Application progress of radiofrequency ablation in thyroid diseases / 肿瘤研究与临床

The incidence of thyroid nodule is on the rise year by year. The traditional treatment methods include surgical operation, thyroxine treatment and radioiodine treatment. In recent years, radiofrequency ablation has been widely used in thyroid diseases because of its advantages of simple operation, minimally invasive and beauty. This paper summarizes the application progress of radiofrequency ablation.

Comparison of radiofrequency ablation and operation for overmuch residual thyroid removal before 131I treatment in differentiated thyroid cancer / 中华医学超声杂志（电子版）

Objectives The aim of this study is to compare efficacy and safety of radiofrequency ablation versus operation for overmuch residual thyroid removal before 131I treatment in differentiated thyroid cancer.Methods Clinical data from 52 newly diagnosed differentiated thyroid cancer patients who treated with operation at Zhejiang Cancer Hospital from January 2014 to December 2016 were retrospectively reviewed.The serum TSH was less than 30 IU/ml,and 99mTc thyroid imaging and ultrasound examination showed obviously residual thyroid tissue after 3 weeks of low iodine diet and discontinuation of euthyrox.Of these patients,28 cases received radiofrequency,while 24 cases treated with operation.The operation time,the waiting time of 131I treatment and the efficacy of residual thyroid tissue clearance were compared between two groups.At the same time,the complications of the two groups were observed.Results The mean values of operation time between two groups were(22.14±7.12)min and(55.45±13.56)min,respectively,and there was a statistically significant difference(t=11.822,P＜0.05).The mean waiting time of 131I treatment in patients received radiofrequency was(9.40±4.14)days,while the mean waiting time in operation group was(13.53±4.55)days,and the differences were statistically significant(t=9.144,P＜0.05).In RFA group,hoarseness,temporary parathyroid injury and permanent parathyroid injury were observed in 2 cases,0 case and 1 case,respectively.While there were 2 cases,3 cases and 0 case in the operative group.There were no significant differences between the two groups(all P ＞ 0.05).85.7%(24/28)of patients in RFA group and 91.7%(22/24)in operation group showed favorable efficacy of residual thyroid removal,and there were no significant differences between the two groups(P＞0.05).Conclusion Compared with operation,postsurgical residual thyroid tissue removal in differentiated thyroid cancer by ultrasound guided radiofrequency ablation by ultrasound guided is safe and effective,and provides a new minimally invasive treatment for patients who are reluctant to undergo surgery.

A methodologic study of quantitative analysis of contrast enhanced ultrasound in liver / 中华超声影像学杂志

Objective To investigate the effects of contrast dose and region of interest (ROI) depth on quantitative analysis of liver by contrast-enhanced ultrasound (CEUS) during clinical application.Methods After bolus injection of contrast agent,the change of quantitative parameters [including echo mean(EM),rise time(RT),peak intensity(PI),mean transit time(MTT),area under the curve(AUC),time from peak to one half(TPH),wash in slope(WIS),time to peak(TTP)] of time-intensity curves were analyzed based on groups from different doses (1.0 ml and 1.6 ml) and different depth (＜30 mm,30-60 mm,and ≥60 mm).Results MTT and TPH were increased with dose increasing from 1.0 ml to 1.6 ml (P＜0.05).With the dose 1.0 ml,TPH,WIS,PI,AUC and MTT showed significant difference when the depth of the ROI changes (P ＜0.05),with the depth increased,TPH,WIS,PI,and AUC all decreases and MTT increases.For all the other parameters,no significant changes were found (P ＞0.05).Conclusions CEUS and its imaging process can directly influence the accuracy of the parameters from the quantitative analysis.Standardization of contrast agent with predefined dose and depth can potentially facilitate future clinical studies in liver CEUS.

Primary experience of improving effectiveness of radiorequency ablation for liver tumor by selective portal vein embolization / 中华超声影像学杂志

Objective To explore the feasibility and efficacy of the selective portal vein embolization (SPVE) before radiofrequency ablation(RFA) for liver tumor large than 3 cm.Methods 63 patients with 63 liver tumor (＞3 cm) located in single liver segment completely or mostly underwent RFA.21 patients (21 lesions) were randomly assigned to receive SPVE before ablation (SPVE + RFA group),other 42 patients were treated with RFA only (RFA group).The complications and treat results of two groups were collected and compared.Results SPVE were achieved in 20 of 21 patients,and no critical complication were happened in both group.During a observation period of median 14.2 months,local tumor progression were observed in 17 of 42 patients (40.5％) in RFA group and in 3 of 20 patients (15.0％) in SPVE+ RFA group,there were significant difference between two groups(P =0.043).Conclusions SPVE can safely and effectively improve the efficacy of RFA for the liver tumors which large than 3 cm and located in single liver segment.

Reliability investigation and influential factors analysis of BI-RADS-ultrasound categorization on the benign breast nodules / 中华超声影像学杂志

Objective To evaluate the reliability of benign nodules diagnosed by ultrasound and analyze the probable factors of infecting the BI-RADS ultrasound categorization of breast lesions. Methods A total of 792 cases with initial category 3 assessments on BI-RADS ultrasound categorization consistent with more than 2 years follow-up or pathologic results were contained. The reliability of probable benign lesions were studied retrospectively,and several factors that could influence the categorization were explored such as age,breast lumps size,multiplicity,palpability,and US radiologist's experience referring to ACR-BI-RADS and the new categorizations recommendation. Results Of 792 breast nodules, 781 (98.6%) were benign and 11 (1.4%) were malignant. If the new categorizations recommendation was applied, 35. 1% (278/792) of all cased would have been upgraded to BI-RADS 4,81. 8% (9/11)of malignant tumors would have been found. The breast masses diagnosed by the junior radiologists were more frequently upgraded to BI-RADS 4 than senior radiologists' findings (P <0. 05), the nodules in women 40 years or older and multiple lesions were more frequently upgraded to category 4 (P <0. 01). The presence of palpability and mass size had on significantly influence the BI-RADS US categorization of breast nodules. Conclusions BI-RADS-Ultrasound categorization is relatively reliable to diagnose breast benign nodules. The multiplicity of breast nodules,patient's age and US radiologist's experience were found to have significant influences on the categorizations of probably benign breast nodules.