Zilin Huang

CT-guided percutaneous microwave ablation of adrenal malignant carcinoma: preliminary results.

Microwave ablation has recently been developed as a safe and effective treatment for a variety of tumors. The authors evaluated the safety and efficacy of computed tomography (CT)‐guided percutaneous microwave ablation of adrenal malignant tumors.

CT-guided radiofrequency ablation prolonged metastatic survival in patients with liver metastases from nasopharyngeal carcinoma

Purpose: The aim of this retrospective study was to evaluate the technical efficacy and survival following CT-guided radiofrequency ablation (RFA) of liver metastases (LM) from nasopharyngeal carcinoma (NPC) and to determine prognostic factors. Materials and methods: Between 2000 and 2008, 376 patients with LM from NPC were identified. Of these 17 patients with 31 LM from NPC underwent CT-guided percutaneous RFA. We assessed the technical effectiveness, complications and prognostic value of LM characteristics including timing (synchronous versus metachronous), number, size, presence of extra hepatic metastases and treatment regimen. Survival rates were calculated using the Kaplan–Meier method. Results: Technical success was achieved in 30/31 metastases (96.7%). The median overall survival was 16.5 months from the time of diagnosis of LM for all the 376 NPC patients with LM, and 48.1 months for the 17 NPC patients with LM who received RFA treatment. Of the 376 patients, 111 had 1–3 LM who did not receive RFA treatment, with a median survival of 25.9 months compared to 48.1 months for the 14 patients with 1–3 LM who received RFA. Conclusion: CT-guided RFA of LM from NPC can be performed with a high degree of technical effectiveness and offers the promise of improved survival in selected patients.

Percutaneous CT-guided radiofrequency ablation for unresectable hepatocellular carcinoma pulmonary metastases

Purpose: This study aimed to evaluate the safety and efficacy of percutaneous CT-guided radiofrequency ablation (RFA) for unresectable hepatocellular carcinoma pulmonary metastases (HCCPM) and to identify the prognostic factors for survival. Materials and methods: We reviewed the medical records of 320 patients with HCCPM treated between January 2005 and January 2012. Among them, 29 patients with 68 lesions of unresectable HCCPM underwent 56 RFA sessions. Safety, local efficacy, survival and prognostic factors were evaluated. Survival was analysed using the Kaplan-Meier method. Univariate analyses were evaluated by the log-rank test. Results: Pneumothorax requiring chest tube placement occurred in five (8.9%, 5/56) RFA sessions. During the median follow-up period of 23 months (range 6–70), 18 patients (62.1%, 18/29) died of tumour progression and 11 (37.9%, 11/29) were alive. The 1-, 2- and 3-year overall survival rates were 73.4%, 41.1% and 30%, respectively. The median progression-free survival was 18 months (95% confidence interval (CI) 9.8–26.2) and the median overall survival time was 21 months (95%CI, 9.7–32.3). The maximum tumour diameter ≤3 cm (p = 0.002), the number of pulmonary metastases ≤3 (p = 0.014), serum AFP level ≤400 ng/mL (p = 0.003), and the controlled status of intrahepatic tumour after lung RFA (p = 0.001) were favourable prognostic factors for overall survival. Conclusions: Our study indicates that percutaneous CT-guided RFA, as an alternative treatment procedure to pulmonary metastasectomy, can be a safe and effective therapeutic option for unresectable HCCPM.

Retroperitoneal schwannoma treated with percutaneous computed tomography–guided radiofrequency ablation

Retroperitoneal schwannomas (RSs) are particularly rare tumors, and resection is the first choice for symptomatic patients. However, some RSs with anatomical complexities pose great challenges for surgeons attempting radical resection without sacrificing the nearby critical structures, and subtotal resection leads to local recurrence, especially in refractory malignant RSs. The authors have successfully applied percutaneous CT-guided radiofrequency ablation in 2 cases of RSs, with favorable long-term progression-free survival.

Superficial malignant tumors: noninvasive treatment with ultrasonographically guided high-intensity focused ultrasound.

The purpose of this study was to evaluate the effectiveness of ultrasonographically guided high-intensity focused ultrasound (HIFU) ablation for superficial malignant tumors. HIFU ablation was applied to 38 cases. The diameter of tumors ranged from 1.5 to 18 cm, including ≤ 3 cm in seven cases, > 3 to ≤ 5 cm in four cases, > 5 to < 10 cm in 15 cases, and ≥ 10 cm in 12 cases. Using imaging techniques, the volume and activity of tumors were observed before and after HIFU ablation, and the effectiveness of HIFU ablation in superficial malignant tumors was evaluated. For tumors ≤ 5 cm in diameter, HIFU ablation was completely effective in 100% (11/11) of cases; for tumors > 5 cm in diameter, HIFU ablation was completely effective in 25.9% (7/27) of cases, partially effective in 14.8% (4/27) of cases, moderately effective in 33.3% (9/27) of cases; the disease remained stable in 14.8% (4/27) of cases and progressed in 11.1% (3/27) of cases. No significant difference was observed in the tumor volumes before (202.6 ± 230.4 cm3) and 6-8 weeks after HIFU ablation (188.1 ± 215.8 cm3). However, the difference in the active volume before (202.6 ± 230.4 cm3) and after (127.6 ± 189.7cm3) HIFU ablation was statistically significant. Among 38 the cases, 32 reported painful symptoms, with a pain score of 4.39 ± 2.36, before the ablation; the values dropped to 0.19 ± 0.54 after HIFU, and the difference was statistically different. Thus, HIFU is a safe, effective, and promising approach for the treatment of superficial malignant tumors.