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Li Z, Jiao D, Si G, Han X, Zhang W, Li Y, Zhou X, Liu J, Li J, Liu Z. Making timely remedial measures after TACE based on the results of cone-beam CT liver perfusion. Int J Hyperthermia 2021; 38:428-436. [PMID: 33691589 DOI: 10.1080/02656736.2021.1895331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the feasibility and safety of using cone-beam CT (CBCT) to measure changes in parenchymal blood volume (PBV) of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) and to guide microwave ablation (MWA) for residual tumors. METHODS A retrospective study was performed on 42 patients with HCC who completed TACE and received CBCT-guided perfusion imaging. The residual active lesions after TACE were supplemented with MWA to complete the treatment process according to the residual PBV. The outcomes were analyzed, including PBV changes, interventional-related complications, local tumor progression (LTP) and overall survival (OS). RESULTS Technical success was achieved in all lesions. Correlation analysis revealed that greater volume of residual PBV after MWA is negatively correlated with LTP. (p = .000); and the decrease of PBV was positively correlated with LTP (p = .000). All adverse events and complications were CTCAE Grade 1/2. After combination treatment, the 1-, 3-, and 5-year LTP-free survival were 97.6%, 69.0% and 15.1%, respectively, with a median LTP of 49.0 months (95% CI:43.129,54.871). Multivariate Cox regression revealed that the residual PBV > 13 ml/1000 was an independent factor predicting a shorter OS and LTP (Both p< .05). For LTP, multivariate Cox regression showed that a tumor in a single lesion were independently predicted to have a longer LTP in patients with HCC (p = .033). CONCLUSION CBCT is feasible and safe to use to measure changes in the PBV before and after TACE treatment, while it can also guide MWA for the treatment of residual tumors in one session.
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Affiliation(s)
- Zhaonan Li
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - DeChao Jiao
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guangyan Si
- Department of Interventional Radiology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, China
| | - Xinwei Han
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenguang Zhang
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yahua Li
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xueliang Zhou
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Juanfang Liu
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jin Li
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zaoqu Liu
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Yao XS, Yan D, Jiang XX, Li X, Zeng HY, Li H. Short-term outcomes of radiofrequency ablation for hepatocellular carcinoma using cone-beam computed tomography for planning and image guidance. World J Clin Cases 2021; 9:1580-1591. [PMID: 33728301 PMCID: PMC7942052 DOI: 10.12998/wjcc.v9.i7.1580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/22/2020] [Accepted: 01/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Percutaneous radiofrequency ablation (RFA) is an effective treatment for unresectable hepatocellular carcinoma (HCC) and a minimally invasive alternative to hepatectomy for treating tumour recurrence. RFA is often performed using contrast-enhanced computed tomography (CECT) and/or ultrasonography. In recent years, angiographic systems with flat panel image detectors and advanced image reconstruction algorithms have broadened the clinical applications of cone-beam computed tomography (CBCT), including RFA. Several studies have shown the effectiveness of using CBCT for immediate treatment assessments and follow-ups.
AIM To assess the treatment response to RFA for HCC using CBCT.
METHODS Forty-eight patients (44 men; aged 37-89 years) with solitary HCC [median size: 3.2 (1.2-6.6) cm] underwent RFA and were followed for 25.6 (median; 13.5-35.2) mo. Image fusion of CBCT and pre-operative CECT or magnetic resonance imaging (MRI) was used for tumour segmentation and needle path and ablation zone planning. Real-time image guidance was provided by overlaying the three-dimensional image of the tumour and needle path on the fluoroscopy image. Treatment response was categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Disease progression, death, time to progression (TTP), and overall survival (OS) were recorded. Kaplan-Meier and Cox regression analyses were performed.
