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

作为基础实验，我们在猪的正常肺中进行了射频消融，并观察了组织病理学结果与CT图像的比较。结果观察到以中央凝固性坏死、周围渗出物和最外周血瘀为主的三层构型。认为CT所见圆形高密度区对应最外周血瘀伴炎性细胞侵袭及纤维化。未坏死的细胞群分散分布在最外层。这意味着靶病变应包括在ct的圆形高密度区内，这对于临床治疗获得良好的治疗效果是很重要的。研究期间共增加17例22个结节（10例原发性肺癌术后复发，12例其他器官转移）。因此，自2000年6月至今，我们对86个结节进行了RFA，我们评估了40个小于3cm的结节，这些结节在RFA后超过6个月观察到的临床结果。达到滚出的33例根瘤局部控制率为81.8%，未滚出的7例根瘤局部控制率为28.6%。两者之间存在显著差异。在主要并发症方面，疼痛和/或热感觉占57.2%，术后发热占51.4%，气胸占30.4%。除2例因中度气胸而置管外，均无严重并发症。我们在日本血管造影与IVR学会第33届会议（东京）、日本肺癌学会第45届会议（横滨）、RSNA2004（芝加哥）、ECR2005（维也纳）上报道了这些结果。此外，还评估了RFA过程中由热引起的血管内微栓塞的发生情况。应用超声图像监测颈动脉，在17例20例手术中有3例观察到微栓子。然而，20例（其中17例为US）弥散MRI未见脑梗死。该研究结果发表在《美国儿科学杂志》上。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