This paper explored the feasibility of using ultrasonic Nakagami statistic parameter imaging to evaluate the thermal lesion induced by microwave ablation (MWA) in porcine models. In this paper, thermal lesions were induced in livers and kidneys in 5 swines using a clinical MWA system. During this treatment progress, ultrasonic radiofrequency (RF) data were collected. The dynamic changes of Nakagami parameter in the thermal lesion were calculated, and the ultrasonic B-mode images and Nakagami images were reconstructed simultaneously. The contrast-to-noise ratio (CNR) between the thermal lesion and the surrounding normal tissue was calculated over the MWA procedure. After MWA, a bright hyperechoic region appeared in the ultrasonic Nakagami image as an indicator of the thermal lesion and this bright spot enlarged with lesion development during MWA exposure. The mean value of Nakagami parameter in the liver and kidney increased from 0.78 and 0.79 before treatment to 0.91 and 0.92 after treatment, respectively. During MWA exposure, the mean values of CNR calculated from the Nakagami parameter increased from 0.49 to 1.13 in the porcine liver and increased from 0.51 to 0.85 in the kidney, which were both higher than those calculated from the B-mode images. This in vivo study on porcine models suggested that the ultrasonic Nakagami imaging may provide an alternative modality for monitoring MWA treatment.
目的 探索无法行手术及化放疗等治疗措施的原发性周围性肺癌患者行微波消融治疗的安全性及效果。 方法 我院 2013 年 12 月至 2015 年 11 月 39 例原发性肺癌患者（其中男 24 例、女 15 例，年龄 44～83 岁，中位年龄 67 岁）行微波消融治疗，肿瘤平均直径 3.5 cm。评价肿瘤局部疗效，随访时间 0.5～2.0 年。 结果 全组 39 例患者进行病灶消融后，病灶立即均质化，CT 值下降，供血终止，6 个月后病灶开始逐步缩小，瘢痕化。随访 39 例患者中有 3 例手术后生存 1.0～1.5 年因肿瘤全身广泛转移死亡；2 例患者手术后 6 个月复查增强 CT 见局部有少许血供予以再次消融；全组患者无 1 例严重并发症发生。 结论 微波消融对原发性小细胞肺癌患者的治疗效果佳、创伤小、手术风险小、安全性高。
Objective To analyze the common post-operative complications of microwave ablation in situ in the treatment of bone tumors and the prevention and control strategies. Methods Between March 2009 and July 2012, 73 cases of bone tumors were treated with microwave ablation in situ, of which 54 cases met the inclusion criteria. There were 31 males and 23 females with a median age of 27 years (range, 9-74 years), including 37 malignant tumors and 17 benign tumors. In 49 primary bone tumors, 17 cases were in stage 3, 13 in stage IIA, and 19 in stage IIB according to Enneking grading system. The postoperative complications, managements, and outcomes in patients were analyzed. Results After operation, 54 patients were followed up 12-40 months (mean, 24 months). Seven kinds of complications occurred in 21 patients (38.9%) with 3 cases suffered from more than one, including pathologic fracture in 4 cases (7.4%), deep infection in 2 cases (3.7%), nerve injury in 7 cases (13.0%), deep vein thrombosis of the lower extremity in 1 case (1.9%), medial collateral ligament heat injury of the knee in 1 case (1.9%), hematoma in 2 cases (3.7%), and fat liquefaction of incision and flap necrosis in 8 cases (14.8%). Conclusion Pathologic fracture is the primary complication which results in a second surgery. Deep infection is the main complication that often leads to failure of the limb salvage. Nerve injury and poor wound healing are the most common complications. Good control of microwave temperature is the key to successful operation, and the related preventive strategies could reduce complications.
