PMC10912499 DOI: 10.3348/kjr.2023.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/29/2023] [Accepted: 12/29/2023] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE The current body of evidence lacks clarity regarding the comparative efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) as minimally invasive treatments for benign thyroid nodules. The primary objective of this study is to clarify these concerns. MATERIALS AND METHODS A comprehensive search was conducted using the Cochrane Library, Scopus, Europe PMC, and Medline databases until October 10th, 2023, using a combination of relevant keywords. This study incorporated literature that compared RFA and MWA for benign thyroid nodules. The primary outcome was the volume reduction ratio (VRR) from baseline to follow-up. Secondary outcomes were symptom score, cosmetic score, ablation time, major complications rate, hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. We used Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool to assess the risk of bias in the included studies. We employed random effects models to analyze the standardized mean difference (SMD) and odds ratio for the presentation of outcomes. RESULTS Nine studies with 2707 nodules were included. The results of our meta-analysis indicated similar efficacy between RFA and MWA in terms of VRR during the 1 (SMD 0.06; 95% confidence interval [CI]: -0.13 to 0.26; P = 0.52) and 3 (SMD 0.11; 95% CI: -0.03 to 0.25; P = 0.12) months of follow-up. VRR was significantly higher in RFA than in MWA at the 6 (SMD 0.25; 95% CI: 0.06-0.43; P = 0.008) and 12 month of follow-up (SMD 0.38; 95% CI: 0.17 to 0.59; P < 0.001). There were no significant differences between RFA and MWA in symptom scores, cosmetic scores, or the incidence of complications, including hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. CONCLUSION RFA showed a higher VRR than MWA at 6 and 12-month follow-ups, with a comparable safety profile.
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Affiliation(s)
- Hendra Zufry
- Department of Internal Medicine, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Innovation and Research Center of Endocrinology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.
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Chen T, Ren Q, Ge Q, Wang F, Jin Y, Liu P, Ma Q. Application of transabdominal ultrasound- and laparoscopy-guided percutaneous microwave ablation for treating uterine fibroids: 24-month follow-up outcomes. Arch Gynecol Obstet 2024; 309:1043-1052. [PMID: 38194092 DOI: 10.1007/s00404-023-07334-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 12/04/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE To determine the ablation efficacy of transabdominal ultrasound- and laparoscopy-guided percutaneous microwave ablation (PMWA), to investigate whether the risk of damage to adjacent organs and endometrium due to this technique can be reduced or even avoided. We also evaluated the clinical efficacy of this technique in the treatment of uterine fibroids of different sizes and at different locations over a 24-month follow-up period. METHODS This study included 50 patients with uterine fibroids who underwent transabdominal ultrasound- and laparoscopy-guided PMWA from August 2018 to July 2020. Lesions were confirmed by pathology. The technical efficacy and complications of PMWA were assessed. The lesion diameter, lesion volume, lesion location, and contrast-enhanced ultrasound (CEUS) features before PMWA and within 24 h after PMWA were recorded. Magnetic resonance imaging (MRI) was used for follow-up at 3 and 6 months after PMWA. Transvaginal ultrasound was used for follow-up at 24 months after PMWA. RESULTS A total of 50 patients with uterine fibroids received treatment. The median ablation rate of uterine fibroids was 97.21%. The mean lesion volume reduction rates were 32.63%, 57.26%, and 92.64% at 3, 6, and 24 months after treatment, respectively. The size and location of uterine fibroids did not significantly affect the ablation rate and the rate of lesion volume reduction. No major complication was found during and after the procedure. CONCLUSION Transabdominal ultrasound- and laparoscopy-guided PMWA can be utilized to safely enhance the ablation rate while minimizing ablation time and avoiding harm to adjacent organs and the endometrium. This technique is applicable for treating uterine fibroids of different sizes and at varying locations. TRIAL REGISTRATION NUMBER ChiCTR-IPR-17011910, and date of trial registration: 08/07/2017.
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Affiliation(s)
- Tong Chen
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu District, Suzhou, 215004, Jiangsu, China
| | - Qiongzhen Ren
- Department of Gynecology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Qiuyan Ge
- Department of Ultrasound, Jiang Yin Maternal and Child Health Hospital, Wuxi, Jiangsu, China
| | - Fei Wang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu District, Suzhou, 215004, Jiangsu, China
| | - Yuma Jin
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu District, Suzhou, 215004, Jiangsu, China
| | - Peiqing Liu
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu District, Suzhou, 215004, Jiangsu, China
| | - Qi Ma
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu District, Suzhou, 215004, Jiangsu, China.
