1,447 results on '"Ablation zone"'
Search Results
102. Satellite Remote Sensing of the Greenland Ice Sheet Ablation Zone: A Review
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Matthew G. Cooper and Laurence C. Smith
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ablation zone ,greenland ,ice sheet ,surface mass balance ,mass balance ,altimetry ,albedo ,scatterometry ,lidar ,sea level rise ,Science - Abstract
The Greenland Ice Sheet is now the largest land ice contributor to global sea level rise, largely driven by increased surface meltwater runoff from the ablation zone, i.e., areas of the ice sheet where annual mass losses exceed gains. This small but critically important area of the ice sheet has expanded in size by ~50% since the early 1960s, and satellite remote sensing is a powerful tool for monitoring the physical processes that influence its surface mass balance. This review synthesizes key remote sensing methods and scientific findings from satellite remote sensing of the Greenland Ice Sheet ablation zone, covering progress in (1) radar altimetry, (2) laser (lidar) altimetry, (3) gravimetry, (4) multispectral optical imagery, and (5) microwave and thermal imagery. Physical characteristics and quantities examined include surface elevation change, gravimetric mass balance, reflectance, albedo, and mapping of surface melt extent and glaciological facies and zones. The review concludes that future progress will benefit most from methods that combine multi-sensor, multi-wavelength, and cross-platform datasets designed to discriminate the widely varying surface processes in the ablation zone. Specific examples include fusing laser altimetry, radar altimetry, and optical stereophotogrammetry to enhance spatial measurement density, cross-validate surface elevation change, and diagnose radar elevation bias; employing dual-frequency radar, microwave scatterometry, or combining radar and laser altimetry to map seasonal snow depth; fusing optical imagery, radar imagery, and microwave scatterometry to discriminate between snow, liquid water, refrozen meltwater, and bare ice near the equilibrium line altitude; combining optical reflectance with laser altimetry to map supraglacial lake, stream, and crevasse bathymetry; and monitoring the inland migration of snowlines, surface melt extent, and supraglacial hydrologic features.
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- 2019
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103. Radiostratigraphy Reflects the Present-Day, Internal Ice Flow Field in the Ablation Zone of Western Greenland
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Caitlyn Florentine, Joel Harper, Jesse Johnson, and Toby Meierbachtol
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ice sheet dynamics ,radiostratigraphy ,ice deformation ,ablation zone ,Greenland ice sheet ,Science - Abstract
Englacial radar reflectors in the ablation zone of the Greenland Ice Sheet are derived from layering deposited in the accumulation zone over past millennia. The original layer structure is distorted by ice flow toward the margin. In a simplified case, shear and normal strain incurred between the ice divide and terminus should align depositional layers such that they closely approximate particle paths through the ablation zone where horizontal motion dominates. It is unclear, however, if this relationship holds in western Greenland where complex bed topography, three dimensional ice flow, and historical changes to ice sheet mass and geometry since layer deposition may promote a misalignment between present-day layer orientation and the modern ice flow field. We investigate this problem using a suite of analyses that leverage ice sheet models and observational datasets. Our findings suggest that across a study sector of western Greenland, the radiostratigraphy of the ablation zone is closely aligned with englacial particle paths, and is not far departed from a state of balance. The englacial radiostratigraphy thus provides insight into the modern, local, internal flow field, and may serve to further constrain ice sheet models that simulate ice dynamics in this region.
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- 2018
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104. MRI-Guided RF Ablation in the Kidney
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Nour, Sherif G., Lewin, Jonathan S., Kahn, Thomas, editor, and Busse, Harald, editor
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- 2012
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105. MRI-Guided Therapeutic Procedures in Recurrent Prostate Cancer
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Woodrum, David A., Kawashima, Akira, Gorny, Krzysztof R., Mynderse, Lance A., Kahn, Thomas, editor, and Busse, Harald, editor
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- 2012
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106. MRI-Guided RF Ablation in the Liver
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Rempp, Hansjörg, Hoffmann, Rüdiger, Clasen, Stephan, Pereira, Philippe L., Kahn, Thomas, editor, and Busse, Harald, editor
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- 2012
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107. Energy Ablative Techniques in Renal Cell Carcinoma
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Shaw, Colette M., Matin, Surena F., Ahrar, Kamran, Lara, Jr., Primo N., editor, and Jonasch, Eric, editor
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- 2012
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108. Principles of Radiofrequency Ablation
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Ahmed, Muneeb, Goldberg, Shraga Nahum, Mueller, Peter, editor, and Adam, Andreas, editor
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- 2012
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109. Radiofrequency Ablation, Cryotherapy, and Microwave Ablation for Renal Tumors
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Hinshaw, J. Louis, Lubner, Meghan G., Mueller, Peter, editor, and Adam, Andreas, editor
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- 2012
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110. The Role of Diagnostic Imaging in the Planning and Evaluation of Ablation Techniques
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Thabet, Ashraf, Gervais, Debra A., Mueller, Peter, editor, and Adam, Andreas, editor
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- 2012
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111. Principles of Cryoablation
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Kujala, Nicholas, Beland, Michael D., Mueller, Peter, editor, and Adam, Andreas, editor
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- 2012
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112. Hands-on Station: Radiofrequency Ablation
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Fuchshuber, Pascal R., Feldman, Liane, editor, Fuchshuber, Pascal, editor, and Jones, Daniel B., editor
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- 2012
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113. Principles and Safety of Radiofrequency and Cryo Ablation
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Fuchshuber, Pascal R., Feldman, Liane, editor, Fuchshuber, Pascal, editor, and Jones, Daniel B., editor
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- 2012
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114. Principles and Safety of Microwave Ablation
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Swan, Ryan Z., Iannitti, David A., Feldman, Liane, editor, Fuchshuber, Pascal, editor, and Jones, Daniel B., editor
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- 2012
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115. Effect of the Primo Vascular System on Liver Tissue Recovery After Irreversible Electroporation: A Preliminary Study
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Kim, Hong-Bae, Sung, Chang-Kyu, Ahn, Saeyoung, Soh, Kwang-Sup, editor, Kang, Kyung A., editor, and Harrison, David K, editor
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- 2012
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116. Effects of tangential supersonic airflow on the laser ablation of laminated CFRP
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Wu Yuan, Ruixing Wang, Hongwei Song, Weina Zhao, Lingling Lu, Te Ma, Chenguang Huang, and Zhe Wang
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Supersonic wind tunnel ,Mining engineering. Metallurgy ,Laser ablation ,Materials science ,medicine.medical_treatment ,Airflow ,TN1-997 ,Metals and Alloys ,Laser ,Ablation ,Surfaces, Coatings and Films ,law.invention ,Biomaterials ,law ,Mechanical erosion ,Ceramics and Composites ,medicine ,Continuous wave ,Supersonic speed ,Laminated CFRP ,Composite material ,Ablation zone - Abstract
Ablation behaviors of laminated carbon fiber reinforced plastics (CFRP) subjected to intense continuous wave laser in the supersonic wind tunnel are investigated experimentally. Comparable laser ablation tests in other environments, i.e., static air, static nitrogen and open airflow, are also carried out. Laser ablation rate in the supersonic wind tunnel is significantly larger than those of the other environments, in particular, at least twice of that in an open tangential airflow condition. The ablation morphology can be classified into two regions, coupled ablation zone (CAZ) and downstream affected zone (DAZ). Coupled thermal-fluid-solid analysis including thermochemical ablation and thermomechanical erosion models reveals that the contribution of each laser mechanisms is distinctive at the different positions of the laser ablation pit.
