1
|
Li J, Gao H, Shen N, Wu D, Feng L, Hu P. High-security automatic path planning of radiofrequency ablation for liver tumors. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 242:107769. [PMID: 37714019 DOI: 10.1016/j.cmpb.2023.107769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Radiofrequency ablation (RFA) is an effective method for the treatment of liver tumors. Preoperative path planning, which plays a crucial role in RFA treatment, requires doctors to have significant experience and ability. Specifically, correct and highly active preoperative path planning should ensure the safety of the whole puncturing process, complete ablation of tumors and minimal damage to healthy tissues. METHODS In this paper, a high-security automatic multiple puncture path planning method for liver tumors is proposed, in which the optimization of the ablation number, puncture number, target positions and puncture point positions subject to comprehensive clinical constraints are studied. In particular, both the safety of the puncture path and the distribution of ablation ellipsoids are taken into consideration. The influence of each constraint on the safety of the whole puncturing process is discussed in detail. On this basis, the efficiency of the planning method is obviously improved by simplifying the computational data and optimized variables. In addition, the performance and adaptability of the proposed method to large and small tumors are compared and summarized. RESULTS The proposed method is evaluated on 10 liver tumors of various geometric characteristics from 7 cases. The test results show that the average path planning time and average ablation efficiency are 41.4 s and 60.19%, respectively. For tumors of different sizes, the planning results obtained from the proposed method have similar healthy tissue coverage. Through the clinical evaluation of doctors, the planning results meet the needs of RFA for liver tumors. CONCLUSIONS The proposed method can provide reasonable puncture paths in RFA planning, which is beneficial to ensure the safety and efficiency of liver tumor ablation.
Collapse
Affiliation(s)
- Jing Li
- Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, China; School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China
| | - Huayu Gao
- Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, China; School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China
| | - Nanyan Shen
- Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, China; School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China
| | - Di Wu
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China.
| | - Lanyun Feng
- Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Peng Hu
- Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, China; School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China
| |
Collapse
|
2
|
CT-guided Percutaneous Cryoablation in Patients with Lung Nodules Mainly Composed of Ground-Glass Opacities. J Vasc Interv Radiol 2022; 33:942-948. [PMID: 35490929 DOI: 10.1016/j.jvir.2022.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/22/2022] [Accepted: 04/20/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To assess the safety and efficacy of cryoablation in patients with lung nodules mainly composed of ground-glass opacities (GGOs). MATERIALS AND METHODS In this retrospective study, 50 patients (mean age, 65.0 ± 12.3; 28 women) diagnosed with lung GGO nodules who underwent cryoablation were included (from June 2016-June 2021). The local recurrence rate, the incidence of regional metastases to lymph nodes, the incidence of distant metastases, adverse events, and the lung function condition were analyzed. RESULTS Follow-up computed tomography (CT) was performed an average of 33 months (range, 3-60 months) after the cryoablation procedure. Outcomes were only evaluated in 30 patients. A total of 20 patients were excluded: 10 patients had no cancer detected at histopathological analysis and were diagnosed with CT scan or positron emission tomography-CT (PET/CT), and the other 10 patients had nodules with a diameter of less than 10 mm and a consolidation-to-tumor ratio (CTR) of more than 0.25, and thus histopathological analysis was not performed due to small nodule size and patients were diagnosed with CT or PET/CT. The local recurrence rate was 0% (0 of 30). Evidence of regional metastases of the lymph nodes was not found in any patients (0%; 0 of 30), and the incidence of distant metastases was 0% (0 of 30). No major complications were noted. Lung function recovered to normal within one month after cryoablation in all patients. CONCLUSION Cryoablation may serve as a safe and feasible option for the treatment of lung nodules mainly composed of GGOs.
Collapse
|
3
|
Chen H, Tao M, Li D, Han J, Cheng C, Ma Y, Wu Y, Shelat VG, Tustumi F, Satapathy SK, Kang KJ, Wang Q. An evaluation of the reporting quality in clinical practice guidelines for hepatocellular carcinoma using the RIGHT checklist. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1004. [PMID: 34277804 PMCID: PMC8267298 DOI: 10.21037/atm-21-2611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/11/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. Clinical practice guidelines (CPGs) on the prevention, surveillance, diagnosis and management of HCC are essential to guide clinical practice. The objective of this study was to evaluate the reporting quality of the most recent CPGs for HCC published worldwide. METHODS We systematically searched literature databases and websites of guideline development organizations and medical associations to extract CPGs on HCC published between January 2018 and December 2020. We evaluated the reporting quality using the Reporting Items for practice Guidelines in Healthcare (RIGHT) statement. We assessed for each of the 35 RIGHT checklist items whether the guidelines reported the corresponding information. We calculated the mean (± standard error of the mean, SEM) percentages of the guidelines' compliance with the items (reporting rate), both overall and for each of the seven domains of the RIGHT checklist. RESULTS We identified 22 guidelines, of which three (14%) were written in Chinese and 19 (86%) in English. The mean ±SEM overall reporting rate in the twenty-two guidelines was 56%±4%. The reporting rates of the seven domains were the following: basic information 81%±3%, background 58%±6%, evidence 58%±6%, recommendations 59%±5%, review and quality assurance 34%±10%, funding and declaration and management of interests 39%±4%, and other information 23%±6%. CONCLUSIONS The reporting quality of the recently published guidelines for HCC was suboptimal. While there is no doubt about the great value of the CPGs' recommendations in clinical practice, the reporting in CPGs for HCC still needs improvement.
