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European Radiology Nov 2022To prospectively investigate the efficacy and safety of ultrasound (US)-guided microwave ablation (MWA) and radiofrequency ablation (RFA) for primary hyperparathyroidism...
OBJECTIVES
To prospectively investigate the efficacy and safety of ultrasound (US)-guided microwave ablation (MWA) and radiofrequency ablation (RFA) for primary hyperparathyroidism (PHPT).
METHODS
We performed a prospective multicenter study of MWA and RFA for PHPT between August 2017 and October 2020 at five centers. Laboratory testing was performed pre- and post-ablation and followed for at least 6 months. The primary outcome was the cure rate. Secondary outcomes were complications and dynamic changes in serum levels of PTH, calcium, phosphorus, and ALP after ablation.
RESULTS
A total of 132 participants (mean age, 57.33 ± 13.90 years), with 141 parathyroid nodules (median maximal diameter, 1.55 cm) undergoing either MWA or RFA, were enrolled in the study. The technique success rate was 99.29% (140/141). The follow-up period was 6-36 months (median, 12 months). The cure rate was 80.30% (106/132). Pre-ablation PTH level was the independent factor associated with cure rate (Odds ratio (OR), 0.22; 95% CI, 0.07-0.69; p = 0.0090). There was no difference in cure rate between the MWA group and the RFA group (80.22% vs. 80.49%, p = 0.971). The only main complication was hoarseness (5.30%).
CONCLUSIONS
US-guided MWA and RFA for PHPT is an effective and safe procedure in the treatment of PHPT. Pre-ablation PTH level is the key factor affecting the cure rate after MWA and RFA.
KEY POINTS
• To our knowledge, this is the first prospective multicenter clinical trial with ultrasound-guided MWA and RFA for primary hyperparathyroidism. • There was no difference in cure rate between the MWA and RFA groups for primary hyperparathyroidism. The overall cure rate was 80.30%. • Pre-ablation PTH level was the independent factor associated with cure rate (odds ratio (OR), 0.22; 95% CI, 0.07-0.69; p = 0.0090).
Topics: Humans; Adult; Middle Aged; Aged; Microwaves; Hyperparathyroidism, Primary; Prospective Studies; Radiofrequency Ablation; Catheter Ablation; Ultrasonography, Interventional; Treatment Outcome; Retrospective Studies
PubMed: 35593958
DOI: 10.1007/s00330-022-08851-y -
Dermatologic Surgery : Official... Jan 2022A microwave-based device is a newly developed method for treating axillary osmidrosis. Few studies have compared the difference between microwave therapy and... (Comparative Study)
Comparative Study
BACKGROUND
A microwave-based device is a newly developed method for treating axillary osmidrosis. Few studies have compared the difference between microwave therapy and subcutaneous curettage for axillary osmidrosis.
OBJECTIVE
To compare the long-term effectiveness, complications, and recurrence of osmidrosis after microwave therapy and subcutaneous curettage.
METHODS AND MATERIALS
Medical records of 155 patients with osmidrosis treated with microwave therapy or subcutaneous curettage were reviewed retrospectively. Demographic data, visual analog scale for odor, hyperhidrosis disease scale, complications, and recurrence were analyzed.
RESULTS
Osmidrosis improved significantly in both treatment groups at 6 months. Effective improvement was observed in 90% and 23% of the patients in the surgery and microwave groups, respectively, after 3 years postoperatively. The recurrence rates were 39% and 21% in the microwave and surgery groups, respectively. The transient complication rate was higher in the microwave group, and long-term complications only occurred in the surgery group.
CONCLUSION
Subcutaneous curettage is a more effective approach for axillary osmidrosis. However, microwave therapy is recommended for patients with cosmetic concerns.
Topics: Adolescent; Adult; Axilla; Curettage; Female; Humans; Hyperhidrosis; Male; Microwaves; Middle Aged; Odorants; Postoperative Complications; Recurrence; Retrospective Studies; Sweat Glands; Treatment Outcome; Young Adult
PubMed: 34856594
DOI: 10.1097/DSS.0000000000003276 -
Computer Methods and Programs in... Nov 2021Percutaneous microwave ablation is an essential and safe method for the treatment of liver cancer. As one therapeutic dose, ablation time is crucial to the treatment... (Review)
Review
OBJECTIVE
Percutaneous microwave ablation is an essential and safe method for the treatment of liver cancer. As one therapeutic dose, ablation time is crucial to the treatment effect determined by the physicians. However, due to the different experiences of physicians and the significant individual differences of patients, the final treatment effect is also different, which makes it difficult for the ablation time recorded in the electronic health records (EHRs) to follow the same pattern. To solve this problem, we propose a data mining method based on historical treatment data recorded in EHR, which uses a robust relapse risk as strong supervision to correct the ablation time. The prediction results of this method are closer to the situation of patients without relapse, which can provide physicians with reference.