RESULTS Initial post-RFA CECT/MRI showed 38 cases of CR (79.2%), 10 of PR (20.8%), 0 of SD, and 0 of PD, which strongly correlated with the planning estimation (42 CR, 87.5%; 6 PR, 12.5%; 0 SD; and 0 PD; accuracy: 91.7%, P < 0.01). Ten (20.8%) patients died, and disease progression occurred in 31 (35.4%, median TTP: 12.8 mo) patients, resulting in 12-, 24-, and 35-mo OS rates of 100%, 81.2%, and 72.2%, respectively, and progression-free survival (PFS) rates of 54.2%, 37.1%, and 37.1%, respectively. The median dose-area product of the procedures was 79.05 Gy*cm2 (range 40.95-146.24 Gy*cm2), and the median effective dose was 10.27 mSv (range 5.32-19.01 mSv). Tumour size < 2 cm (P = 0.008) was a significant factor for OS, while age (P = 0.001), tumour size < 2 cm (P < 0.001), tumour stage (P = 0.010), and initial treatment response (P = 0.003) were significant factors for PFS.
CONCLUSION Reliable RFA treatment planning and satisfactory outcomes can be achieved with CBCT.
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Affiliation(s)
- Xue-Song Yao
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Dong Yan
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xian-Xian Jiang
- Australian Research Council Training Centre for Innovation in Biomedical Imaging Technology, University of Queensland, Brisbane 4000, Australia
| | - Xiao Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Hui-Ying Zeng
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Huai Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Li J, Li Z, Jiao DC, Si G, Zhou X, Li Y, Liu J, Han X. Clinical Outcomes After Selective Renal Artery Embolization Combined With DynaCT-Guided Microwave Ablation for T1a Renal-Cell Carcinoma: Case Series. Clin Genitourin Cancer 2020; 19:e1-e5. [PMID: 32782134 DOI: 10.1016/j.clgc.2020.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/30/2020] [Accepted: 06/23/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Jing Li
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhaonan Li
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - De-Chao Jiao
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guangyan Si
- Department of Interventional Radiology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, China
| | - Xueliang Zhou
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yahua Li
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Juanfang Liu
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinwei Han
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Li Z, Jiao D, Han X, Si G, Li Y, Liu J, Xu Y, Zheng B, Zhang X. Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma. Cancer Imaging 2020; 20:13. [PMID: 32000862 PMCID: PMC6993318 DOI: 10.1186/s40644-020-0294-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 01/20/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To evaluate the method and effectiveness of transcatheter arterial chemoembolization (TACE) combined with simultaneous DynaCT-guided Microwave ablation (MWA) for the treatment of small hepatocellular carcinoma (SHCC). MATERIALS AND METHODS From June 2015 to May 2017, a total of 28 consecutive patients with SHCC received single treatment of TACE and 23 subjects received a combination treatment of TACE with simultaneous DynaCT-guided MWA. Following 1 month of treatment, the tumor response was assessed using the mRECIST criteria and the outcomes were analyzed including intervention-associated complications, changes in liver function, imaging response, and progression-free survival (PFS). RESULTS The technical success rate was 100%. The rates of CR (65%) in the combined TACE and MWA group were higher than those of the TACE group (46%). The rate of common adverse events, such as liver abscess, spontaneous bacterial peritonitis and liver dysfunction, in the combined TACE and MWA group (56%) was comparable to the corresponding rate of the TACE group (P > 0.411). The median and mean PFS of the TACE group were significantly lower than those of the combined TACE and MWA group (19.00 months vs. 29.00 months, 21.076 months vs. 24.693 months, p = 0.019, log-rank test). CONCLUSION Stereotactic DynaCT-guided MWA is a safe and effective method for the treatment of SHCC, which usually provides an effective tumor puncture path, notably for lesions that cannot be detected following TACE. Overall, the data suggested that this treatment method could improve the clinical outcome of patients with SHCC.
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Affiliation(s)
- Zhaonan Li
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China
| | - Dechao Jiao
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China
| | - Xinwei Han
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China.
