Department of Radiology, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.
Department of Urology, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.
Investig Clin Urol. 2022 Mar;63(2):159-167. doi: 10.4111/icu.20210389.
To determine whether real-time ultrasonography-computed tomography (US-CT) fusion imaging can improve technical feasibility versus B-mode US and provide comparable outcomes of radiofrequency ablation (RFA) for T1a renal cell carcinoma (RCC) compared with laparoscopic partial nephrectomy (LPN).
Between June 2013 and August 2016, biopsy- or pathologically confirmed stage T1a RCCs were retrospectively reviewed. Of these, 39 cases were included in the RFA group, and 46 cases were included in the LPN group. In the RFA group, we evaluated tumor visibility and technical feasibility before RFA on a four-point scale on B-mode US and US-CT fusion images. After RFA, hospital days, creatinine value, complications, and disease-free survival rate were compared between the two groups. All results were analyzed by use of the Mann-Whitney U-test and Kaplan-Meier method.
Compared with B-mode US alone, real-time US-CT fusion significantly improved the tumor visibility score and overall mean technical feasibility grade (p<0.001). The 5-year disease-free survival rate was 97.4% and 97.8% in the RFA and LPN groups, respectively, and there was no statistically significant difference between groups (p=0.1). Mean periprocedural creatinine levels were significantly lower in the RFA group than in the LPN group. The number of hospital days was shorter in the RFA group. Minor complications were present in 5.1% of the RFA group and 13.0% of the LPN group, with no major complications.
US-CT fusion-image-guided RFA improved tumor visibility scores and overall mean technical validity and resulted in a comparable disease-free survival rate to LPN.
确定实时超声计算机断层扫描（US-CT）融合成像是否能提高技术可行性，与腹腔镜部分肾切除术（LPN）相比，能否为 T1a 期肾细胞癌（RCC）提供类似的射频消融（RFA）结果。
回顾性分析 2013 年 6 月至 2016 年 8 月经活检或病理证实的 T1a 期 RCC 患者。其中，RFA 组 39 例，LPN 组 46 例。在 RFA 组中，我们在 B 超和 US-CT 融合图像上对 RFA 前肿瘤的可视性和技术可行性进行了四点评分。RFA 后，比较两组间住院天数、肌酐值、并发症及无病生存率。所有结果均采用 Mann-Whitney U 检验和 Kaplan-Meier 法进行分析。
与单纯 B 超相比，实时 US-CT 融合显著提高了肿瘤可视性评分和整体平均技术可行性等级（p<0.001）。RFA 和 LPN 组的 5 年无病生存率分别为 97.4%和 97.8%，两组间无统计学差异（p=0.1）。RFA 组围手术期肌酐水平显著低于 LPN 组。RFA 组的住院天数较短。RFA 组有 5.1%的患者出现轻微并发症，LPN 组有 13.0%的患者出现轻微并发症，均无严重并发症。
US-CT 融合图像引导的 RFA 提高了肿瘤可视性评分和整体平均技术有效性，与 LPN 相比，无病生存率相当。