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- 2021
117. Repeat Percutaneous Radiofrequency Ablation of T1 Renal Cell Carcinomas is Safe in Patients with Von Hippel–Lindau Disease
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Andreas H. Mahnken, Alexander König, Joel Wessendorf, and Hendrik Heers
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Adult ,Male ,medicine.medical_specialty ,von Hippel-Lindau Disease ,Percutaneous ,Radiofrequency ablation ,Short Communication ,medicine.medical_treatment ,Renal function ,Renal tumor ,urologic and male genital diseases ,law.invention ,Renal cell carcinoma ,law ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Von Hippel–Lindau disease ,Carcinoma, Renal Cell ,Dialysis ,Retrospective Studies ,Radiofrequency Ablation ,business.industry ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Nephrectomy ,Surgery ,Catheter Ablation ,Renal mass ,Female ,Neoplasm Recurrence, Local ,Cardiology and Cardiovascular Medicine ,business ,Ablation zone - Abstract
Purpose Patients with Von Hippel-Lindau disease often develop multifocal, metachronous renal cell carcinomas which require therapy. The purpose of this retrospective single-center study is to evaluate the outcomes of radiofrequency ablation (RFA) in the treatment of renal cell carcinomas in patients with Von Hippel-Lindau disease. Materials and Methods 9 patients (4 male, 5 female, 47.9 ± 10.7 y/o) with Von Hippel-Lindau disease underwent 18 CT-guided percutaneous RFA procedures for the treatment 21 renal cell carcinomas (largest diameter: 32.9 ± 8.6 mm, cT1a: 16, cT1b: 5). Seven patients were previously treated either by partial or radical nephrectomy. Technical success, effectiveness, safety, progression-free survival, overall survival and tumor characteristics were analyzed. Results All RFA procedures were technically successful without major complications. There were 5 minor complications. No residual or recurrent tumor was seen in the ablation zone during a follow-up of 34.0 ± 18.1 months (0–58 months). No patient required dialysis during follow-up. One patient died after 63 months after the first treatment due to complications from a cerebellar hemangioblastoma. No endpoint was reached for overall or progression-free survival. Conclusions The results from this limited case series suggest that RFA of RCCs in patients with VHL is a safe and effective therapy, which can preserve sufficient renal function even after renal surgery.
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- 2021
118. Priming of Sorafenib Prior to Radiofrequency Ablation Does Not Increase Treatment Effect in Hepatocellular Carcinoma
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Thomas A. Abrams, Muneeb Ahmed, S. Nahum Goldberg, Andrea J. Bullock, Salomao Faintuch, Rebecca A. Miksad, Bruno Bockorny, and David C. Alsop
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Sorafenib ,medicine.medical_specialty ,Physiology ,business.industry ,Radiofrequency ablation ,Gastroenterology ,Urology ,Hepatology ,medicine.disease ,Placebo ,digestive system diseases ,law.invention ,surgical procedures, operative ,law ,Hepatocellular carcinoma ,Internal medicine ,medicine ,Adverse effect ,business ,therapeutics ,Perfusion ,medicine.drug ,Ablation zone - Abstract
Preclinical studies have shown that modulation of the tumor microvasculature with anti-angiogenic agents decreases tumor perfusion and may increase the efficacy of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC). Retrospective studies suggest that sorafenib given prior to RFA promotes an increase in the ablation zone, but prospective randomized data are lacking. We conducted a randomized, double-blind, placebo-controlled phase II trial to evaluate the efficacy of a short-course of sorafenib prior to RFA for HCC tumors sized 3.5–7 cm (NCT00813293). Treatment consisted of sorafenib 400 mg twice daily for 10 days or matching placebo, followed by RFA on day 10. The primary objectives were to assess if priming with sorafenib increased the volume and diameter of the RFA coagulation zone and to evaluate its impact on RFA thermal parameters. Secondary objectives included feasibility, safety and to explore the relationship between tumor blood flow on MRI and RFA effectiveness. Twenty patients were randomized 1:1. Priming with sorafenib did not increase the size of ablation zone achieved with RFA and did not promote significant changes in thermal parameters, although it significantly decreased blood perfusion to the tumor by 27.9% (p = 0.01) as analyzed by DCE-MRI. No subject discontinued treatment owing to adverse events and no grade 4 toxicity was observed. Priming of sorafenib did not enhance the effect of RFA in intermediate sized HCC. Future studies should investigate whether longer duration of treatment or a different antiangiogenic strategy in the post-procedure setting would be more effective in impairing tumor perfusion and increasing RFA efficacy.