| | - Guangyan Si
- Department of Interventional Radiology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, China
| | - Yahua Li
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China
| | - Juanfang Liu
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China
| | - Yanneng Xu
- Department of Interventional Radiology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, China
| | - Bo Zheng
- Department of Interventional Radiology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, China
| | - Xun Zhang
- Department of Interventional Radiology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, China
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Lyu T, Wang J, Cao S, Song L, Tong X, Zou Y. Radiofrequency ablation guided by cone beam computed tomography for hepatocellular carcinoma: a comparative study of clinical results with the conventional spiral computed tomography-guided procedure. J Int Med Res 2019; 47:3699-3708. [PMID: 31248301 PMCID: PMC6726783 DOI: 10.1177/0300060519858010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Objective To compare the outcomes of cone beam computed tomography (CBCT)-guided radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) with those of traditional spiral computed tomography (s-CT)-guided RFA. Methods This retrospective study analysed data from patients with HCC that underwent RFA guided by either CBCT or s-CT. A number of preoperative and postoperative characteristics, including operation time, ablation time, radiation dose and hospital stay were recorded for all patients. The incidence of intraoperative and postoperative complications was recorded. The therapeutic effect was evaluated at 1, 3 and 6 months after RFA. Results A total of 47 patients with HCC (12 females and 35 males) underwent successful RFA: 21 underwent CBCT-guided RFA and 26 underwent s-CT-guided RFA. Except for one case of pneumothorax in the s-CT group, no serious complications occurred. The objective response rate and disease control rate at 1, 3 and 6 months after RFA showed no significant differences between the two groups. Throughout the 6-month follow-up period, the complete ablation rate was 19 of 21 patients (90.5%) in the CBCT group and 19 of 26 patients (73.1%) in the s-CT group. Conclusions CBCT was a safe and effective guiding modality for RFA in patients with HCC.
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Affiliation(s)
- Tianshi Lyu
- Department of Interventional and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Jian Wang
- Department of Interventional and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Shoujin Cao
- Department of Interventional and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Li Song
- Department of Interventional and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Xiaoqiang Tong
- Department of Interventional and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Yinghua Zou
- Department of Interventional and Vascular Surgery, Peking University First Hospital, Beijing, China
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A Novel Technique in the Treatment of Lymphoceles After Renal Transplantation: C-Arm Cone Beam CT-Guided Percutaneous Embolization of Lymphatic Leakage After Lymphangiography. Transplantation 2019; 102:1955-1960. [PMID: 29757895 DOI: 10.1097/tp.0000000000002268] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND We aimed to evaluate the efficacy of percutaneous embolization after lymphangiography using C-arm cone-beam computed tomography (CBCT) performed at the site of lymphatic leakage in patients with postrenal transplant lymphocele. METHODS Between July 2014 and August 2017, 13 patients not responding to percutaneous ethanol sclerotherapy and conservative treatment for recurrent lymphocele after renal transplant were included. The mean age of the patients was 56.38 ± 9.91 (range, 36-70) years, and it comprised 9 men and 4 women. All patients underwent intranodal lymphangiography. C-arm CBCT-guided percutaneous embolization was performed in patients with confirmed lymphatic leakage. Patients who had no lymphatic leakage underwent drainage with fibrin glue injection. RESULTS Lymphatic leakage was observed in 9 patients after lymphangiography, and they underwent CBCT-guided percutaneous N-butyl-2-cyanoacrylate embolization. The volume of lymphatic drainage reduced to less than 10 mL in 8 patients. One patient who was not responding to embolization was treated surgically, after percutaneous drainage and fibrin glue injection. Lymphatic leakage was not observed in 4 patients after lymphangiography. Of these, 3 patients showed a reduction in the amount of lymphatic drainage after lymphangiography. All 4 patients underwent percutaneous drainage and fibrin glue injection. One patient did not respond to the treatment and was treated surgically. Prelymphangiography and postlymphangiography and embolization, the volume of lymphatic drainage was 113.07 ± 21.75 mL, and 53.84 ± 30.96 mL, respectively, and statistically significant decrease was detected (P < 0.005). CONCLUSIONS Lymphangiography and CBCT-guided percutaneous embolization procedures might be an effective treatment method for patients with lymphocele refractory to treatment.