METHODS
In the proposed method, we introduce the optimization method to iteratively minimize the postoperative relapse risk and utilize gradient propagation between the risk and ablation time during iteration to correct the latter. We also apply a self-attention mechanism to find the global dependencies between each feature in EHR to improve the final prediction performance of the model.
RESULTS
Comparative experimental results show that compared with other baseline model, the proposed model achieves better performance on R-square, MAE, and MSE metric. The results of ablation experiments show that the integration of label correction and self-attention mechanism can improve the model performance.
CONCLUSIONS
We using relapse risk as strong supervision related to the ablation time can effectively correct the deviation of the ablation time as weak supervision. The self-attention mechanism in the proposed model can significantly improve the prediction performance.
Topics: Catheter Ablation; Data Mining; Delivery of Health Care; Electronic Health Records; Humans; Liver Neoplasms; Microwaves; Physicians; Recurrence
PubMed: 34656904
DOI: 10.1016/j.cmpb.2021.106438 -
Journal of Clinical Ultrasound : JCU Feb 2022We aimed to evaluate the clinical efficacy and safety of ultrasonographically (US)-guided percutaneous microwave ablation (MWA) in the treatment of primary...
PURPOSE
We aimed to evaluate the clinical efficacy and safety of ultrasonographically (US)-guided percutaneous microwave ablation (MWA) in the treatment of primary hyperparathyroidism (PHPT).
METHODS
A total of 35 patients who received MWA treatment in our hospital between August, 2019 and January, 2021 were retrospectively analyzed. Serum parathyroid hormone (PTH), calcium, phosphorus levels, and improvement in clinical symptoms were recorded before and after MWA. All patients were followed up for 6 months. Paired-sample t-tests and paired sample Wilcoxon signed-rank tests were used to indicate PTH, calcium, and P levels before and after ablation. Postoperative complications were statistically analyzed to evaluate the therapeutic effect of MWA on PHPT patients.
RESULTS
A total of 38 parathyroid nodules in 35 PHPT patients were completely ablated at one time. These results indicated that MWA could effectively destroy parathyroid tissue and decrease the concentrations of PTH, calcium, and phosphorus compared with those before MWA, and the effect was sustained. Moreover, MWA improved clinical symptoms, and improved quality of life of patients. None of patients developed tracheal and esophageal injuries, peripheral hematoma, infection, or other serious complications.
CONCLUSION
US-guided MWA has shown to be an effective and safe approach to treat PHPT patients.
Topics: Catheter Ablation; Humans; Hyperparathyroidism, Primary; Microwaves; Quality of Life; Retrospective Studies; Treatment Outcome; Ultrasonography, Interventional
PubMed: 34984687
DOI: 10.1002/jcu.23134 -
Journal of Translational Medicine Sep 2022The immune checkpoint inhibitors (ICIs) combined with other therapeutic strategies have shown exciting results in various malignancies, and ICIs have now become the gold...
BACKGROUND
The immune checkpoint inhibitors (ICIs) combined with other therapeutic strategies have shown exciting results in various malignancies, and ICIs have now become the gold standard for current cancer treatment. In several preclinical and clinical investigations, ablation coupled with immunotherapy has proved to be quite effective. Our previous studies have shown that ablation coupled with ICI is a potential anti-cancer regimen for colorectal cancer liver metastases (CRLM). Furthermore, we have reported that following microwave ablation (MWA), the expression of LAG3 is up-regulated in tumor microenvironment (TME), indicating that LAG3 is implicated in the regulation of immunosuppressive immune response, and combination therapy of MWA and LAG3 blockade can serve as a promising therapeutic strategy against cancer.
METHODS
The expression of LAG3 was investigated in this study utilizing a preclinical mouse model treated with MWA. Moreover, we monitored the tumor development and survival in mice to assess the anti-cancer effects of MWA alone or in combination with LAG3 blockade. Flow cytometry was also used to phenotype the tumor-infiltrating lymphocytes (TILs) and CD8 T cell effector molecules. We finally analyzed the single-cell RNA sequencing (scRNA-seq) data of infiltrating CD45 immune cells in the tumors from the MWA alone and MWA combined with LAG3 blockade groups.
RESULTS
After MWA, the expression of LAG3 was up-regulated on sub-populations of TILs, and introducing LAG3 blockade to MWA postponed tumor development and extended survival in the MC38 tumor model. Flow cytometry and scRNA-seq revealed that LAG3 blockade in combination with MWA markedly boosted the proliferation and the function of CD8 TILs, leading to altered myeloid cells in the TME.
