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Li J, Su L, Liu J, Peng Q, Xu R, Cui W, Deng Y, Xie W, Huang B, Chen J. Optical navigation robot-assisted puncture system for accurate lung nodule biopsy: an animal study. Quant Imaging Med Surg 2023; 13:7789-7801. [PMID: 38106300 PMCID: PMC10722077 DOI: 10.21037/qims-23-576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/06/2023] [Indexed: 12/19/2023]
Abstract
Background As lung cancer is one of the most significant factors seriously endangering human health, a robot-assisted puncture system with high accuracy and safety is urgently needed. The purpose of this investigation was to compare the safety and effectiveness of such a robot-assisted system to the conventional computed tomography (CT)-guided manual method for percutaneous lung biopsies (PLBs) in pigs. Methods An optical navigation robot-assisted puncture system was developed and compared to the traditional CT-guided PLB using simulated lesions in experimental animals. A total of 30 pulmonary nodules were successfully created in 5 pigs (Wuzhishan pig, 1 male and 4 females). Of these, 15 were punctured by the optical navigation robot-assisted puncture system (robotic group), and 15 were manually punctured under CT guidance (manual group). The biopsy success rate, operation time, first needle tip-target point deviation, and needle adjustment times were compared between groups. Postoperative CT scans were performed to identify complications. Results The single puncture success rate was higher in the robotic group (13/15; 86.7%) than in the manual group (8/15; 53.3%). The first puncture was closer to the target lesion (1.8±1.7 mm), and the operation time was shorter (7.1±3.7 minutes) in the robotic group than in the manual group (4.4±2.8 mm and 12.9±7.6 minutes, respectively). The angle deviation was smaller in the robotic group (3.26°±2.48°) than in the manual group (7.71°±3.86°). The robotic group displayed significant advantages (P<0.05). The primary complication in both groups was slight bleeding, with an incidence of 26.7% in the robotic group and 40.0% in the manual group. There was 1 case of pneumothorax in the manual group, and there were no deaths due to complications in either group. Conclusions An optical navigation robot-assisted system for PLBs guided by CT images was developed and demonstrated. The experimental results indicate that the proposed system is accurate, efficient, and safe in pigs.
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Affiliation(s)
- Jing Li
- Department of Pulmonary and Critical Care Medicine, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Liyilei Su
- College of Big Data and Internet, Shenzhen Technology University, Shenzhen, China
| | - Jun Liu
- Wuerzburg Dynamics Inc., Shenzhen, China
| | - Qian Peng
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Rongde Xu
- Department of Interventional Radiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Wei Cui
- Department of Interventional Radiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yi Deng
- Department of Pulmonary and Critical Care Medicine, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Weiguo Xie
- Wuerzburg Dynamics Inc., Shenzhen, China
| | - Bingding Huang
- College of Big Data and Internet, Shenzhen Technology University, Shenzhen, China
| | - Jingjing Chen
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
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Dual-Applicator MR Imaging-Guided Microwave Ablation with Real-Time MR Thermometry: Phantom and Porcine Tissue Model Experiments. J Vasc Interv Radiol 2023; 34:46-53.e4. [PMID: 36202337 DOI: 10.1016/j.jvir.2022.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 08/17/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To investigate the effect of simultaneous use of dual applicators on the image quality of real-time magnetic resonance (MR) thermometry and to characterize the dual-applicator treatment zone pattern during MR imaging-guided microwave ablation (MWA). MATERIALS AND METHODS MWA experiments were performed on a 1.5-T MR scanner with 2 commercial microwave systems (902-928 MHz). Phantom experiments were first performed to evaluate the effect of dual-applicator MWA on the image quality of MR. Then, porcine tissue model experiments were conducted with real-time MR thermometry using either a single applicator or dual applicators inserted 2.6, 3.6, and 4.6 cm apart. Fiberoptic thermal probes were used to measure the temperature changes at the tissue surface. RESULTS Simultaneous use of dual applicators resulted in a decrease in the relative signal-to-noise ratio (SNR) in the MR thermometry images to 55% ± 2.9% when compared with that of a single applicator (86.2% ± 2.0%). Despite the lower SNR, the temperature and ablation zone maps were of adequate quality to allow visualization of the ablation zone(s). The extents of increase in the temperature at the tissue surface using dual applicators (19.7 °C ± 2.6 °C) and a single applicator (18.2 °C ± 3.3 °C) were not significantly different (P = .40). Treatment zones were significantly larger (P < .05) in dual-applicator ablations (29.4 ± 0.4, 39.9 ± 0.6, and 42.6 ± 0.9 cm2 with 2.6-, 3.6-, and 4.6-cm spacing, respectively) at the end of the ablation procedure than in the single-applicator MWA (18.6 ± 0.9 cm2). CONCLUSIONS MR imaging-guided dual-applicator MWA produced larger ablation zones while allowing adequate real-time MR thermometry image quality for monitoring the evolution of the treatment zone.