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- 2021
119. Transcostal Histotripsy Ablation in an In Vivo Acute Hepatic Porcine Model
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Timothy J. Ziemlewicz, Allison C. Rodgers, Emily A. Knott, Annie M. Zlevor, Timothy L. Hall, Eli Vlaisavljevich, John F. Swietlik, Xaiofei Zhang, Fred T. Lee, Zhen Xu, Katherine C. Longo, and Paul F. Laeseke
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medicine.medical_specialty ,Lung ,Ablation Techniques ,business.industry ,medicine.medical_treatment ,Ultrasound ,Ablation ,Histotripsy ,medicine.anatomical_structure ,Edema ,medicine ,Radiology, Nuclear Medicine and imaging ,Histopathology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business ,Ablation zone - Abstract
To determine whether histotripsy can create human-scale transcostal ablations in porcine liver without causing severe thermal wall injuries along the beam path. Histotripsy was applied to the liver using a preclinical prototype robotic system through a transcostal window in six female swine. A 3.0 cm spherical ablation zone was prescribed. Duration of treatment (75 min) was longer than a prior subcostal treatment study (24 min, 15 s) to minimize beam path heating. Animals then underwent contrast-enhanced MRI, necropsy, and histopathology. Images and tissue were analyzed for ablation zone size, shape, completeness of necrosis, and off-target effects. Ablation zones demonstrated complete necrosis with no viable tissue remaining in 6/6 animals by histopathology. Ablation zone volume was close to prescribed (13.8 ± 1.8 cm3 vs. prescribed 14.1 cm3). Edema was noted in the body wall overlying the ablation on T2 MRI in 5/5 (one animal did not receive MRI), though there was no gross or histologic evidence of injury to the chest wall at necropsy. At gross inspection, lung discoloration in the right lower lobe was present in 5/6 animals (mean size: 1 × 2 × 4 cm) with alveolar hemorrhage, preservation of blood vessels and bronchioles, and minor injuries to pneumocytes noted at histology. Transcostal hepatic histotripsy ablation appears feasible, effective, and no severe injuries were identified in an acute porcine model when prolonged cooling time is added to minimize body wall heating.
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- 2021
120. Efficacy and Safety of Thermal Ablation for Treatment of Solitary T1N0M0 Papillary Thyroid Carcinoma: A Multicenter Retrospective Study
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Hong-Ling Wang, Geng Liu, Xiao-Jing Cao, Zhi-Bin Cong, Mei Jian, Li-Li Peng, Ying Che, Ying Hao, Juan Liu, Ying Wei, Ya-Lin Zhu, Shu-Rong Wang, Guo-Zhen Yan, Jian-Qin Guo, Jun-Feng He, Lu Qi, Zhen-Long Zhao, Aini Shataer, Yan Li, Zhong-Hua Wang, Xiao-Fang Liu, Li-Li Shi, Xue Wang, Ming-An Yu, and Ying Zhou
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Adult ,Male ,China ,medicine.medical_specialty ,Adolescent ,Radiofrequency ablation ,medicine.medical_treatment ,Thermal ablation ,Urology ,Malignancy ,030218 nuclear medicine & medical imaging ,law.invention ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,law ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Microwaves ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,Radiofrequency Ablation ,business.industry ,Microwave ablation ,Retrospective cohort study ,Middle Aged ,Ablation ,medicine.disease ,Thyroid Cancer, Papillary ,030220 oncology & carcinogenesis ,Disease Progression ,Female ,business ,Ablation zone - Abstract
Background Microwave ablation (MWA) and radiofrequency ablation (RFA) have recently attracted interest as minimally invasive treatment modalities for papillary thyroid carcinoma (PTC). However, the ablation outcomes of T1N0M0 PTC are not well characterized. Purpose To evaluate the efficacy and safety of thermal ablation (MWA or RFA) of solitary T1N0M0 PTC in patients who were ineligible for (due to presence of comorbid cardiovascular disease, renal failure, other malignancy, etc) or who refused surgery. Materials and Methods This was a retrospective multicenter study of 847 patients (660 women) who underwent thermal ablation for PTC (673 T1a, 174 T1b) between March 2015 and March 2020; of these patients, 645 underwent MWA and 202 underwent RFA. The mean age of patients was 46 years ± 11 (standard deviation) (age range, 18-81 years); the mean follow-up time was 22 months ± 13 (range, 6-60 months). Changes in tumor size and volume and the rates of technical success, tumor disappearance, disease progression, and complications were assessed. Results The technical success rate was 100%. Relative to preablation measurements, the maximum diameter and volume of the ablation zone increased during the 1st month after ablation (P < .001), whereas there was no difference by the 3rd month; subsequently, the tumors showed reduction in size at 6, 9, and 12 months (all P < .001). Complete disappearance of tumors occurred in 68% of patients (577 of 847; 69% [466 of 673] in the T1a group vs 64% [111 of 174] in the T1b group; P < .001). The postablation disease progression rate was 1.1% (nine of 847 patients; 0.9% [six of 673 patients] in the T1a group vs 1.7% [three of 174 patients] in the T1b group; P = .54). The overall complication rate was 3.4% (29 of 847 patients; 2.7% [18 of 673 patients] in the T1a group vs 6.3% [11 of 174 patients] in the T1b group; P = .02). Conclusion This multicenter study provided evidence that thermal ablation is an effective and safe treatment option in selected -patients with solitary T1N0M0 papillary thyroid carcinoma. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Baek and Cho in this issue.
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- 2021
121. Numerical Design of RF Ablation Applicator for Hepatic Cancer Treatment.
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Rakhmadi, Aditya and Basari
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CATHETER ablation , *CANCER treatment , *CANCER cells , *LIVER cells , *COMPUTER simulation - Abstract
Currently, cancer has become one of health problems that is difficult to be overcomed. This disease is not only difficult to be cured, but also to be detected and may cause death. For this reason, RF ablation treatment method is proposed to cure cancer. RF ablation therapy is a method in which an applicator is inserted into the body to kill cancer cells by heating the cells. The cancer cells are exposed to the temperature more than 60°C in short duration (few second to few minutes) so thus cell destruction occurs locally. For the sake of the successful treatment, a minimally invasive method is selected in order for perfect local temperature distribution in cancer cells can be achieved. In this paper, a coax-fed dipole-type applicator with interstitial irradiation technique is proposed aimed at RF ablation into hepatic cells. Numerical simulation is performed to obtain a suitable geometric dimension at operating frequency around 2.45 GHz, in order to localize the ablation area. The proposed applicator is inserted into a simple phantom representing an adult human body model in which normal and cancerous liver cells. The simulated results show that the proposed applicator is able to operate at center frequency of 2.355 GHz with blood droplet-type ablation zone and the temperature around the cancer cell by 60°C can be achieved. [ABSTRACT FROM AUTHOR]
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- 2017
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122. The Role of Radiofrequency Ablation in the Treatment of Stage 1 Non-Small Cell Lung Cancer
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Varlotto, John M., Shelkey, Julia A., Mahraj, Rickhesvar P., and Jeremic, Branislav, editor
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- 2011
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123. Prediction of ablation zone disappearance after microwave ablation for the patients with papillary thyroid microcarcinoma using nomograph.