CONCLUSION
Combination therapy of LAG3 blockade and MWA was a unique therapeutic regimen for some solid tumors, and such combination therapy might reprogram the TME to an anti-tumor manner.
Topics: Animals; CD8-Positive T-Lymphocytes; Immune Checkpoint Inhibitors; Liver Neoplasms; Lymphocytes, Tumor-Infiltrating; Mice; Microwaves; Tumor Microenvironment
PubMed: 36180876
DOI: 10.1186/s12967-022-03646-7 -
Orthopaedic Surgery Aug 2020Microwave ablation has been used to treat bone tumors in extremities for more than 30 years. With improved recognition, updated microwave equipment, and expanded...
Microwave ablation has been used to treat bone tumors in extremities for more than 30 years. With improved recognition, updated microwave equipment, and expanded clinical application, microwave ablation has recently been widely used to treat bone tumors. To standardize the application of microwave ablation in the clinical treatment of bone tumors in the limbs, research results and clinical experience involving the use of microwave ablation to treat bone tumors in the limbs have been summarized, and a clinical guideline has been designed. This guideline is aimed at providing a reliable clinical basis for indications, preoperative evaluation and decision-making, perioperative treatment, complications, and other issues via evidence-based medicine. Two aspects are considered-percutaneous microwave ablation and intraoperative microwave ablation of bone tumors in extremities. Ultimately, the guideline is intended to standardize treatment and improve the clinical efficacy of microwave ablation of bone tumors in extremities.
Topics: Ablation Techniques; Bone Neoplasms; Clinical Decision-Making; Extremities; Guidelines as Topic; Humans; Microwaves
PubMed: 32776475
DOI: 10.1111/os.12749 -
Skeletal Radiology Dec 2020Osteoid osteomas are benign bone tumors commonly treated using thermal ablation. We compare the technical success, complication rates, and long-term efficacy of the two...
OBJECTIVE
Osteoid osteomas are benign bone tumors commonly treated using thermal ablation. We compare the technical success, complication rates, and long-term efficacy of the two most common ablation types: radiofrequency and microwave.
MATERIALS AND METHODS
A retrospective study was performed of all osteoid osteoma ablation procedures between 2007 and 2017. A ten-point numerical pain scale was used to quantify symptoms before and after the procedures with > 12-month follow-up. Complications were reported using the Society of Interventional Radiology Adverse Events reporting criteria.
RESULTS
Twenty-nine patients successfully underwent 15 radiofrequency ablations and 15 microwave ablations with a technical success rate of 83% for radiofrequency and 100% for microwave (p = 0.23). Long-term recurrence rates (p = 1.0) and complication rates (p = 0.60) were not significantly different for the groups. One patient developed a skin burn following microwave ablation and another developed 12 months of sciatic neuropathy following radiofrequency ablation.
CONCLUSION
Microwave and radiofrequency ablation are safe and effective methods for treating osteoid osteomas with similar long-term efficacies. Although radiofrequency ablation is more commonly reported to result in skin burns, this complication can arise during microwave ablation.
Topics: Bone Neoplasms; Catheter Ablation; Humans; Microwaves; Neoplasm Recurrence, Local; Osteoma, Osteoid; Radiofrequency Ablation; Retrospective Studies; Treatment Outcome
PubMed: 32564104
DOI: 10.1007/s00256-020-03518-5 -
Journal of Cancer Research and... Dec 2022Percutaneous image-guided thermal ablation has an increasing role in the treatment of primary and metastatic lung tumors. Although microwave ablation (MWA) has emerged...
BACKGROUND
Percutaneous image-guided thermal ablation has an increasing role in the treatment of primary and metastatic lung tumors. Although microwave ablation (MWA) has emerged advantageous as a new ablation technology, more research is needed to improve it. This study aims to investigate the ablation zone of three microwave antennas in ex vivo porcine lung.
MATERIALS AND METHODS
In the ex vivo standard model and porcine lung model, MWA was performed in three power output settings (50 W, 60 W, and 70 W) for 3, 6, 9, and 12 min using three microwave antennas, with outer diameter of 1.03 mm (19G), 1.6 mm (16G), and 2.0 mm (14G). A total of 108 and 216 sessions were performed (3 or 6 sessions per time setting with the 14G, 16G, and 19G microwave antennas). After the MWA was complete, we evaluated the shape and extent of the coagulation zone and measured the maximum long-axis (along the needle axis; length [L]) and maximum short-axis (perpendicular to the needle; diameter [D]) of the ablation zones using a ruler; subsequently, the sphericity index (L/D) was calculated. The sphericity index can be simplified as long-axis/short-axis.