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2450-MHz microwave ablation of liver metastases under 3.0 T wide-bore magnetic resonance guidance: a pilot study. Sci Rep 2022; 12:12640. [PMID: 35879411 PMCID: PMC9314346 DOI: 10.1038/s41598-022-16989-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/19/2022] [Indexed: 11/29/2022] Open
Abstract
To investigate the feasibility and effectiveness of 3.0 T wide-bore magnetic resonance (MR)-guided microwave ablation (MA) of liver metastases (LM). From October 2018 to May 2020, 39 patients with 63 LM were treated with 3.0 T wide-bore MR-guided 2450-MHz MA therapy. The procedure parameters, technical success, complications, biochemical index changes, local tumor response, local tumor progression (LTP), 12-month disease-free survival (DFS) and 12-month overall survival (OS) were recorded and analyzed. The mean tumor maximum diameter and total procedure time were 3.0 cm and 55.2 min, respectively. Technical success was 100%, but 5 cases (12.8%) had grade-1 complications. Alanine transaminase, aspartate transaminase and total bilirubin showed a slight transient increase on day 3 (P < 0.05) and returned to normal by day 30 (P > 0.05). The complete ablation rates for ≤ 2.5 and > 2.5 cm lesions were 100% and 92.5%, respectively. During the median follow-up of 12.0 months, the LTP rate was 4.8% (3/63), and the 12-month DFS and OS rates were 61.3% and 92.2%, respectively. 3.0 T wide-bore MR-guided MA for LM is a safe and effective approach, especially for small LM.
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Pan L, Valdeig S, Kägebein U, Qing K, Fetics B, Roth A, Nevo E, Hensen B, Weiss CR, Wacker FK. Integration and evaluation of a gradient-based needle navigation system for percutaneous MR-guided interventions. PLoS One 2020; 15:e0236295. [PMID: 32706813 PMCID: PMC7380643 DOI: 10.1371/journal.pone.0236295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/01/2020] [Indexed: 12/22/2022] Open
Abstract
The purpose of the present study was to integrate an interactive gradient-based needle navigation system and to evaluate the feasibility and accuracy of the system for real-time MR guided needle puncture in a multi-ring phantom and in vivo in a porcine model. The gradient-based navigation system was implemented in a 1.5T MRI. An interactive multi-slice real-time sequence was modified to provide the excitation gradients used by two sets of three orthogonal pick-up coils integrated into a needle holder. Position and orientation of the needle holder were determined and the trajectory was superimposed on pre-acquired MR images. A gel phantom with embedded ring targets was used to evaluate accuracy using 3D distance from needle tip to target. Six punctures were performed in animals to evaluate feasibility, time, overall error (target to needle tip) and system error (needle tip to the guidance needle trajectory) in vivo. In the phantom experiments, the overall error was 6.2±2.9 mm (mean±SD) and 4.4±1.3 mm, respectively. In the porcine model, the setup time ranged from 176 to 204 seconds, the average needle insertion time was 96.3±40.5 seconds (min: 42 seconds; max: 154 seconds). The overall error and the system error was 8.8±7.8 mm (min: 0.8 mm; max: 20.0 mm) and 3.3±1.4 mm (min: 1.8 mm; max: 5.2 mm), respectively.
