Yamada Ricardo, Bassaco Beatriz, Dufour Lea, Collins Heather, Anderson Michael Bret, Hannegan Christopher, Guimaraes Marcelo
Division of Vascular & Interventional Radiology, Department of Radiology, Medical University of South Carolina, 25 Courtenay Dr., MSC 226, Charleston, SC 29425.
Division of Vascular & Interventional Radiology, Department of Radiology, Medical University of South Carolina, 25 Courtenay Dr., MSC 226, Charleston, SC 29425.
J Vasc Interv Radiol. 2019 Mar;30(3):390-395. doi: 10.1016/j.jvir.2018.11.015.
To assess the safety and efficacy of single-session transarterial embolization and radiofrequency (RF) ablation for hepatic tumors with the use of needle navigation software.
Retrospective analysis was conducted of 24 patients with liver cancer undergoing embolization followed by RF ablation between May 2014 and August 2017. Twelve patients each underwent (i) embolization and computed tomography (CT)-guided RF ablation during different sessions (group 1) and (ii) embolization followed by RF ablation with cone-beam CT and Needle Assist software in 1 session (group 2). Median age (70.5 y [range, 58-78 y] vs 70.5 y [range, 50-82 y]; P = .76) and performance status (0/1) were comparable between groups. Median tumor size was significantly larger in group 2 (2 cm [range, 1.0-7.3 cm] vs 3.2 cm [range, 1.1-9.6 cm]; P < .03). Procedure time, effective dose, and number of scans were examined. Efficacy was assessed by modified Response Evaluation Criteria In Solid Tumors after 1 month. Safety was assessed by Society of Interventional Radiology adverse event classification.
Group 1 had a mean of 8.5 CT scans, vs a mean of 5.0 cone-beam CT scans in group 2 (P < .001). Median procedure times were 110 min in group 1 and 199.5 min in group 2 (P < .001). Median effective doses were 68.8 mSv in group 1 and 55.4 mSv in group 2 (P = .38). There was no difference in complete response between groups (66.7% vs 63.6%; P = 1).
Transarterial embolization followed by RF ablation with cone-beam CT and needle guidance software in a single session seems to be safe and effective.
评估使用针导航软件进行单期经动脉栓塞和射频（RF）消融治疗肝肿瘤的安全性和有效性。
对2014年5月至2017年8月期间接受栓塞治疗后再进行射频消融的24例肝癌患者进行回顾性分析。12例患者分别接受了（i）在不同时间段进行栓塞和计算机断层扫描（CT）引导下的射频消融（第1组），以及（ii）在1个时间段内进行栓塞后再使用锥形束CT和针辅助软件进行射频消融（第2组）。两组患者的中位年龄（70.5岁[范围，58 - 78岁]对70.5岁[范围，50 - 82岁]；P = 0.76）和体能状态（0/1）相当。第2组的中位肿瘤大小明显更大（2厘米[范围，1.0 - 7.3厘米]对3.2厘米[范围，1.1 - 9.6厘米]；P < 0.03）。检查了手术时间、有效剂量和扫描次数。在1个月后通过改良实体瘤疗效评价标准评估疗效。通过介入放射学会不良事件分类评估安全性。
第1组平均进行8.5次CT扫描，而第2组平均进行5.0次锥形束CT扫描（P < 0.001）。第1组的中位手术时间为110分钟，第2组为199.5分钟（P < 0.001）。第1组的中位有效剂量为68.8毫希沃特，第2组为55.4毫希沃特（P = 0.38）。两组之间的完全缓解率无差异（66.7%对63.6%；P = 1）。
在单期使用锥形束CT和针引导软件进行经动脉栓塞后再进行射频消融似乎是安全有效的。