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Hu C, Liang S, Liu H, Yang J, Kang H, Guan S, Yan R, and Xu E
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- Humans, Microwaves therapeutic use, Retrospective Studies, Thyroid Neoplasms surgery, Carcinoma, Papillary surgery
- Abstract
Objectives: To construct a prognostic nomogram to predict the ablation zone disappearance for patients with papillary thyroid microcarcinoma (PTMC) after microwave ablation (MWA)., Materials and Methods: From April 2020 to April 2022, patients with PTMC who underwent MWA treatment were collected retrospectively. Ultrasound (US) or contrast-enhanced ultrasound (CEUS) was performed at 1 day, 1, 3, 6, 12, 18 and 24 months after MWA to observe the curative effect after ablation. The volume, volume reduction rate (VRR) and complete disappearance rate of the ablation zone at each time point were calculated. Univariate and multivariate logistic regression analysis were used to determine the prognostic factors associated with the disappearance of the ablation zone after MWA, and the nomogram was established and validated., Results: 72 patients with PTMCs underwent MWA were enrolled into this study. After MWA, no tumor progression (residual, recurrence or lymph node metastasis) and major postoperative complications occurred. The ablation zone in 28 (38.89%) patients did not completely disappear after MWA in the follow-up period. Three variables, including age (odds ratio [OR]: 1.216), calcification type (OR: 12.283), initial maximum diameter (OR: 2.051) were found to be independent prognostic factors predicting ablation zone status after MWA by multivariate analysis. The above variables and outcomes were visualized by nomogram (C-index=0.847)., Conclusions: MWA was a safe and effective treatment for PTMC. Older patients with macrocalcification and larger size PTMCs were more unlikely to obtain complete disappearance of ablation zones. Incomplete disappearance of ablation zone was not related to recurrence., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hu, Liang, Liu, Yang, Kang, Guan, Yan and Xu.)
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- 2023
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124. Laparoscopic Ablation of Liver Tumors
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Iannitti, David A., Sindram, David, Greene, Frederick L., editor, and Heniford, B. Todd, editor
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- 2010
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125. Destructive Therapies for Colorectal Cancer Metastases
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Blazer, Dan G., III, Anaya, Daniel A., Abdalla, Eddie K., Vauthey, Jean-Nicolas, editor, Hoff, Paulo M., editor, Audisio, Riccardo A., editor, and Poston, Graeme J., editor
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- 2009
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126. Brachytherapy of Liver Metastases
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Denecke, Timm, Lopez Hänninen, Enrique, Riess, Hanno, Goerke, Andrea, and Oettle, Helmut
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- 2008
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127. Breast
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Pfleiderer, Stefan O. R., Kaiser, Werner A., Baert, A. L., editor, Knauth, M., editor, Sartor, K., editor, Vogl, Thomas J., editor, Helmberger, Thomas K., editor, Mack, Martin G., editor, and Reiser, Maximilian F., editor
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- 2008
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128. Radiofrequency Ablation (RFA)
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Jakobs, Tobias F., Hoffmann, Ralf-Thorsten, Reiser, Maximilian F., Helmberger, Thomas K., Baert, A. L., editor, Knauth, M., editor, Sartor, K., editor, Vogl, Thomas J., editor, Helmberger, Thomas K., editor, Mack, Martin G., editor, and Reiser, Maximilian F., editor
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- 2008
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129. Microwave ablation of lung tumors: A probabilistic approach for simulation‐based treatment planning
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Pinyo Taeprasartsit, Punit Prakash, Henky Wibowo, Warren L. Beard, Jan Sebek, and Radoslav Bortel
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Ablation Techniques ,Radiofrequency Ablation ,Lung Neoplasms ,Computer science ,medicine.medical_treatment ,Microwave ablation ,Probabilistic logic ,General Medicine ,Ablation ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Margin (machine learning) ,030220 oncology & carcinogenesis ,Histogram ,Catheter Ablation ,medicine ,Humans ,Computer Simulation ,Microwaves ,Radiation treatment planning ,Simulation based ,Ablation zone ,Biomedical engineering - Abstract
Purpose Microwave ablation (MWA) is a clinically established modality for treatment of lung tumors. A challenge with existing application of MWA, however, is local tumor progression, potentially due to failure to establish an adequate treatment margin. This study presents a robust simulation-based treatment planning methodology to assist operators in comparatively assessing thermal profiles and likelihood of achieving a specified minimum margin as a function of candidate applied energy parameters. Methods We employed a biophysical simulation-based probabilistic treatment planning methodology to evaluate the likelihood of achieving a specified minimum margin for candidate treatment parameters (i.e., applied power and ablation duration for a given applicator position within a tumor). A set of simulations with varying tissue properties was evaluated for each considered combination of power and ablation duration, and for four different scenarios of contrast in tissue biophysical properties between tumor and normal lung. A treatment planning graph was then assembled, where distributions of achieved minimum ablation zone margins and collateral damage volumes can be assessed for candidate applied power and treatment duration combinations. For each chosen power and time combination, the operator can also visualize the histogram of ablation zone boundaries overlaid on the tumor and target volumes. We assembled treatment planning graphs for generic 1, 2, and 2.5 cm diameter spherically shaped tumors and also illustrated the impact of tissue heterogeneity on delivered treatment plans and resulting ablation histograms. Finally, we illustrated the treatment planning methodology on two example patient-specific cases of tumors with irregular shapes. Results The assembled treatment planning graphs indicate that 30 W, 6 min ablations achieve a 5-mm minimum margin across all simulated cases for 1-cm diameter spherical tumors, and 70 W, 10 min ablations achieve a 3-mm minimum margin across 90% of simulations for a 2.5-cm diameter spherical tumor. Different scenarios of tissue heterogeneity between tumor and lung tissue revealed 2 min overall difference in ablation duration, in order to reliably achieve a 4-mm minimum margin or larger each time for 2-cm diameter spherical tumor. Conclusions An approach for simulation-based treatment planning for microwave ablation of lung tumors is illustrated to account for the impact of specific geometry of the treatment site, tissue property uncertainty, and heterogeneity between the tumor and normal lung.