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Deniz R, Güzelbey T, Mutlu İN, Karaalioğlu B, Özgür DS, Akkuzu G, Yıldırım F, Kalkan K, Kılıçkesmez Ö, Bes C. Microwave ablation of synovial hypertrophy in recurrent monoarthritis: preliminary results of a new technique in rheumatology. Rheumatology (Oxford) 2024; 63:e83-e85. [PMID: 37831913 DOI: 10.1093/rheumatology/kead559] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Affiliation(s)
- Rabia Deniz
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
- Department of Medical Biology and Genetics, Marmara University, Istanbul, Turkey
| | - Tevfik Güzelbey
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - İlhan Nahit Mutlu
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Bilgin Karaalioğlu
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Duygu Sevinç Özgür
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Gamze Akkuzu
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Fatih Yıldırım
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Kübra Kalkan
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Özgür Kılıçkesmez
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Cemal Bes
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
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Rossebo AE, Zlevor AM, Knott EA, Mao L, Couillard AB, Ziemlewicz TJ, Hinshaw JL, Abel EJ, Lubner MG, Knavel Koepsel EM, Wells SA, Stratchko LM, Laeseke PF, Lee FT. Percutaneous Microwave Ablation for Treatment of Retroperitoneal Tumors. Radiol Imaging Cancer 2024; 6:e230080. [PMID: 38334471 PMCID: PMC10988338 DOI: 10.1148/rycan.230080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/05/2023] [Accepted: 12/15/2023] [Indexed: 02/10/2024]
Abstract
Purpose To determine if microwave ablation (MWA) of retroperitoneal tumors can safely provide high rates of local tumor control. Materials and Methods This retrospective study included 19 patients (median age, 65 years [range = 46-78 years]; 13 [68.4%] men and six [31.6%] women) with 29 retroperitoneal tumors treated over 22 MWA procedures. Hydrodissection (0.9% saline with 2% iohexol) was injected in 17 of 22 (77.3%) procedures to protect nontarget anatomy. The primary outcomes evaluated were local tumor progression (LTP) and complication rates. Oncologic outcomes, including overall survival (OS), progression-free survival (PFS), and treatment-free interval (TFI), were examined as secondary outcome measures. Results Median follow-up was 18 months (range = 0.5-113). Hydrodissection was successful in displacing nontarget anatomy in 16 of 17 (94.1%) procedures. The LTP rate was 3.4% (one of 29; 95% CI: 0.1, 17.8) per tumor and 5.3% (one of 19; 95% CI: 0.1, 26.0) per patient. The overall complication rate per patient was 15.8% (three of 19), including two minor complications and one major complication. The OS rate at 1, 2, and 3 years was 81.8%, 81.8%, and 72.7%, respectively, with a median OS estimated at greater than 7 years. There was no evidence of a difference in OS (P = .34) and PFS (P = .56) between patients with renal cell carcinoma (six of 19 [31.6%]) versus other tumors (13 of 19 [68.4%]) and patients treated with no evidence of disease (15 of 22 [68.2%]) versus patients with residual tumors (seven of 22 [31.8%]). Median TFI was 18 months (range = 0.5-108). Conclusion Treatment of retroperitoneal tumors with MWA combined with hydrodissection provided high rates of local control, prolonged systemic therapy-free intervals, and few serious complications. Keywords: Ablation Techniques (ie, Radiofrequency, Thermal, Chemical), Retroperitoneum, Microwave Ablation, Hydrodissection © RSNA, 2024.
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Affiliation(s)
- Annika E. Rossebo
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Annie M. Zlevor
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Emily A. Knott
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Lu Mao
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Allison B. Couillard
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Timothy J. Ziemlewicz
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - J. Louis Hinshaw
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - E. Jason Abel
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Meghan G. Lubner
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Erica M. Knavel Koepsel
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Shane A. Wells
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Lindsay M. Stratchko
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Paul F. Laeseke
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
| | - Fred T. Lee
- From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z.,
J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical
Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and
Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin–Madison School
of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center,
Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine,
Cleveland, Ohio (E.A.K.)