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Affiliation(s)
- Li Pan
- Siemens Healthineers, Baltimore, MD, United States of America
| | - Steffi Valdeig
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States of America
| | - Urte Kägebein
- Department of Radiology, Hannover Medical School, Hannover, Germany
- STIMULATE–Research Campus: Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
| | - Kun Qing
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, United States of America
- Siemens Corporate Technology, Baltimore, MD, United States of America
| | - Barry Fetics
- Robin Medical Inc., Baltimore, MD, United States of America
| | - Amir Roth
- Robin Medical Inc., Baltimore, MD, United States of America
| | - Erez Nevo
- Robin Medical Inc., Baltimore, MD, United States of America
| | - Bennet Hensen
- Department of Radiology, Hannover Medical School, Hannover, Germany
- STIMULATE–Research Campus: Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
- * E-mail:
| | - Clifford R. Weiss
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States of America
| | - Frank K. Wacker
- Department of Radiology, Hannover Medical School, Hannover, Germany
- STIMULATE–Research Campus: Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
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Zhang S, Wu S, Shang S, Qin X, Jia X, Li D, Cui Z, Xu T, Niu G, Bouakaz A, Wan M. Detection and Monitoring of Thermal Lesions Induced by Microwave Ablation Using Ultrasound Imaging and Convolutional Neural Networks. IEEE J Biomed Health Inform 2020; 24:965-973. [DOI: 10.1109/jbhi.2019.2939810] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lu A, Woodrum DA, Felmlee JP, Favazza CP, Gorny KR. Improved MR-thermometry during hepatic microwave ablation by correcting for intermittent electromagnetic interference artifacts. Phys Med 2020; 71:100-107. [PMID: 32114323 DOI: 10.1016/j.ejmp.2020.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/01/2020] [Accepted: 02/19/2020] [Indexed: 12/22/2022] Open
Abstract
MRI-guided microwave ablation (MWA) is a minimally invasive treatment for localized cancer. MR thermometry has been shown to be able to provide vital information for monitoring the procedure in real-time. However, MRI during active MWA can suffer from image quality degradation due to intermittent electromagnetic interference (EMI). A novel approach to correct for EMI-contaminated images is presented here to improve MR thermometry during clinical hepatic MWA. The method was applied to MR-thermometry images acquired during four MR-guided hepatic MWA treatments using a commercially available MRI-configured microwave generator system. During the treatments MR thermometry data acquisition was synchronized to respiratory cycle to minimize the impact of motion. EMI was detected and corrected using uncontaminated k-space data from nearby frames in k-space. Substantially improved temperature and thermal damage maps have been obtained and the treatment zone can be better visualized. Our ex vivo tissue sample study shows the correction introduced minimal errors to the temperature maps and thermal damage maps.
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Affiliation(s)
- Aiming Lu
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States.
| | - David A Woodrum
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
| | - Joel P Felmlee
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
| | | | - Krzysztof R Gorny
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
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Practical implementation of robust MR-thermometry during clinical MR-guided microwave ablations in the liver at 1.5 T. Phys Med 2019; 67:91-99. [PMID: 31704392 DOI: 10.1016/j.ejmp.2019.10.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/01/2019] [Accepted: 10/04/2019] [Indexed: 12/22/2022] Open
Abstract
Practical non-invasive equipment modifications and effective acquisition methods to achieve robust and reliable real-time MR thermometry for monitoring of clinical hepatic microwave ablations were implemented. These included selection of the microwave generator location (inside versus outside the MR scan room), the number of radiofrequency chokes added to the microwave generator's coaxial lines, and the use of copper wool to maximize their electrical grounding. Signal-to-noise ratio (SNR) of MR thermometry images of a small fluid-filled phantom acquired during activation of microwave antenna were used to evaluate image quality as a function of each modification. SNR measurements corresponding to both locations of the microwave generator were comparable and so it was located outside the MR scan room. For this location, addition of one RF choke on the power and four chokes on the sensor coaxial lines was found to be optimal, corresponding to a 68% increase in SNR. Furthermore, image quality strongly depended on the proper electrical grounding of the power and sensor lines. SNR ratio (relative to SNR of baseline images) during activation of microwave generator was found to be 0.49 ± 0.28 without adequate grounding, and 0.88 ± 0.08 with adequate grounding (p = 0.002, Student's t-test). These SNR measurements were sufficiently sensitive to detect issues related to equipment performance and hence formed part of the quality assurance testing performed prior to each clinical treatment. Incorporating these non-invasive approaches resulted in significant improvements to image quality and, importantly while maintaining the clinical integrity of the microwave system which is of paramount importance in a highly regulated healthcare environment.