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- 2021
130. Radiomics complements clinical, radiological, and technical features to assess local control of colorectal cancer lung metastases treated with radiofrequency ablation
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Amandine Crombé, Romane Markich, Xavier Buy, Maxime Cazayus, Marianne Fonck, Jean Palussière, Dominique Béchade, and Vittorio Catena
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medicine.medical_specialty ,Lung Neoplasms ,Radiofrequency ablation ,Colorectal cancer ,030218 nuclear medicine & medical imaging ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Retrospective Studies ,Neuroradiology ,Radiofrequency Ablation ,Univariate analysis ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,Retrospective cohort study ,Interventional radiology ,General Medicine ,Middle Aged ,medicine.disease ,Confidence interval ,Treatment Outcome ,surgical procedures, operative ,030220 oncology & carcinogenesis ,Catheter Ablation ,Quality of Life ,Radiology ,Colorectal Neoplasms ,business ,Ablation zone - Abstract
Radiofrequency ablation (RFA) of lung metastases of colorectal origin can improve patient survival and quality of life. Our aim was to identify pre- and per-RFA features predicting local control of lung metastases following RFA. This case-control single-center retrospective study included 119 lung metastases treated with RFA in 48 patients (median age: 60 years). Clinical, technical, and radiological data before and on early CT scan (at 48 h) were retrieved. After CT scan preprocessing, 64 radiomics features were extracted from pre-RFA and early control CT scans. Log-rank tests were used to detect categorical variables correlating with post-RFA local tumor progression-free survival (LTPFS). Radiomics prognostic scores (RPS) were developed on reproducible radiomics features using Monte-Carlo cross-validated LASSO Cox regressions. Twenty-six of 119 (21.8%) nodules demonstrated local progression (median delay: 11.2 months). In univariate analysis, four non-radiomics variables correlated with post-RFA-LTPFS: nodule size (> 15 mm, p < 0.001), chosen electrode (with difference between covered array and nodule diameter < 20 mm or non-expandable electrode, p = 0.03), per-RFA intra-alveolar hemorrhage (IAH, p = 0.002), and nodule location into the ablation zone (not seen or in contact with borders, p = 0.005). The highest prognostic performance was reached with the multivariate model including a RPS built on 4 radiomics features from pre-RFA and early revaluation CT scans (cross-validated concordance index= 0.74) in which this RPS remained an independent predictor (cross-validated HR = 3.49, 95% confidence interval = [1.76 – 6.96]). Technical, radiological, and radiomics features of the lung metastases before RFA and of the ablation zone at 48 h can help discriminate nodules at risk of local progression that could benefit from complementary local procedure. • The highest prognostic performance to predict post-RFA LTPFS was reached with a parsimonious model including a radiomics score built with 4 radiomics features. • Nodule size, difference between electrode diameter, use of non-expandable electrode, per-RFA hemorrhage, and a tumor not seen or in contact with the ablation zone borders at 48-h CT were correlated with post-RFA LTPFS.
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- 2021
131. Effectiveness and Safety of Thermal Ablation in the Treatment of Primary Hyperparathyroidism: A Multicenter Study
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Ying Wei, Shu-Rong Wang, Jun-Feng He, Zhen-Long Zhao, Ming-An Yu, Li-Li Peng, Xiao-Jing Cao, Cheng-Zhong Peng, and Yan Li
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Radiofrequency ablation ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Clinical Biochemistry ,Context (language use) ,Biochemistry ,030218 nuclear medicine & medical imaging ,law.invention ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,law ,Interquartile range ,Internal medicine ,medicine ,Humans ,primary hyperparathyroidism ,Microwaves ,Clinical Research Articles ,Aged ,Retrospective Studies ,Aged, 80 and over ,Radiofrequency Ablation ,intact parathyroid hormone ,business.industry ,Biochemistry (medical) ,Ultrasound ,Microwave ablation ,Middle Aged ,Hyperparathyroidism, Primary ,medicine.disease ,Ablation ,Surgery ,microwave ablation ,030220 oncology & carcinogenesis ,Catheter Ablation ,Female ,business ,AcademicSubjects/MED00250 ,Primary hyperparathyroidism ,Ablation zone - Abstract
Context Ultrasound (US)-guided thermal ablation has generated recent interest as minimally invasive treatments of primary hyperparathyroidism (pHPT). But definitive evidence for the efficacy of thermal ablation in treating pHPT is not well characterized. Objective This work aims to evaluate the effectiveness and safety of thermal ablation for pHPT. Methods From January 2015 to March 2020, data pertaining to patients who received thermal ablation for pHPT at 4 centers were retrospectively analyzed. The median follow-up duration was 18.1 months (interquartile range, 6.5-42.2 months). A cure referred to the reestablishment of normal values of serum calcium and intact parathyroid hormone throughout the entire follow-up period, at least more than 6 months. The technical success, effectiveness, and safety of treatment were analyzed. Results A total of 119 patients (mean age, 57.2 ± 16.3 years; 81 female) with 134 parathyroid nodules were enrolled. The mean maximum diameter of the parathyroid glands was 1.6 ± 0.9 cm. Ninety-six patients underwent microwave ablation (MWA), and 23 patients underwent radiofrequency ablation (RFA). The technical success rate was 98.3% and the cure rate was 89.9%. Significant differences were found in the maximum diameter between the cured patients and the patients who did not undergo ablation of the target lesions. Except for cases with pHPT nodules less than 0.6 cm in diameter, the cure rate was 95%. There were no difference in cure rates at 6 months between the MWA and RFA groups (MWA vs RFA, 90.6% vs 87.0%; χ 2 = 0.275, P = .699). The volume reduction rate of the ablation zone was 94.6% at 12 months. The complication rate was 6.7% (8/119). With the exception of one patient with persistent voice impairment, other symptoms spontaneously resolved within 6 months. Conclusion Thermal ablation is effective and safe for pHPT.
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- 2021
132. Three-year outcomes of mixed astigmatism correction with single-step transepithelial photorefractive keratectomy with a large ablation zone
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Magdalena Kaszuba-Modrzejewska, Bartłomiej J. Kałużny, Samuel Arba-Mosquera, Shwetabh Verma, Jagoda Rzeszewska-Zamiara, Joanna Stachura, and Ilona Piotrowiak-Słupska
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medicine.medical_specialty ,Distance visual acuity ,genetic structures ,medicine.medical_treatment ,Single step ,Astigmatism ,Refraction, Ocular ,Photorefractive Keratectomy ,Cornea ,03 medical and health sciences ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,Dioptre ,Retrospective Studies ,business.industry ,Mixed astigmatism ,medicine.disease ,eye diseases ,Sensory Systems ,Photorefractive keratectomy ,Intensity (physics) ,Treatment Outcome ,030221 ophthalmology & optometry ,Lasers, Excimer ,Surgery ,business ,030217 neurology & neurosurgery ,Follow-Up Studies ,Ablation zone - Abstract
PURPOSE To evaluate refractive and visual outcomes of single-step transepithelial photorefractive keratectomy (transPRK) in the treatment of mixed astigmatism with the use of an aberration-neutral profile and large ablation zone. SETTING Nicolaus Copernicus University and Oftalmika Eye Hospital, Bydgoszcz, Poland. DESIGN Retrospective, observational case series. METHODS This study included patients who underwent transPRK to correct mixed astigmatism and completed the 3-year follow-up. Procedures were performed with an Amaris 750S excimer laser using an aberration-neutral profile and optical zone of 7.2 mm or more. RESULTS A total 48 eyes of 39 patients were included. Preoperatively, mean spherical manifest refraction was +1.37 ± 0.98 diopter (D) (0.25 to 4.00 D), and astigmatism was -4.00 ± 0.76 D (-2.25 to -6.00 D). Three years postsurgery, it was -0.17 ± 0.26 D and -0.41 ± 0.44 D, respectively. Attempted spherical equivalent correction within ±0.50 D was achieved in 45 eyes (94%) and cylindrical correction in 34 (71%). Preoperative corrected distance visual acuity (CDVA) was 20/20 or better in 38 eyes (79%), and postoperative uncorrected was 20/20 or better in 29 eyes (60.0%). No eye had lost 2 or more Snellen lines of CDVA, whereas 3 eyes (6%) gained 2 or more lines. In 4 eyes (8%), haze of low intensity was observed at the periphery, with scores between 0.5 and 1.0, and only 1 eye getting a score of 2 in 0- to 4-degree scale. CONCLUSIONS Mixed astigmatism correction with large-ablation-zone transPRK provided good results for efficacy, safety, predictability, and visual outcomes in a 3-year follow-up.
