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[三维重建CT在不可切除肺肿瘤集束电极经皮射频消融(RFA)中的应用评估。]

[Evaluation of Three-Dimensional Reconstruction CT in Percutaneous Radiofrequency Ablation (RFA) of the Unresectable Lung Tumor with a Clustered Electrode.].

作者信息

Liu Baodong, Zhi Xiuyi, Liu Lei, Hu Mu, Wang Ruotian, Xu Qingsheng, Zhang Yi, Su Lei

机构信息

Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2009 Jul 20;12(7):775-9. doi: 10.3779/j.issn.1009-3419.2009.07.006.

Abstract

BACKGROUND

Radiofrequency ablation (RFA) of lung tumours has recently received much attention for the promising results achieved. Here, to evaluate the value of three-dimensional reconstruction CT in radiofrequency ablation (RFA) of advanced non-small cell lung cancer.

METHODS

Sixty-six cases of advanced non-small cell lung cancer with 68 lesions (2 patients had 2 lesion treated in one session) were underwent three-dimensional reconstruction CT-giuded percutaneous RFA therapy. To evaluate short-term therapeutic effect of lung tumors using spiral CT scanning in 1-3 months after RFA to investigate the alterations of tumor size and density pre-and post-procedure, and complications, to observe the short-term curative effect.

RESULTS

Our experiences have shown an initial increase in lesion size at immediate follow-up CT. The density of 64 lesions was lowered (94.1%) and 4 lesion is increased (5.9%) at immediate and one month follow-up CT. SPECT scan findings that 82.4% (56/68) cases of FDG uptake in tumors after RFA with tumor/non-tumor of lower than 2.5 at one month follow-up. The change in treated lesion size over time, radiologically assessed through measurements of the lesions on axial CT scans in the lung window setting no lesions had complete response, 50 lesions (73.5%) had partial response, 2 lesions with stable disease, 6 lesions showed progressive disease at 3 month follow-up CT. SPECT scan findings that 79.4% (54/68) cases of FDG uptake in tumors after RFA with tumor/non-tumor of lower than 2.5 at 3 month follow-up.

CONCLUSIONS

The percutaneous RFA therapy under the guidance of three-dimensional reconstruction CT scan is safe and effective, with few complications, and can serve as a new method to the treatment of advanced non-small cell lung cancers.

摘要

背景

肺肿瘤的射频消融术(RFA)因其取得的良好效果最近备受关注。在此,评估三维重建CT在晚期非小细胞肺癌射频消融术(RFA)中的价值。

方法

66例晚期非小细胞肺癌患者共68个病灶(2例患者一次治疗2个病灶)接受了三维重建CT引导下的经皮RFA治疗。在RFA术后1至3个月使用螺旋CT扫描评估肺肿瘤的短期治疗效果,以研究术前和术后肿瘤大小及密度的变化以及并发症情况,观察短期疗效。

结果

我们的经验显示,术后即刻CT检查时病灶大小最初会增大。术后即刻及术后1个月的CT检查显示,64个病灶(94.1%)密度降低,4个病灶(5.9%)密度升高。SPECT扫描结果显示,术后1个月随访时,82.4%(56/68)的病例肿瘤FDG摄取降低,肿瘤/非肿瘤比值低于2.5。通过在肺窗设置下的轴向CT扫描测量病灶大小来进行影像学评估,随时间推移,治疗病灶大小的变化情况为:3个月随访CT时无病灶完全缓解,50个病灶(73.5%)部分缓解,2个病灶病情稳定,6个病灶病情进展。SPECT扫描结果显示,术后3个月随访时,79.4%(54/68)的病例肿瘤FDG摄取降低,肿瘤/非肿瘤比值低于2.5。

结论

三维重建CT扫描引导下的经皮RFA治疗安全有效,并发症少,可作为治疗晚期非小细胞肺癌的一种新方法。

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