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Dong J, Geng X, Yang Y, Cai X, Hu P, Xia L, Zhang B, Wu P. Dynamic imaging and pathological changes in pig liver after MR-guided microwave ablation. BMC Cancer 2018; 18:397. [PMID: 29625559 PMCID: PMC5889530 DOI: 10.1186/s12885-018-4157-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 02/20/2018] [Indexed: 01/30/2023] Open
Abstract
Background Magnetic resonance (MR)-guided microwave ablation is a well-developed technique for the treatment of tumors, especially hepatic carcinomas. However, there are no detailed reports on the changes in the MR images and histology observed after the ablation. This study aimed to dynamically map the pathological changes after ablation and the changes occurring on MR images. Methods We performed MR-guided microwave ablation in 10 Wuzhishan pigs and obtained an MR scan immediately after ablation (0 weeks) and at 1, 2, 3, and 4 weeks after ablation. We compared the ablation assessed on MR images to tissue specimens obtained during follow-up. Results We found no significant difference in the ablation size between MR images and tissue specimens; the mean length and width of the ablated zone were 4.27 cm and 2.42 cm, respectively, on MR images and 4.26 cm and 2.45 cm, respectively, on specimens (P > 0.05). Immediately after ablation, carbonization and cavities were observed in the center of the ablation zone. Surrounding layer cells were necrotic but maintained their original shapes. The outermost layer was inflamed, but gradually showed fibrotic characteristics. The MR images accurately reflected the exact histological tissue changes after the ablation procedure. Conclusion The dynamic imaging and pathological features of liver ablation outlined in this study will provide a useful reference for patient follow-up after MR-guided microwave ablation. Electronic supplementary material The online version of this article (10.1186/s12885-018-4157-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jun Dong
- Department of Integrated Therapy in Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Xiaojing Geng
- Department of Aging Medicine, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519000, People's Republic of China
| | - Yadi Yang
- Department of Medical Imaging & Image Guided Therapy, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, East Dong Feng Road 651, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xiuyu Cai
- Department of Integrated Therapy in Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Pili Hu
- Department of Integrated Therapy in Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Liangping Xia
- Department of Integrated Therapy in Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Bei Zhang
- Department of Integrated Therapy in Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Peihong Wu
- Department of Medical Imaging & Image Guided Therapy, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, East Dong Feng Road 651, Guangzhou, Guangdong, 510060, People's Republic of China.