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- 2021
133. A review on radiofrequency, microwave and high-intensity focused ultrasound ablations for hepatocellular carcinoma with cirrhosis
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Ka Wing Ma, Tan To Cheung, and Wong Hoi She
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medicine.medical_specialty ,Radiofrequency ablation ,business.industry ,medicine.medical_treatment ,Microwave ablation ,Liver transplantation ,medicine.disease ,Ablation ,High-intensity focused ultrasound ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,medicine ,030211 gastroenterology & hepatology ,Radiology ,Liver cancer ,business ,Ablation zone - Abstract
Importance Hepatocellular carcinoma (HCC) is usually accompanied by liver cirrhosis, which makes treatment of this disease challenging. Liver transplantation theoretically provides an ultimate solution to the disease, but the maximal surgical stress and the scarcity of liver graft make this treatment option impossible for some patients. In an ideal situation, a treatment that is safe and effective should provide a better outcome for patients with the dilemma. Objective This article aims to give a comprehensive review of various types of loco-ablative treatment for HCC. Evidence review Loco-ablative treatment bridges the gap between surgical resection and transarterial chemotherapy. Various types of ablative therapy have their unique ability, and evidence-based outcome analysis is the most important key to assisting clinicians to choose the most suitable treatment modality for their patients. Findings Radiofrequency ablation (RFA) has a relatively longer history and more evidence to support its effectiveness. Microwave ablation (MWA) is gaining momentum because of its shorter ablation time and consistent ablation zone. High-intensity focused ultrasound (HIFU) ablation is a relatively new technology that provides non-invasive treatment for patients with HCC. It has been carried out at centers of excellence and it is a safe and effective treatment option for selected patients with HCC and liver cirrhosis. Conclusion and relevance Selective use of different loco-ablative therapies will enhance clinicians' treatment options for treatment of HCC.
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- 2021
134. A review of antenna designs for percutaneous microwave ablation
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Bing Zhang, Lifeng Zhang, Hangming Huang, Wenjun Zhang, and Michael A. J. Moser
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Ablation Techniques ,Parabolic antenna ,animal structures ,Materials science ,Biophysics ,General Physics and Astronomy ,Energy delivery ,macromolecular substances ,Tumor ablation ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,polycyclic compounds ,Electronic engineering ,Radiology, Nuclear Medicine and imaging ,Microwaves ,Microwave ablation ,Temperature ,Equipment Design ,General Medicine ,030220 oncology & carcinogenesis ,biological sciences ,sense organs ,Antenna (radio) ,Energy (signal processing) ,Microwave ,Ablation zone - Abstract
Microwave (MW) antenna is a key element in microwave ablation (MWA) treatments as the means that energy is delivered in a focused manner to the tumor and its surrounding area. The energy delivered results in a rise in temperature to a lethal level, resulting in cell death in the ablation zone. The delivery of energy and hence the success of MWA is closely dependent on the structure of the antennas. Therefore, three design criteria, such as expected ablation zone pattern, efficiency of energy delivery, and minimization of the diameter of the antennas have been the focus along the evolution of the MW antenna. To further improve the performance of MWA in the treatment of various tumors through inventing novel antennas, this article reviews the state-of-the-art and summarizes the development of MW antenna designs regarding the three design criteria.
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- 2021
135. Spectral Analysis of the Acoustic Signal During Ablation of Biological Tissue with Pulsed CO2- Lasers
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Steigerwald, Hendrik, Werner, Martin, Klasing, Manfred, Ivanenko, Mikhail, Harbecke, Daniela, Wagner, Christian, Hering, Peter, Buzug, Thorsten M., editor, Holz, Dietrich, editor, Bongartz, Jens, editor, Kohl-Bareis, Matthias, editor, Hartmann, Ulrich, editor, and Weber, Simone, editor
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- 2007
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136. Prediction of Thermal Tissue Damage Using Fluorescence Spectroscopy
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Anderson, Christopher D., Lin, Wei-Chiang, Chari, Ravi S., Geddes, Chris D., editor, and Lakowicz, Joseph R., editor
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- 2006
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137. Ultrasound Monitoring of Tissue Ablation Via Deformation Model and Shape Priors
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Boctor, Emad, deOliveira, Michelle, Choti, Michael, Ghanem, Roger, Taylor, Russell, Hager, Gregory, Fichtinger, Gabor, Hutchison, David, editor, Kanade, Takeo, editor, Kittler, Josef, editor, Kleinberg, Jon M., editor, Mattern, Friedemann, editor, Mitchell, John C., editor, Naor, Moni, editor, Nierstrasz, Oscar, editor, Pandu Rangan, C., editor, Steffen, Bernhard, editor, Sudan, Madhu, editor, Terzopoulos, Demetri, editor, Tygar, Dough, editor, Vardi, Moshe Y., editor, Weikum, Gerhard, editor, Larsen, Rasmus, editor, Nielsen, Mads, editor, and Sporring, Jon, editor
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- 2006
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138. Liver Metastases
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Lubienski, Andreas, Leibecke, Thorsten, Lubienski, Karin, Helmberger, Thomas, Schlag, P. M., editor, Senn, H. -J., editor, Kleihues, P., editor, Stiefel, F., editor, Groner, B., editor, Wallgren, A., editor, Rentchnik, P., editor, and Stroszczynski, Christian, editor
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- 2006
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139. The Surgical Approach for Radiofrequency Ablation of Liver Tumors
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Schumacher, Guido, Eisele, Robert, Spinelli, Antonino, Neuhaus, Peter, Schlag, P. M., editor, Senn, H. -J., editor, Kleihues, P., editor, Stiefel, F., editor, Groner, B., editor, Wallgren, A., editor, Rentchnik, P., editor, and Stroszczynski, Christian, editor
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- 2006
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140. Imaging Guidance, Monitoring, and Follow-Up
