Study about safety and efficacy of percutaneous radiofrequency ablation for lung tumor

作为基础实验，我们对一只猪的正常肺进行了RFA，并与CT图像对照观察了组织病理学结果。结果：肝实质内可见中央凝固性坏死、周围渗出物和最外周缘血瘀区三层结构。认为CT所见的环形高密度区对应于血瘀证的最外周部，并伴有炎细胞的侵袭和纤维化。未达坏死的细胞团散在最外周层。这意味着在临床治疗中，靶区应包括在CT的环形高密度区内，以获得良好的治疗效果。在研究期间，17例可增加22个结节(原发癌术后复发10个，其他器官转移12个)。因此，从2000年6月至今，我们对86个结节进行了rfia，我们评估了clin…。在射频消融后6个月以上观察到40个3 cm以下结节的疗效较好，33个达到消退的结节局部控制率为81.8%，7个未消退的结节局部控制率为28.6%。两者之间存在着显著的差异。主要并发症有疼痛和(或)热感占57.2%，术后发热占51.4%，气胸占30.4%。我们在第33届日本血管造影术和IVR学会(东京)，第45届日本肺癌学会(横滨)，RSNA2004(芝加哥)，ECR2005(维也纳)上报道了这些结果。此外，还评估了射频消融术中热引起的血管内微栓子的发生情况。17例患者20次手术中有3次超声监测颈动脉可见大血栓形成。磁共振弥散成像未发现脑梗塞20例，含17例超声。这一结果发表在《美国放射学杂志》上。较少

As fundamental experiment, we performed RFA in normal lungs of a pig and observed histopathological findings in comparison with a CT image. As a result, three layer configurations which consisted of central coagulative necrosis, the surrounding exudates and the most outer circumferential blood stasis were observed. It was thought that the circular high density area observed in CT corresponded in the most outer circumferential blood stasis with inflammatory cell invasion and fibrosis. The cellular group that did not reach necrosis lay scattered in the most outer circumferential layer. That means that it was important to get a good therapeutic effect at a clinical treatment that target lesion should be included inside the circular high density area in CT.22 nodules (ten postoperative recurrences of primary lung cancer and 12 metastases from the other organ) of 17 case could be added during study period. So, out of 86 nodules we performed RFA on since June 2000 till now, we evaluated clin … More ical results in 40 nodules less than 3cm which were observed more than 6 months after RFA.Local control rate was 81.8% in 33 nodules which reached roll off although it was 28.6% in seven nodules which did not do roll off. A significant difference was recognized between both. As for major complications, it revealed pain and/or heat sensation in 57.2%, postoperative fever in 51.4% and pneumothorax in 30.4%. Serious complications were not experienced except two cases who were inserted a chest tube because of moderate pneumothorax.We reported these results at the 33rd meeting of society of Japanese angiography and IVR (Tokyo), the 45th meeting of Japan lung cancer society (Yokohama), RSNA2004 (Chicago), ECR2005 (Vienna). In addition, occurrence of intravascular microembolisms caused by heat during RFA procedure was evaluated. Mocroemboli were observed in three of 20 procedures in 17 cases by monitoring a carotid artery using ultrasound image. However, diffusion MRI showed no cerebral infarction in 20 cases containing containing 17 US cases. The result was reported in American Journal of Roentogenology. Less