RESULTS
In the ex vivo standard model study, the long- and short-axis diameters and sphericity indices were not statistically different between the 14G, 16G, and 19G groups. In the ex vivo porcine lung study, the long- and short-axis diameters did not differ statistically between the 14G, 16G, and 19G groups (P < 0.05 each). The sphericity index for the 19G microwave antenna was higher than the sphericity indices for the 14G and 16G microwave antennas (P < 0.05); however, the index for the 14G microwave antenna was not statistically different than that for the 16G microwave antenna (P > 0.05).
CONCLUSIONS
The ablation zone of the 19G antenna was the same as those of the 14G and 16G antennas in vitro. Thus, the 19G antenna may reduce the incidence of complications in lung tumor ablation.
Topics: Swine; Animals; Liver; Microwaves; Radiofrequency Ablation; Lung; Ablation Techniques; Catheter Ablation; Lung Neoplasms
PubMed: 36647945
DOI: 10.4103/jcrt.jcrt_1124_22 -
Diagnostic and Interventional Radiology... Nov 2020There are many therapeutic options for primary hepatocellular carcinoma (HCC), but very limited options for unresectable HCC with a single lesion larger than 5 cm... (Meta-Analysis)
Meta-Analysis
There are many therapeutic options for primary hepatocellular carcinoma (HCC), but very limited options for unresectable HCC with a single lesion larger than 5 cm (Barcelona Clinic Liver Cancer [BCLC] stage A) or with 2-3 nodules beyond 5 cm (BCLC stage B). Transcatheter arterial chemoembolization (TACE) is considered the first-line treatment for these patients, and combination therapy has also been tried. However, the effectiveness of microwave ablation (MWA) combined with TACE in the treatment of the above tumors remains to be further confirmed. Therefore, this meta-analysis aimed to compare the effectiveness of combination therapy and TACE monotherapy on these patients. PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, and the Wan Fang electronic databases were retrieved to search for studies comparing combination therapy and TACE monotherapy, published between the earliest available date and August 20, 2019. A total of 20 articles (reporting 1736 patients) were included. Meta-analysis showed that, compared to TACE alone, TACE + MWA resulted in significantly higher 1-, 2-, and 3-year overall survival (OS) (1-year OS rate: RR = 1.36, 95% CI 1.28-1.44, P < 0.001; 2-year OS rate: RR = 1.56, 95% CI 1.40-1.74, P < 0.001 and 3-year OS rate: RR = 2.07, 95% CI: 1.67-2.57, P < 0.001). Complete response, partial response, and objective response rates were significantly higher in TACE + MWA than those in TACE alone (P < 0.001). Meanwhile, publication bias and sensitivity analysis were performed and did not show statistical significance.
Topics: Carcinoma, Hepatocellular; Chemoembolization, Therapeutic; Combined Modality Therapy; Humans; Liver Neoplasms; Microwaves; Radiofrequency Ablation; Treatment Outcome
PubMed: 32965220
DOI: 10.5152/dir.2020.19615 -
Medicine Oct 2020Ultrasound guided percutaneous thermal ablation has been well acknowledged in treating hepatic malignancy. Although thermal ablation is safe for the treatment, it may... (Review)
Review
Ultrasound guided percutaneous thermal ablation has been well acknowledged in treating hepatic malignancy. Although thermal ablation is safe for the treatment, it may induce some lethal complications such as diaphragmatic injury, bile-stained pleural fistula, and bilious pleuritis.We presented 2 cancer patients in hepatic diaphragmatic dome showed diaphragmatic injury, bile-stained pleural fistula, and bilious pleuritis after microwave ablation (MVA). The symptoms were attenuated after chest drainage and anti-infection therapy. In the literature review, 17 articles published in the recent 10 years on diaphragmatic injury after MVA for treating hepatic cancer were available. Twenty-three cases were obtained, among which 2 showed bilious pleuritis after radiofrequency treatment. Most of the lesions were adjacent to the diaphragma. Among the articles reporting the localization of lesions, most of the cases showed lesions in S8, 2 in S7, 3 in S4, and 3 in S5, respectively. Surgical recovery was required for the patients with massive diaphragmatic injury. Only 2 cases underwent thorascopic surgery. After chest drainage and anti-infection, their symptoms were attenuated to some extent.Radiofrequency or MVA may induce pleural effusion, and special attention should be paid to the diaphragmatic injury induced by thermal ablation.
Topics: Diaphragm; Female; Humans; Liver Neoplasms; Male; Microwaves; Middle Aged; Pleural Diseases; Pleurisy; Radiation Injuries; Radiofrequency Ablation; Respiratory Tract Fistula
PubMed: 33126314
DOI: 10.1097/MD.0000000000022763