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Gillams, Alice R., Baert, A. L., editor, Sartor, K., editor, Lencioni, Riccardo, editor, Cioni, Dania, editor, and Bartolozzi, Carlo, editor
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- 2005
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141. Radiofrequency Ablation: Principles and Techniques
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Lencioni, Riccardo, Cioni, Dania, Lera, Jacopo, Rocchi, Erika, Della Pina, Clotilde, Crocetti, Laura, Baert, A. L., editor, Sartor, K., editor, Lencioni, Riccardo, editor, Cioni, Dania, editor, and Bartolozzi, Carlo, editor
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- 2005
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142. Optimal Voltage and Electrical Pulse Conditions for Electrical Ablation to Induce Immunogenic Cell Death (ICD)
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Wooram Park, Dong Keun Han, Chan Kim, Kyung-Soon Park, Dong-Hyun Kim, Eun Jin Go, Hong Jae Chon, WonHyoung Ryu, and Dasom Yang
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Materials science ,Pulse (signal processing) ,General Chemical Engineering ,medicine.medical_treatment ,02 engineering and technology ,010402 general chemistry ,021001 nanoscience & nanotechnology ,Ablation ,01 natural sciences ,0104 chemical sciences ,Cancer immunotherapy ,In vivo ,Cancer cell ,Cancer research ,medicine ,Immunogenic cell death ,Viability assay ,0210 nano-technology ,Ablation zone - Abstract
Electrical ablation (EA) is a non-thermal ablation technique that causes less damage to the tissue surrounding the targeted area than conventional thermal ablation. EA induces immunogenic cell death (ICD) and can potentially synergize with cancer immunotherapy. In this study, the optimal voltage and pulse conditions for the induction of ICD were identified. Finite element analysis was used to estimate the ablation zone under a variety of voltage and pulse conditions. Cancer cells were cultured in vitro under two- and three-dimensional conditions to assess cell viability under different voltage and pulse conditions. Additionally, the expression of damage-associated molecular pattern (DAMP) markers of ICD was measured to identify an optimal voltage condition. Tumor volume, body weight, and survival after EA treatment were measured in vivo to identify the optimal pulse conditions. The optimal conditions to induce ICD by EA identified in this study are suitable to be combined with cancer immunotherapy.
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- 2021
143. Recessional pattern of Thelu and Swetvarn glaciers between 1968 and 2019, Bhagirathi basin, Garhwal Himalaya, India
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Dhruv Sen Singh, Dhirendra Kumar, Ajay Kumar Taloor, and Anoop Kumar Singh
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010506 paleontology ,geography ,geography.geographical_feature_category ,Glacier ,Shuttle Radar Topography Mission ,Structural basin ,010502 geochemistry & geophysics ,01 natural sciences ,Precipitation ,Physical geography ,Glacial period ,Upward shift ,Snout ,Geology ,0105 earth and related environmental sciences ,Earth-Surface Processes ,Ablation zone - Abstract
This study assesses the temporal changes of Swetvarn and Thelu glaciers between 1968 and 2019 in Rakvarn glacial valley of Bhagirathi basin. Here we utilized high-resolution satellite images of CORONA KHA (1968), LISS IV (2012) and SENTINEL-2 MSI (2019), along with medium resolution images of LANDSAT TM (1990) and SRTM (2000) to carry out the research work. Analytical viewed strongly convinced that the selected glaciers receding continuously with non homogeneous retreat rate since 1968. During 1968 to 2019 the snout of the Swetvarn glacier lost ∼623m total length with 12.21ma−1 retreat rate, while the snout of Thelu glacier lost ∼590m total length (11.56ma−1). Results further confirmed that about 16.60% glaciated area of Swetvarn glacier and 24.50% glaciated area of Thelu glacier also vanished completely between 1968 and 2019. During this tenure the ablation zone shows 160m upward shift for Swetvarn glacier and 145m for Thelu glacier respectively. Overall analysis explains that three climatic trends of Garhwal Himalayan region; (1) catastrophic variation between rainfall and temperature during 1960–1990, (2) gradual increase in temperature and decrease in precipitation, (3) increased liquid precipitation and decreased solid precipitation highly influences the process of melting of the study region.
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- 2021
144. The cooling signature of basal crevasses in a hard-bedded region of the Greenland Ice Sheet
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Joel T. Harper, Toby Meierbachtol, Ian E. McDowell, and Neil F. Humphrey
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lcsh:GE1-350 ,010504 meteorology & atmospheric sciences ,Geothermal heating ,lcsh:QE1-996.5 ,Borehole ,Greenland ice sheet ,Heat sink ,010502 geochemistry & geophysics ,Thermal conduction ,01 natural sciences ,lcsh:Geology ,Latent heat ,Petrology ,Meltwater ,Geology ,lcsh:Environmental sciences ,0105 earth and related environmental sciences ,Earth-Surface Processes ,Water Science and Technology ,Ablation zone - Abstract
Temperature sensors installed in a grid of nine full-depth boreholes drilled in the southwestern ablation zone of the Greenland Ice Sheet recorded cooling in discrete sections of ice over time within the lowest third of the ice column in most boreholes. Rates of temperature change outpace cooling expected from vertical conduction alone. Additionally, observed temperature profiles deviate significantly from the site-average thermal profile that is shaped by all thermomechanical processes upstream. These deviations imply recent, localized changes to the basal thermal state in the boreholes. Although numerous heat sources exist to add energy and warm ice as it moves from the central divide towards the margin such as strain heat from internal deformation, latent heat from refreezing meltwater, and the conduction of geothermal heat across the ice–bedrock interface, identifying heat sinks proves more difficult. After eliminating possible mechanisms that could cause cooling, we find that the observed cooling is a manifestation of previous warming in near-basal ice. Thermal decay after latent heat is released from freezing water in basal crevasses is the most likely mechanism resulting in the transient evolution of temperature and the vertical thermal structure observed at our site. We argue basal crevasses are a viable englacial heat source in the basal ice of Greenland's ablation zone and may have a controlling influence on the temperature structure of the near-basal ice.