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Liu B, Ye X, Fan W, Li X, Feng W, Lu Q, Mao Y, Lin Z, Li L, Zhuang Y, Ni X, Shen J, Fu Y, Han J, Li C, Liu C, Yang W, Su Z, Wu Z, Liu L. [Expert Consensus for Image-guided Radiofrequency Ablation of Pulmonary Tumors (2018 Version)]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2018. [PMID: 29526174 PMCID: PMC5973020 DOI: 10.3779/j.issn.1009-3419.2018.02.09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Baodong Liu
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xin Ye
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250100, China
| | - Weijun Fan
- Imaging and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Xiaoguang Li
- Department of Tumor Minimally Invasive Therapy, Beijing Hospital, Beijing 100005, China
| | - Weijian Feng
- Department of Oncology, Fuxing Hospital, Capital Medical University, Beijing 100038, China
| | - Qiang Lu
- Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Yu Mao
- Department of Thoracic Surgery, Hohhot First Hospital, Inner Mongolia, Hohhot 010020, China
| | - Zhengyu Lin
- Department of Interventional Therapy, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Lu Li
- Department of Thoracic Surgery, 306th Hospital of PLA, Beijing 100101, China
| | - Yiping Zhuang
- Department of Interventional Therapy, Jiangsu Cancer Hospital, Nanjing 210009, China
| | - Xudong Ni
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200001, China
| | - Jialin Shen
- Department of Tumor Interventional Therapy, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China
| | - Yili Fu
- Department of Thoracic Surgery, Chaoyang Hospital, Capital medical University, Beijing 100020, China
| | - Jianjun Han
- Department of Minimally Invasive Interventional Therapy, Shandong Provincial Tumor Hospital, Jinan 250117, China
| | - Chenrui Li
- Department of Interventional Therapy, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - Chen Liu
- Department of Interventional Therapy, Beijing Cancer Hospital, Beijing 100142, China
| | - Wuwei Yang
- Department of Tumor Minimally Invasive Therapy, 307th Hospital of PLA, Beijing 100071, China
| | - Zhiyong Su
- Affiliated Hospital of Chifeng University, Chifeng 024005, China
| | - Zhiyuan Wu
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Lei Liu
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Liu B, Ye X, Fan W, Li X, Feng W, Lu Q, Mao Y, Lin Z, Li L, Zhuang Y, Ni X, Shen J, Fu Y, Han J, Li C, Liu C, Yang W, Su Z, Wu Z, Liu L. Expert consensus on image-guided radiofrequency ablation of pulmonary tumors: 2018 edition. Thorac Cancer 2018; 9:1194-1208. [PMID: 30039918 PMCID: PMC6119618 DOI: 10.1111/1759-7714.12817] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 12/28/2022] Open
Abstract
Lung cancer ranks first in incidence and mortality in China. Surgery is the primary method to cure cancer, but only 20-30% of patients are eligible for curative resection. In recent years, in addition to surgery, other local therapies have been developed for patients with numerous localized primary and metastatic pulmonary tumors, including stereotactic body radiation therapy and thermal ablative therapies through percutaneously inserted applicators. Percutaneous thermal ablation of pulmonary tumors is minimally invasive, conformal, repeatable, feasible, cheap, has a shorter recovery time, and offers reduced morbidity and mortality. Radiofrequency ablation (RFA), the most commonly used thermal ablation technique, has a reported 80-90% rate of complete ablation, with the best results obtained in tumors < 3 cm in diameter. Because the clinical efficacy of RFA of pulmonary tumors has not yet been determined, this clinical guideline describes the techniques used in the treatment of localized primary and metastatic pulmonary tumors in nonsurgical candidates, including mechanism of action, devices, indications, techniques, potential complications, clinical outcomes, post-ablation surveillance, and use in combination with other therapies. In the future, the role of RFA in the treatment of localized pulmonary tumors should ultimately be determined by evidence from prospective randomized controlled trials comparing sublobar resection or stereotactic body radiation therapy.
