Characteristic CT Findings After Percutaneous Cryoablation Treatment of Malignant Lung Nodules.
Characteristic CT Findings After Percutaneous Cryoablation Treatment of Malignant Lung Nodules.
复制标题
DOI：
10.1097/md.0000000000001672
复制
发表时间：
2015-10
期刊：
影响因子：
1.6
通讯作者：
Moore W
中科院分区：
文献类型：
--
作者：
Chaudhry A;Grechushkin V;Hoshmand M;Kim CW;Pena A;Huston B;Chaya Y;Bilfinger T;Moore W
评估肺癌经皮冷冻治疗后的计算机断层扫描（CT）成像特征。本研究纳入了IRB批准的对40例在2007年1月至2011年3月期间接受非手术治疗的原发性1期肺癌患者的回顾性分析。所有手术均在全身麻醉和CT引导下进行。在术后1个月、3个月、6个月和12个月获得胸部CT随访成像，以评价消融的肺结节。记录伤口表面积、密度（Hounsfield单位）以及是否存在空化。此外，还记录了结节增强的程度。无法获得上述随访的患者从研究中排除。36例患者接受了经皮冷冻消融术，男性与女性的比例为75%，男性平均年龄为74.6岁，女性平均年龄为74.3岁。在1个月、3个月、6个月和12个月的随访中，消融前和冷冻消融后的平均结节表面积分别为2.99、7.86、3.89、3.18和3.07平方厘米。冷冻消融前的平均造影前结节密度为8.9，术后1、3、6和12个月随访时的平均造影前结节密度分别为8.5、−5.9、−9.4和−3.8 HU。随着时间的推移，肺结节的衰减增加，在上述时间间隔内，平均增强后增强为11.4、18.5、16.1和25.7 HU。53%（19/36）的患者在冷冻消融区发生气穴。80.6%（29/36）的冷冻消融区空洞在12个月内消退。4例患者（11%）在冷冻消融部位出现肿瘤复发，无患者出现卫星或远处转移。我们的研究表明，接受冷冻治疗肺结节的患者在随访CT上有特征性变化，包括。结节的表面积在1个月随访时增加，随后表面积逐渐减小。每次间隔随访时结节密度（Hounsfield单位）降低与肺癌完全消融相关，而结节密度增加则提示复发。消融结节区域内形成空洞，其中大部分通常在最初3至6个月内消退。由于现有的数据集有限，因此难以评估创伤性增强。
Assess computed tomography (CT) imaging characteristics after percutaneous cryotherapy for lung cancer. A retrospective IRB-approved analysis of 40 patients who underwent nonsurgical treatment for primary stage 1 lung cancer performed from January 2007 to March 2011 was included in this study. All procedures were performed using general anesthesia and CT guidance. Follow-up imaging with CT of the chest was obtained at 1 month, 3 months, 6 months, and 12 months postprocedure to evaluate the ablated lung nodule. Nodule surface area, density (in Hounsfield units), and presence or absence of cavitations were recorded. In addition, the degree of nodule enhancement was also recorded. Patients who were unable to obtain the aforementioned follow-up were excluded from the study. Thirty-six patients underwent percutaneous cryoablation with men to women ratio of 75% with mean age for men 74.6 and mean age for women 74.3 years of age. The average nodule surface area preablation and postcryoablation at 1-, 3-, 6-, and 12-month follow-ups were 2.99, 7.86, 3.89, 3.18 and 3.07�cm2, respectively. The average precontrast nodule density before cryoablation was 8.9 and average precontrast nodule density postprocedure at 1, 3, 6, and 12 months follow-ups were 8.5, −5.9, −9.4, and −3.8 HU, respectively. There is increased attenuation of lung nodules over time with an average postcontrast enhancement of 11.4, 18.5, 16.1, and 25.7 HU at the aforementioned time intervals. Cavitations occurred in the cryoablation zone in 53% (19/36) of patients. 80.6% (29/36) of the cavitations in the cryoablation zone resolved within 12 months. Four patients (11%) had recurrence of tumor at the site of cryoablation and none of the patients had satellite or distant metastasis. Our study shows that patients who underwent cryotherapy for lung nodules treatment had characteristic changes on follow-up CT including. The surface area of the nodule increases at the 1-month follow-up with subsequent gradual decrease in the surface area. Decreased nodule density (Hounsfield units) at each interval follow-up is associated with complete ablation of the lung cancer whereas increasing nodule density was suggestive of recurrence. Cavity formation within the region of the ablated nodule, most of which typically resolved within the first 3 to 6 months. Nodule enhancement is difficult to assess because of the limited data sets that are available.