Merckel Laura G, Knuttel Floor M, Deckers Roel, van Dalen Thijs, Schubert Gerald, Peters Nicky H G M, Weits Teun, van Diest Paul J, Mali Willem P Th M, Vaessen Paul H H B, van Gorp Joost M H H, Moonen Chrit T W, Bartels Lambertus W, van den Bosch Maurice A A J
Department of Radiology, University Medical Center Utrecht, HP E 01.132, P.O. Box 85500, 3584 CX, Utrecht, The Netherlands.
Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
Eur Radiol. 2016 Nov;26(11):4037-4046. doi: 10.1007/s00330-016-4222-9. Epub 2016 Feb 6.
To assess the safety and feasibility of MRI-guided high-intensity focused ultrasound (MR-HIFU) ablation in breast cancer patients using a dedicated breast platform.
Patients with early-stage invasive breast cancer underwent partial tumour ablation prior to surgical resection. MR-HIFU ablation was performed using proton resonance frequency shift MR thermometry and an MR-HIFU system specifically designed for breast tumour ablation. The presence and extent of tumour necrosis was assessed by histopathological analysis of the surgical specimen. Pearson correlation coefficients were calculated to assess the relationship between sonication parameters, temperature increase and size of tumour necrosis at histopathology.
Ten female patients underwent MR-HIFU treatment. No skin redness or burns were observed in any of the patients. No correlation was found between the applied energy and the temperature increase. In six patients, tumour necrosis was observed with a maximum diameter of 3-11 mm. In these patients, the number of targeted locations was equal to the number of areas with tumour necrosis. A good correlation was found between the applied energy and the size of tumour necrosis at histopathology (Pearson = 0.76, p = 0.002).
Our results show that MR-HIFU ablation with the dedicated breast system is safe and results in histopathologically proven tumour necrosis.
• MR-HIFU ablation with the dedicated breast system is safe and feasible • In none of the patients was skin redness or burns observed • No correlation was found between the applied energy and the temperature increase • The correlation between applied energy and size of tumour necrosis was good.
使用专用乳腺平台评估磁共振成像引导下高强度聚焦超声（MR-HIFU）消融术在乳腺癌患者中的安全性和可行性。
早期浸润性乳腺癌患者在手术切除前接受部分肿瘤消融。使用质子共振频率偏移磁共振测温法和专门设计用于乳腺肿瘤消融的MR-HIFU系统进行MR-HIFU消融。通过手术标本的组织病理学分析评估肿瘤坏死的存在和范围。计算Pearson相关系数以评估超声处理参数、温度升高与组织病理学上肿瘤坏死大小之间的关系。
10名女性患者接受了MR-HIFU治疗。所有患者均未观察到皮肤发红或烧伤。未发现施加的能量与温度升高之间存在相关性。6名患者观察到肿瘤坏死，最大直径为3-11毫米。在这些患者中，靶向位置的数量与肿瘤坏死区域的数量相等。在组织病理学上，发现施加的能量与肿瘤坏死大小之间存在良好的相关性（Pearson = 0.76，p = 0.002）。
我们的结果表明，使用专用乳腺系统进行MR-HIFU消融是安全的，并导致经组织病理学证实的肿瘤坏死。
• 使用专用乳腺系统进行MR-HIFU消融是安全可行的 • 所有患者均未观察到皮肤发红或烧伤 • 未发现施加的能量与温度升高之间存在相关性 • 施加的能量与肿瘤坏死大小之间的相关性良好
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