Korkusuz Y, Kohlhase K, Gröner D, Erbelding C, Luboldt W, Happel C, Ahmad S, Vogl T J, Gruenwald F
Department of Nuclear Medicine, Johann Wolfgang Goethe University Hospital, Frankfurt, Germany.
Radiology, Multiorgan Screening Foundation, Munich, Germany.
Rofo. 2016 Nov;188(11):1054-1060. doi: 10.1055/s-0042-115416. Epub 2016 Sep 14.
Microwave ablation (MWA) represents a novel thermal ablative treatment of benign thyroid nodules. The aim was to determine the energy required per ml volume reduction in order to match the required energy to the volume-of-interest (VOI). 25 patients with 25 nodules (6 solid, 13 complex and 6 cystic) were treated by microwave ablation (MWA). The transmitted energy (E) was correlated with the volume change (∆ V) after 3 months. The energy required per ml volume reduction after 3 months was calculated by E/∆ V. MWA resulted in a significant (p < 0.0001) volume reduction (∆ V) with a mean of 12.4 ± 13.0 ml (range: 1.5 - 63.2 ml) and relative reduction of 52 ± 16 % (range: 22 - 77 %). There was a positive correlation between E and ∆ V (r = 0.82; p < 0.05). The mean E/∆ V was 1.52 ± 1.08 (range: 0.4 - 4.6) kJ/ml for all nodules and 2.30 ± 1.5 (0.9 - 4.6), 1.5 ± 0.9 (0.4 - 3.6), 0.75 ± 0.25 (0.4 - 1.2) kJ/ml, respectively, for solid, complex and cystic nodules with a significant difference in E/∆ V for solid and cystic (p < 0.03). The energy required per volume depends on the nodule consistency. Solid nodules require more energy than cystic ones. The estimation of the energy needed per volume-of-interest as an additional parameter should help to avoid under- or overtreatment. • The estimated required energy for a volume-of-interest depends on the nodule consistency• In solid nodules a higher energy transmission than in cystic nodules is recommended• The energy transmission as an additional marker to ultrasound is helpful for improving periprocedural monitoring • Korkusuz Y, Kohlhase K, Gröner D et al. Microwave Ablation of Symptomatic Benign Thyroid Nodules: Energy Requirement per ml Volume Reduction. Fortschr Röntgenstr 2016; 188: 1054 - 1060.
微波消融（MWA）是一种治疗良性甲状腺结节的新型热消融疗法。目的是确定每减少1毫升体积所需的能量，以便使所需能量与感兴趣体积（VOI）相匹配。对25例患有25个结节（6个实性、13个混合性和6个囊性）的患者进行了微波消融（MWA）治疗。将传输能量（E）与3个月后的体积变化（∆V）进行关联。3个月后每减少1毫升体积所需的能量通过E/∆V计算得出。MWA导致显著的（p<0.0001）体积减少（∆V），平均减少12.4±13.0毫升（范围：1.5 - 63.2毫升），相对减少52±16%（范围：22 - 77%）。E与∆V之间存在正相关（r = 0.82；p<0.05）。所有结节的平均E/∆V为1.52±1.08（范围：0.4 - 4.6）千焦/毫升，实性、混合性和囊性结节的平均E/∆V分别为2.30±1.5（0.9 - 4.6）、1.5±0.9（0.4 - 3.6）、0.75±0.25（0.4 - 1.2）千焦/毫升，实性和囊性结节的E/∆V存在显著差异（p<0.03）。每单位体积所需的能量取决于结节的质地。实性结节比囊性结节需要更多能量。将每感兴趣体积所需的能量估计作为一个额外参数应有助于避免治疗不足或过度治疗。
• 感兴趣体积的估计所需能量取决于结节质地
• 对于实性结节，建议比囊性结节传输更高的能量
• 将能量传输作为超声的一个额外标志物有助于改善术中监测
• 科尔库苏兹Y，科尔哈泽K，格勒纳D等。有症状良性甲状腺结节的微波消融：每毫升体积减少的能量需求。《德国放射学杂志》2016年；188：1054 - 1060。