ObjectiveTo investigate the feasibility and safety of DynaCT microwave ablation (MWA) guided by 3D iGuide puncture technology for lung cancer.MethodsThe clinical data of 19 patients with primary or metastatic lung cancer who underwent DynaCT MWA from June 2019 to December 2020 in our hospital were retrospectively analyzed, including 15 males and 4 females with an average age of 64.9±11.7 years. The technical success rates, adverse reactions and complications, postoperative hospital stay, and local therapeutic efficacy were recorded.ResultsTechnical success rate was 100.0%. The mean time required to target and place the needle was 15.7±3.7 min and the mean ablation time was 5.7±1.6 min. Thirteen patients underwent biopsy synchronously before the ablation, and 10 (76.9%) patients had positive pathological results. The main adverse reactions were pain (7/19, 36.8%), post-ablation syndrome (4/19, 21.1%) and cough (2/19, 10.5%). The minor complications were pneumothorax (6/19, 31.6%), hemorrhage (5/19, 26.3%), pleural effusion (2/19, 10.5%) and cavity (1/19, 5.3%). Three patients had moderate pneumothorax and received closed thoracic drainage. The median hospitalization time after ablation was 2.0 (2.0, 3.0) d, and no patient died during the perioperative period. The initial complete ablation rate was 89.5% (17 patients) and the incomplete ablation rate was 10.5% (2 patients) at 1-month follow-up, and no local progression was observed.ConclusionDynaCT MWA of lung cancer under the guidance of 3D iGuide system is safe and feasible with a high short-term local control rate, but the long-term efficacy remains to be further observed.
Objective To evaluate short-term effects of percutaneous microwave coagulation therapy（PMCT） combined with chemotherapy in patients with advanced non-small cell lung cancer（NSCLC）.Methods Eighty cases with advanced NSCLC were randomly assigned to underwent chemotherapy plus PMCT(PMCT group，n=40) or single chemotherapy(chemotherapy group，n=40).The chemotherapeutics regimen was Taxotere plus Cisplatin.The preliminary results and quality of life score of two groups were compared.Results In PMCT group and chemotherapy group，the 3-month relieve rate was 52.5% and 32.5%，and the half-year survival rate was 87.5% and 62.5%，respectively.The differences between the two groups were both significant(Plt;0.05).The quality of life score in PMCT group was significantly higher than that in chemotherapy group (Plt;0.05).Conclusion PMCT combined with chemotherapy is effective and safe in the treatment of advanced NSCLC.
The feasibility of ultrasound backscatter homodyned K model parametric imaging (termed homodyned K imaging) to monitor coagulation zone during microwave ablation was investigated. Two recent estimators for the homodyned K model parameter, RSK (the estimation method based on the signal-to-noise ratio, the skewness, and the kurtosis of the amplitude envelope of ultrasound) and XU (the estimation method based on the first moment of the intensity of ultrasound, X statistics and U statistics), were compared. Firstly, the ultrasound backscattered signals during the microwave ablation of porcine liver ex vivo were processed by the noise-assisted correlation algorithm, envelope detection, sliding window method, digital scan conversion and color mapping to obtain homodyned K imaging. Then 20 porcine livers’ microwave ablation experiments ex vivo were used to evaluate the effect of homodyned K imaging in monitoring the coagulation zone. The results showed that the area under the receiver operating characteristic curve of the RSK method was 0.77 ± 0.06 (mean ± standard deviation), and that of the XU method was 0.83 ± 0.08 (mean ± standard deviation). The accuracy to monitor the coagulation zone was (86 ± 10)% (mean ± standard deviation) by the RSK method and (90 ± 8)% (mean ± standard deviation) by the XU method. Compared with the RSK method, the Bland-Altman consistency for the coagulation zone estimated by the XU method and that of actual porcine liver tissue was higher. The time for parameter estimation and imaging by the XU method was less than that by the RSK method. We conclude that ultrasound backscatter homodyned K imaging can be used to monitor coagulation zones during microwave ablation, and the XU method is better than the RSK method.
Objective To evaluate the methodological and reporting qualities of randomize controlled trials involving MTC (microwave tissue coagulation) therapy for cervical erosion. Methods Through computer and handsearch, randomized controlled trials (RCTs) and/or quasi-randomized controlled trials (quasi-RCTs) were collected. The methodological quality of the included studies was assessed using quality assessment criteria of Cochrane systematic review guideline, and the reporting quality was assessed using the CONSORT (Consolidated Standards of Reporting Trials) checklist.Results Eleven clinical controlled trials (CCTs) were included. Three were RCTs and eight were quasi-RCTs. The methodological and reporting qualitiy of the included studies was generally low (10 trials ranked Level C, and the maximum CONSORT score was only 17).Conclusions The quality of the CCTs involving microwave therapy for cervical erosion is generally low with a high risk of biases. And the reporting of these trials is also incomplete. Therefore, more randomized controlled trials of high quality are required to provide reliable evidence.