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47
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Huang W, Zeng W, Lin XQ, Zhang LF, Wei HJ, He CS. Comparison of one-year outcomes and quality of life between endovenous microwave ablation and high ligation and stripping of the great saphenous vein. Phlebology 2024; 39:108-113. [PMID: 37936273 DOI: 10.1177/02683555231214338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
INTRODUCTION The objective of this study is to evaluate and compare the effectiveness of endovenous microwave ablation (EMA) and high ligation and strippingn (HLS) of the great saphenous vein (GSV) in the treatment of varicose veins. METHODS We included 182 patients in each EMA and HLS groups. Follow-up outcomes included AVVQ, VCSS, chronic venous insufficiency questionnaire-14 (CIVIQ14) score, clinical recurrence rate of varicose vein treatment, and patient satisfaction during the 1-year follow-up period. RESULTS At the 1-year follow-up, no significant difference was found in the clinical recurrence rate of varicose veins between the EMA and HLS groups (p = .75). The duration of the operation and the length of hospital stay for patients in the EMA group was shorter than that for the HLS group (p < .01). The Aberdeen Varicose Vein Questionnaire (AVVQ), Venous Clinical Severity Score (VCSS) score, and ecchymosis were lower for patients who underwent EMA surgery (p < .01). CONCLUSION Our research results confirm that EMA improves patients' quality of life with lower limb varicose veins, with EMA showing higher patient satisfaction.
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Affiliation(s)
- Wei Huang
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wei Zeng
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xue-Qing Lin
- People's Liberation Army the General Hospital of Western Theater Command, Chengdu, China
| | - Li-Feng Zhang
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hai-Jun Wei
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chun-Shui He
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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48
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Acosta Ruiz V, Dahlman P, Brekkan E, Lönnemark M, Magnusson A. Microwave ablation of 105 T1 renal tumors: technique efficacy with a mean follow-up of two years. Acta Radiol 2024; 65:294-301. [PMID: 32910687 DOI: 10.1177/0284185120956283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Thermal ablation (TA) with radiofrequency (RFA) or cryoablation (CA) are established treatments for small renal masses (≤4 cm). Microwave ablation (MWA) has several potential benefits (decreased ablation time, less susceptibility to heat-sink, higher lesion temperatures than RFA) but is still considered experimental considering the available small-sample studies with short follow-up. PURPOSE To evaluate technique efficacy and complications of our initial experience of renal tumors treated using percutaneous MWA with a curative intent. MATERIAL AND METHODS A total of 105 renal tumors (in 93 patients) were treated between April 2014 and August 2017. MWA was performed percutaneously with computed tomography (CT) guidance under conscious sedation (n=82) or full anesthesia. Patients were followed with contrast-enhanced CT scans at six months and yearly thereafter for a minimum of five years. The mean follow-up time was 2.1 years. The percentage of tumors completely ablated in a single session (primary efficacy rate) and those successfully treated after repeat ablation (secondary efficacy rate) were recorded. Patient and tumor characteristics as well as complications were collected retrospectively. RESULTS The median patient age was 70 years and median tumor size was 25 mm. Primary efficacy rate was 96.2% (101/105 tumors). After including two residual tumors for a second ablation session, secondary efficacy was 97.1% (102/105). Periprocedural complications were found in 5.2% (5/95) sessions: four Clavien-Dindo I and one Clavien-Dindo IIIa. One postprocedural Clavien-Dindo II complication was found. CONCLUSION MWA has high efficacy rates and few complications compared to other TA methods at a mean follow-up of two years.
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Affiliation(s)
- Vanessa Acosta Ruiz
- Department of Surgical Sciences - Radiology, Uppsala University, Uppsala Sweden
| | - Pär Dahlman
- Department of Surgical Sciences - Radiology, Uppsala University, Uppsala Sweden
| | - Einar Brekkan
- Department of Surgical Sciences - Urology, Uppsala University, Uppsala Sweden
| | - Maria Lönnemark
- Department of Surgical Sciences - Radiology, Uppsala University, Uppsala Sweden
| | - Anders Magnusson
- Department of Surgical Sciences - Radiology, Uppsala University, Uppsala Sweden
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49
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Lee FT, Williams J, Nordgren R, Schwarz JL, Setia N, Roggin K, Polite B, Rangrass G, Liao CY, Millis JM, Keutgen XM. Single center outcomes from parenchymal-sparing resections and microwave ablations for neuroendocrine tumor liver metastases. Am J Surg 2024; 229:17-23. [PMID: 37802701 DOI: 10.1016/j.amjsurg.2023.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/02/2023] [Accepted: 09/13/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Reported outcomes after surgical debulking in patients with advanced neuroendocrine tumor liver metastases (NETLM) are sparse. METHODS NETLM patients that underwent surgical debulking from 2019 to 2021 were reviewed. Trends in perioperative liver function, complications, symptom response, and progression-free survival were examined. RESULTS 1069 liver lesions were debulked from 53 patients using a combination of parenchymal-sparing resections (PSR) and ultrasound-guided microwave ablations (MWA). Post-operative transaminitis and thrombocytopenia were common, and severity correlated with increasing number of lesions. Laboratory markers for synthetic liver function did not differ according to the number of lesions debulked. 13% of patients sustained a Clavien-Dindo grade 3 or 4 complication which was not associated with the number of lesions targeted. All patients with preoperative symptoms had improvement after surgery. Median time to progression was 10.9 months. CONCLUSIONS PSR with MWA for large numbers of NETLM is safe and effective for symptom control and does not affect synthetic liver function.
