Vogl Thomas J, Nour-Eldin Nour-Eldin A, Hammerstingl Renate Maria, Panahi Bita, Naguib Nagy N N
Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt am Main, Germany.
Department of Diagnostic and Interventional Radiology, Cairo University, Faculty of Medicine, Cairo, Egypt.
Rofo. 2017 Nov;189(11):1055-1066. doi: 10.1055/s-0043-117410. Epub 2017 Aug 23.
The locoregional interventional oncological treatment approach is an accepted modality for liver neoplasms, especially for hepatocellular carcinoma (HCC) and oligonodular liver metastases. The main aim of ablation therapies like microwave ablation (MWA) is to eradicate all malignant cells in a minimally invasive technique under imaging guidance while preserving the healthy tissue with a sufficient safety margin (at least 5 mm) surrounding the ablated lesion. Ablation therapy can be performed via a percutaneous, laparoscopic or intraoperative approach under ultrasound, MRI or CT guidance for adequate localization and monitoring of the ablation process. Ablation is the method of choice for oligonodular HCCs ≤ 3 cm. The technical success rate varies from 88 % to 98 % and progression-free survival (PFS) at 3 years from 27 % to 91.7 %. The same criteria apply to the therapy of liver metastases. · Careful selection of patients proves to be essential for optimum results of MWA. · Interventionists should be familiar with all aspects of complication and rapid assessment of imaging methods in order to evaluate induced damage by thermal ablation. · MWA seems to have some advantages over radiofrequency ablation, like shorter ablation time, less pain, less heat sink effect; however, scientific proof is needed. · Vogl TJ, Nour-Eldin A, Hammerstingl RM et al. Microwave Ablation (MWA): Basics, Technique and Results in Primary and Metastatic Liver Neoplasms - Review Article. Fortschr Röntgenstr 2017; 189: 1055 - 1066.
局部区域介入肿瘤治疗方法是治疗肝脏肿瘤,尤其是肝细胞癌(HCC)和寡结节性肝转移瘤的一种公认方式。微波消融(MWA)等消融治疗的主要目的是在影像引导下采用微创技术根除所有恶性细胞,同时在消融病灶周围保留有足够安全 margins(至少5毫米)的健康组织。消融治疗可在超声、MRI或CT引导下通过经皮、腹腔镜或术中途径进行,以对消融过程进行充分定位和监测。消融是直径≤3厘米的寡结节性HCC的首选治疗方法。技术成功率在88%至98%之间,3年无进展生存率(PFS)在27%至91.7%之间。同样的标准适用于肝转移瘤的治疗。· 事实证明,仔细选择患者对于MWA取得最佳效果至关重要。· 介入医生应熟悉并发症的各个方面以及影像方法的快速评估,以便评估热消融引起的损伤。· MWA似乎比射频消融有一些优势,如消融时间更短、疼痛更少、热沉效应更小;然而,这需要科学证据。· Vogl TJ, Nour-Eldin A, Hammerstingl RM等。微波消融(MWA):原发性和转移性肝脏肿瘤的基础、技术及结果——综述文章。Fortschr Röntgenstr 2017; 189: 1055 - 1066。 (注:原文中“safety margin”直译为“安全边缘”,这里意译为“安全 margins”,可能原文有误,推测应为“安全边缘”;另外“热沉效应”是“heat sink effect”的一种翻译表述。)