a Department of Breast Surgery , The First Affiliated Hospital, Nanjing Medical University , Nanjing , China.
b Department of Breast Surgery , Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Medical College of Southeast University , Xuzhou , China.
Int J Hyperthermia. 2018 Dec;34(8):1179-1185. doi: 10.1080/02656736.2018.1442589. Epub 2018 Mar 6.
To determine the characteristics of ultrasound (US) imaging of completely ablated cases and the effects of duration and clinical experience on accurate microwave ablation (MWA) for the treatment of benign breast tumours.
With written informed consent and approval of the institutional ethics committee, patients with symptomatic or palpable benign breast tumours (longest diameter, 7-32 mm), to whom MWA (2450 MHz) was performed, were enrolled in this prospective nonrandomised study. US and contrast-enhanced US (CEUS) images were applied for follow-up and analysed.
Forty-seven consecutive patients with 52 completely ablated tumours were enrolled. Of these 52 tumour ablations in US, 16 ablations were defined as concentric type, and 36 were defined as nonconcentric type. Of these 52 ablations, 7 cases were defined as nonaccurate ablation with the largest margin ≥10 mm in US. The nonaccurate ablation rate in the training group (the first consecutive 30 cases, 7/30) was significant higher than that (the last 22 cases, 0/22) in the practiced group (p = 0.016). Of 38 completely ablated cases (9 mm < the longest diameter <20 mm), the average largest margin in >70 s group was significant larger than that in <70 s group (p = 0.019).
Experience was important for accurate MWA in the treatment of benign breast tumour, and at least 30 cases training was recommended. Nevertheless, clinical trials are still required to validate our findings in the future.
确定完全消融病例的超声(US)成像特征,以及持续时间和临床经验对微波消融(MWA)治疗良性乳腺肿瘤的准确性的影响。
在获得书面知情同意书并获得机构伦理委员会批准的情况下,对因有症状或可触及的良性乳腺肿瘤(最长直径为 7-32mm)而接受 MWA(2450MHz)治疗的患者进行了前瞻性非随机研究。对超声和超声造影(CEUS)图像进行了随访和分析。
连续纳入 47 例 52 个完全消融的肿瘤患者。在这些 52 个 US 消融中,16 个被定义为同心型,36 个被定义为非同心型。在这些 52 个消融中,有 7 个病例在 US 中定义为最大边缘≥10mm 的非准确消融。在培训组(前 30 例,7/30)中,非准确消融率显著高于实践组(后 22 例,0/22)(p=0.016)。在 38 个完全消融的病例(最长直径 9mm<20mm)中,>70s 组的平均最大边缘明显大于<70s 组(p=0.019)。
经验对于治疗良性乳腺肿瘤的准确 MWA 很重要,建议至少培训 30 例。然而,未来仍需要临床试验来验证我们的发现。