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Affiliation(s)
- Frances T Lee
- Southern Illinois University, Department of Surgery. 701 N. 1st St, Springfield IL 62794, USA
| | - Jelani Williams
- University of Chicago, Department of Surgery. 5841 S Maryland Ave, Chicago IL 60637, USA
| | - Rachel Nordgren
- University of Chicago, Department of Public Health Sciences. 5481 S Maryland Ave, Chicago, IL 60637, USA
| | - Jason L Schwarz
- University of Chicago, Department of Surgery. 5841 S Maryland Ave, Chicago IL 60637, USA
| | - Namrata Setia
- University of Chicago, Department of Pathology. 5841 S Maryland Ave, Chicago IL 60637, USA
| | - Kevin Roggin
- University of Chicago, Department of Surgery. 5841 S Maryland Ave, Chicago IL 60637, USA
| | - Blase Polite
- University of Chicago, Department of Medicine, Section of Hematology/Oncology. 5841 S Maryland Ave, Chicago IL 60637, USA
| | - Govind Rangrass
- University of Chicago, Department of Anesthesia and Critical Care. 5841 S Maryland Ave, Chicago IL 60637, USA
| | - Chih-Yi Liao
- University of Chicago, Department of Medicine, Section of Hematology/Oncology. 5841 S Maryland Ave, Chicago IL 60637, USA
| | - J Michael Millis
- University of Chicago, Department of Surgery. 5841 S Maryland Ave, Chicago IL 60637, USA
| | - Xavier M Keutgen
- University of Chicago, Department of Surgery. 5841 S Maryland Ave, Chicago IL 60637, USA.
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50
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Li B, Ren ZW, Zhang C, Yu XX, Xu XX, Du Y, Yang HF. Computed tomography-guided percutaneous cryoablation and microwave ablation in the treatment of perivascular hepatocellular carcinoma: A comparative study with propensity score matching. Clin Res Hepatol Gastroenterol 2024; 48:102298. [PMID: 38367802 DOI: 10.1016/j.clinre.2024.102298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/13/2024] [Accepted: 02/10/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE To evaluate the safety and efficacy of cryoablation (CYA) and microwave ablation (MWA) in the treatment of patients with perivascular hepatocellular carcinoma (HCC). METHODS Patients with perivascular HCC who underwent computed tomography (CT)-guided percutaneous CYA or MVA treatment in our hospital from August 2009 to March 2019 were included. Propensity score matching (PSM) was performed to adjust for potential baseline differences in the two groups. The technical success rate (TS), complications, and visual analog scale (VAS) were analyzed. The overall survival (OS) was evaluated using Kaplan-Meier curves and Cox proportional hazards models. RESULTS After PSM, 32 patients from each group were selected. The technical success rate was 94 % for CYA and 91 % for MWA, and 13 patients developed recurrence (CYA, n = 5, 2 local, 3 distant; MWA, n = 8, 6 local, 2 distant). There were no significant differences in OS (36-months OS: CYA 53.1 % vs, MWA 40.6 %; P = 0.191). No intraoperative deaths or complication-related deaths were observed, and 19 patients (CYA, n = 8; MWA, n = 11) experienced complications (P = 0.435). The VAS in the MWA group (5.38 ± 1.21) was significantly higher than that in the CYA group (2.22 ± 0.87; P < 0.001). CONCLUSIONS While CYA has equal safety and high primary efficacy as MWA in the treatment of perivascular HCC, it is associated with less periprocedural pain.
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Affiliation(s)
- Bing Li
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province, China
| | - Zi Wang Ren
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province, China
| | - Chuan Zhang
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province, China
| | - Xiao Xuan Yu
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province, China
| | - Xiao Xue Xu
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province, China
| | - Yong Du
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province, China.
| | - Han Feng Yang
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province, China.
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