Collapse
Affiliation(s)
- Haiyang Chen
- Department of Internal Medicine, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Meng Tao
- Department of General Surgery, Huaihe Hospital of Henan University, Kaifeng, China
| | - Ding Li
- Department of Pharmacy, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Jing Han
- Department of Internal Medicine, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Cheng Cheng
- Department of Hematology, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Yanfang Ma
- School of Chinese Medicine of Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Yingxi Wu
- Department of Internal Medicine, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Vishal G. Shelat
- Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Francisco Tustumi
- Department of Gastroenterology, Digestive Surgery Division, University of São Paulo Medical School, Sao Paulo, Brazil
| | - Sanjaya K. Satapathy
- Division of Hepatology and Sandra Atlas Bass Center for Liver Diseases, Northwell Health, Manhasset, NY, USA
| | - Koo Jeong Kang
- Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea
| | - Qiming Wang
- Department of Internal Medicine, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| |
Collapse
|
4
|
Hu C, Song Y, Zhang J, Dai L, Tang C, Li M, Liao W, Zhou Y, Xu Y, Zhang YY, Zhou Y. Preoperative Gadoxetic Acid-Enhanced MRI Based Nomogram Improves Prediction of Early HCC Recurrence After Ablation Therapy. Front Oncol 2021; 11:649682. [PMID: 34094938 PMCID: PMC8176857 DOI: 10.3389/fonc.2021.649682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/06/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose This study aimed to identify preoperative gadoxetic acid-enhanced MRI features and establish a nomogram for predicting early recurrence (≤ 2 years) of hepatocellular carcinoma (HCC) after ablation therapy. Methods A total of 160 patients who underwent gadoxetic acid-enhanced MRI and ablation HCC therapy from January 2015 to June 2018, were included retrospectively and divided into a training cohort (n = 112) and a validation cohort (n = 48). Independent clinical risk factors and gadoxetic acid-enhanced MRI features associated with early recurrence were identified by univariate and multivariate logistic regression analysis and used for construction of a nomogram. The performance of the nomogram was evaluated by discrimination, calibration, and clinical utility. Results Alpha-fetoprotein (AFP) level, tumor number, arterial peritumoral enhancement, satellite nodule and peritumoral hypointensity at hepatobiliary phases in the training cohort were identified as independent risk factors for early recurrence after ablation. A new nomogram that was constructed with these five features showed an area under the curve (AUC) of 0.843 (95%CI 0.771-0.916) and 0.835 (95%CI 0.713-0.956) in the training and validation cohort, respectively. The calibration curve and decision curve analysis (DCA) suggested that the nomogram had good consistency and clinical utility. Conclusions A new nomogram that was constructed using four preoperative gadoxetic acid-enhanced MRI features and serum AFP level can predict the risk of early HCC recurrence after ablation therapy with AUC up to 0.843. The strong performance of this nomogram may help hepatologists to categorize patients' recurrent risk to guide selecting treatment options and improve postoperative management.
Collapse
Affiliation(s)
- Chengguang Hu
- Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yangda Song
- Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jing Zhang
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lin Dai
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Cuirong Tang
- Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Meng Li
- Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Weijia Liao
- Laboratory of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Yuchen Zhou
- Department of General Surgery, Hospital of Integrated TCM and Western Medicine, Southern Medical University, Guangzhou, China
| | - Yikai Xu
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | | | - Yuanping Zhou
- Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
5
|
Danni HMS, Qiao JMD, Huitong LMD, Xuankun LMM, Lujing LMM, Fengping LMM, Xianxiang WMM, Kun YMS, Zuofeng XMD. A New-Designed Microwave Ablation System: Testing in ex vivo and in vivo Liver Model. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2021. [DOI: 10.37015/audt.2021.200014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
6
|
A practical pretreatment planning method of multiple puncturing for thermal ablation surgery. Biocybern Biomed Eng 2020. [DOI: 10.1016/j.bbe.2020.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|