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Jiang H, Luo P, Zhi D, Qi F, Huang X, Lu Z, Ge M, Wang L, Qiu B. <italic>In Vitro</italic> and <italic>In Vivo</italic> Experimental Studies of A Novel MR-Guided Method for Bipolar Radiofrequency Liver Ablation. IEEE ACCESS 2018; 6:21859-21866. [DOI: 10.1109/access.2017.2788858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/11/2024]
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Zhang S, Han Y, Zhu X, Shang S, Huang G, Zhang L, Niu G, Wang S, He X, Wan M. Feasibility of Using Ultrasonic Nakagami Imaging for Monitoring Microwave-Induced Thermal Lesion in Ex Vivo Porcine Liver. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:482-493. [PMID: 27894833 DOI: 10.1016/j.ultrasmedbio.2016.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/05/2016] [Accepted: 10/13/2016] [Indexed: 06/06/2023]
Abstract
The feasibility of using ultrasonic Nakagami imaging to evaluate thermal lesions induced by microwave ablation (MWA) in ex vivo porcine liver was explored. Dynamic changes in echo amplitudes and Nakagami parameters in the region of the MWA-induced thermal lesion, as well as the contrast-to-noise ratio (CNR) between the MWA-induced thermal lesion and the surrounding normal tissue, were calculated simultaneously during the MWA procedure. After MWA exposure, a bright hyper-echoic region appeared in ultrasonic B-mode and Nakagami parameter images as an indicator of the thermal lesion. Mean values of the Nakagami parameter in the thermal lesion region increased to 0.58, 0.71 and 0.91 after 1, 3 and 5 min of MVA. There were no significant differences in envelope amplitudes in the thermal lesion region among ultrasonic B-mode images obtained after different durations of MWA. Unlike ultrasonic B-mode images, Nakagami images were less affected by the shadow effect in monitoring of MWA exposure, and a fairly complete hyper-echoic region was observed in the Nakagami image. The mean value of the Nakagami parameter increased from approximately 0.47 to 0.82 during MWA exposure. At the end of the postablation stage, the mean value of the Nakagami parameter decreased to 0.55 and was higher than that before MWA exposure. CNR values calculated for Nakagami parameter images increased from 0.13 to approximately 0.61 during MWA and then decreased to 0.26 at the end of the post-ablation stage. The corresponding CNR values calculated for ultrasonic B-mode images were 0.24, 0.42 and 0.17. This preliminary study on ex vivo porcine liver suggested that Nakagami imaging have potential use in evaluating the formation of MWA-induced thermal lesions. Further in vivo studies are needed to evaluate the potential application.
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Affiliation(s)
- Siyuan Zhang
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Yuqiang Han
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Xingguang Zhu
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Shaoqiang Shang
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Guojing Huang
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Lei Zhang
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Gang Niu
- Department of Radiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Supin Wang
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Xijing He
- Department of Orthopedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mingxi Wan
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China.
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Kaltenbach B, Roman A, Eichler K, Nour-Eldin NEA, Vogl TJ, Zangos S. Real-time qualitative MR monitoring of microwave ablation in ex vivo livers. Int J Hyperthermia 2016; 32:757-64. [DOI: 10.1080/02656736.2016.1204629] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Benjamin Kaltenbach
- Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt am Main, Germany
| | - Andrei Roman
- Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt am Main, Germany
| | - Katrin Eichler
- Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt am Main, Germany
| | - Nour-Eldin A. Nour-Eldin
- Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt am Main, Germany
- Department of Diagnostic and Interventional Radiology, Cairo University Hospital, Cairo, Egypt
| | - Thomas J. Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt am Main, Germany
| | - Stephan Zangos
- Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt am Main, Germany
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Eisele RM. Advances in local ablation of malignant liver lesions. World J Gastroenterol 2016; 22:3885-3891. [PMID: 27099433 PMCID: PMC4823240 DOI: 10.3748/wjg.v22.i15.3885] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 02/23/2016] [Accepted: 03/14/2016] [Indexed: 02/06/2023] Open
Abstract
Local ablation of liver tumors matured during the recent years and is now proven to be an effective tool in the treatment of malignant liver lesions. Advances focus on the improvement of local tumor control by technical innovations, individual selection of imaging modalities, more accurate needle placement and the free choice of access to the liver. Considering data found in the current literature for conventional local ablative treatment strategies, virtually no single technology is able to demonstrate an unequivocal superiority. Hints at better performance of microwave compared to radiofrequency ablation regarding local tumor control, duration of the procedure and potentially achievable larger size of ablation areas favour the comparably more recent treatment modality; image fusion enables more patients to undergo ultrasound guided local ablation; magnetic resonance guidance may improve primary success rates in selected patients; navigation and robotics accelerate the needle placement and reduces deviation of needle positions; laparoscopic thermoablation results in larger ablation areas and therefore hypothetically better local tumor control under acceptable complication rates, but seems to be limited to patients with no, mild or moderate adhesions following earlier surgical procedures. Apart from that, most techniques appear technically feasible, albeit demanding. Which technology will in the long run become accepted, is subject to future work.
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