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Affiliation(s)
- Bao‐Dong Liu
- Department of Thoracic Surgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Xin Ye
- Department of OncologyProvincial Hospital of Shandong UniversityJinanChina
| | - Wei‐Jun Fan
- Imaging and Interventional DepartmentSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Xiao‐Guang Li
- Minimally Invasive Department of CancerBeijing HospitalBeijingChina
| | - Wei‐Jian Feng
- Department of Oncology, Fuxing HospitalCapital Medical UniversityBeijingChina
| | - Qiang Lu
- Department of Thoracic Surgery, Tangdu HospitalAir Force Medical UniversityXi'anChina
| | - Yu Mao
- Department of Thoracic SurgeryHohhot No.1 Hospital of Inner Mongolia Autonomous RegionHohhotChina
| | - Zheng‐Yu Lin
- Intervention DepartmentThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Lu Li
- Department of Thoracic SurgeryThe 306th Hospital of PLABeijingChina
| | - Yi‐Ping Zhuang
- Minimally Invasive Intervention Department of Jiangsu Cancer HospitalNanjingChina
| | - Xu‐Dong Ni
- Department of Thoracic SurgeryShanghai Zhongshan HospitalShanghaiChina
| | - Jia‐Lin Shen
- Cancer Intervention DepartmentSouth Hospital of Shanghai Renji HospitalShanghaiChina
| | - Yi‐Li Fu
- Department of Thoracic SurgeryBeijing Chao Yang Hospital Affiliated to Capital Medical UniversityBeijingChina
| | - Jian‐Jun Han
- Minimally Invasive Department of Shandong Cancer HospitalJinanChina
| | - Chen‐Rui Li
- Intervention DepartmentCancer Hospital of Chinese Academy of Medical SciencesBeijingChina
| | - Chen Liu
- Intervention Department, Cancer HospitalPeking UniversityBeijingChina
| | - Wu‐Wei Yang
- Minimally Invasive Department of CancerThe 307th Hospital of PLABeijingChina
| | - Zhi‐Yong Su
- Department of Thoracic SurgeryAffiliated Hospital of Chifeng University of Inner Mongolia Autonomous RegionChifengChina
| | - Zhi‐Yuan Wu
- Radiation Intervention DepartmentShanghai Ruijin HospitalShanghaiChina
| | - Lei Liu
- Department of Thoracic Surgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
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Yuan H, Liu F, Li X, Guan Y, Wang M. Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided radiofrequency ablation in the treatment of solitary large hepatocellular carcinoma. Radiol Med 2018; 124:1-7. [PMID: 30132184 PMCID: PMC6339665 DOI: 10.1007/s11547-018-0932-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 08/07/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE To introduce the technique and investigate the clinical efficacy of transcatheter arterial chemoembolization (TACE) in combination with simultaneous DynaCT-guided radiofrequency ablation (RFA) in the treatment of solitary large hepatocellular carcinomas (HCCs) (maximal diameter > 5 cm). MATERIALS AND METHODS Forty-six patients who received TACE combined with simultaneous DynaCT-guided RFA for solitary large HCCs between January 2012 and August 2016 were reviewed, and the success rate, safety, local tumor progression (LTP), and overall survival (OS) were retrospectively investigated. OS and time to progression were analyzed with the Kaplan-Meier method. RESULTS Technical success rate was 100%, average operative time for DynaCT-guided RFA was 45.3 ± 4.8 min, average radiation dose was 730.5 ± 78.8 mGy, and no life-threatening complications were observed. At 1-month follow-up enhanced MRI, complete remission was achieved in 82.6% of patients (38/46), and partial remission in 17.4% (8/46). The median follow-up period was 29.5 months (interquartile range 4.0-69.0 months). At 1, 2, and 3 years after surgery, the LTP rates were 4.3, 13.1, and 30.4%, respectively, and the OS rates were 89.1, 71.7, and 56.5%, respectively. CONCLUSION DynaCT-guided TACE + RFA is safe and feasible for the treatment of solitary large HCCS. TACE combined with simultaneous RFA provides a new treatment option for solitary large HCCs in which DynaCT has important clinical value.
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Affiliation(s)
- Hongjun Yuan
- Department of Interventional Radiology, General Hospital of People's Liberation Army, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Fengyong Liu
- Department of Interventional Radiology, General Hospital of People's Liberation Army, 28 Fuxing Road, Beijing, 100853, People's Republic of China.
| | - Xin Li
- Department of Interventional Radiology, General Hospital of People's Liberation Army, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Yang Guan
- Department of Interventional Radiology, General Hospital of People's Liberation Army, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Maoqiang Wang
- Department of Interventional Radiology, General Hospital of People's Liberation Army, 28 Fuxing Road, Beijing, 100853, People's Republic of China
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