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- 2021
145. Locoregional options in the management of cholangiocarcinoma: single center experience
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Elizabeth David, Hussein Baydoun, Natalie G. Coburn, Harley Meirovich, and Gilbert Maroun
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medicine.medical_specialty ,Carcinoma, Hepatocellular ,Percutaneous ,Radiofrequency ablation ,medicine.medical_treatment ,Single Center ,030218 nuclear medicine & medical imaging ,law.invention ,Cholangiocarcinoma ,03 medical and health sciences ,0302 clinical medicine ,law ,medicine ,Humans ,Progression-free survival ,Chemoembolization, Therapeutic ,Retrospective Studies ,Advanced and Specialized Nursing ,business.industry ,Liver Neoplasms ,medicine.disease ,Ablation ,Combined Modality Therapy ,Bile Ducts, Intrahepatic ,Treatment Outcome ,Anesthesiology and Pain Medicine ,Bile Duct Neoplasms ,Response Evaluation Criteria in Solid Tumors ,030220 oncology & carcinogenesis ,Adenocarcinoma ,Radiology ,business ,Ablation zone - Abstract
Background The purpose of this case series is to assess the safety and efficacy, as well as the overall survival (OS) and progression free survival (PFS) of patients with intrahepatic cholangiocarcinoma (ICC) treated with percutaneous ablation, transarterial arterial chemoembolization (TACE) or a combination of both at our institution. Methods Ten patients with pathological diagnosis of adenocarcinoma treated at out institution between January 1st 2013 and January 1st 2019 were reviewed. Three patients received a combined TACE and ablation treatment, three patients received TACE without ablation and four patients were treated with ablation only. Ablation technical success was determined by absence of residual tumor in the ablation zone on follow-up imaging one-month post-ablation. TACE response was assessed using the Modified Response Evaluation Criteria in Solid Tumors (mRECIST). Technical success was defined as injection of chemoembolic material in the involved liver lobes. PFS and OS were calculated from the date of diagnosis. Results In the TACE and radiofrequency ablation (RFA) group, OS was 12, 55 and 56 months; PFS was 5, 6 and 32 months, one patient died and two others remain alive. In the TACE group, OS was 29, 10 and 5 months; PFS was 15, 10 and 4 months. All three patients remain alive. In the ablation group, OS and PFS were 16, 31, 30 and 40 months. All patients remain alive. Overall, 9 of 10 patients are alive, with a Median OS and PFS of 29.5 and 15.5 months, respectively, with some patients remain alive over four years following initial presentation. Conclusions Our study shows that ablation and TACE in combination with more traditional modalities such as chemoradiation and surgical resection can extend survival in patients with ICC significantly. Locoregional therapy is well tolerated with only minor adverse events. The use of stereotactic body radiation therapy (SBRT) with ablation demonstrated the synergistic nature of using multiple lines of interventions.
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- 2021
146. Effect of iodinated contrast material on post-operative eGFR when administered during renal mass ablation
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Kimberly A Maciolek, Shane A. Wells, Elaine M. Caoili, Gauri Bhutani, Matthew S. Davenport, Leo D. Dreyfuss, Nicole E. Curci, Glenn O. Allen, Benjamin L Triche, and E. Jason Abel
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medicine.medical_specialty ,Percutaneous ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Microwave ablation ,Urology ,Renal function ,Interventional radiology ,General Medicine ,medicine.disease ,Ablation ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Iodinated contrast ,Renal cell carcinoma ,030220 oncology & carcinogenesis ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Ablation zone - Abstract
To evaluate the effect of intravenous iodinated contrast on estimated glomerular filtration rate (eGFR) when administered immediately after thermal ablation of clinically localized T1a (cT1a) renal cell carcinoma (RCC). This HIPAA-compliant, dual-center retrospective study was performed under a waiver of informed consent. Three hundred forty-two consecutive patients with cT1a biopsy-proven RCC were treated with percutaneous ablation between January 2010 and December 2017. Immediate post-ablation contrast-enhanced CT was the routine standard of care at one institution (contrast group), but not the other (control group). One-month pre- and 6-month post-ablation eGFR were compared using the Wilcoxon signed-rank test or the Kruskal-Wallis test. Multivariate linear regression was used to determine the effect of contrast on eGFR. A 1:1 propensity score matching was performed for all patients with a logistic model using patient, tumor, and procedural covariates. In total, 246 patients (158 M; median age 69 years, IQR 62–74) were included. Median tumor diameter (2.4 vs 2.5, p = 0.23) and RENAL nephrometry scores (6 vs 6, p = 0.92), surrogates for ablation zone size, were similar. Baseline kidney function was similar for the control and contrast groups, respectively (median eGFR: 70 vs 74 mL/min/1.73 m2, p = 0.29). There was an expected mild decline in eGFR after ablation (control: 70 vs 60 mL/min/1.73 m2, p < 0.001; contrast: 75 vs 71 mL/min/1.73 m2, p = 0.001). Intravenous iodinated contrast was not associated with a decline in eGFR on multivariate linear regression (1.91, 95% CI - 3.43–7.24, p = 0.46) or 1:1 propensity score-matched model (- 0.33, 95% CI - 6.81–6.15, p = 0.92). Intravenous iodinated contrast administered during ablation of cT1a RCC has no effect on eGFR. • Intravenous iodinated contrast administered during thermal ablation of clinically localized T1a renal cell carcinoma has no effect on kidney function. • Thermal ablation of clinically localized T1a renal cell carcinoma results in a mild decline in kidney function. • A decline in kidney function is similar for radiofrequency and microwave ablation of clinically localized T1a renal cell carcinoma.
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- 2021
147. Risk factors for local tumor progression after RFA of pulmonary metastases: a matched case-control study
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Thierry de Baere, Arash Najafi, Alexandre Delpla, Edouard Purenne, Charles Roux, Frederic Deschamps, Jessica Assouline, Marc Al Ahmar, Khaled Madani, Lambros Tselikas, and Amine Bayar
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medicine.medical_specialty ,Bronchus ,Lung ,medicine.diagnostic_test ,business.industry ,Radiofrequency ablation ,medicine.medical_treatment ,Interventional radiology ,General Medicine ,Ablation ,medicine.disease ,030218 nuclear medicine & medical imaging ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Pneumothorax ,Tumor progression ,law ,030220 oncology & carcinogenesis ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Ablation zone - Abstract
Curative treatment of oligometastatic pulmonary disease aims at eradication of all metastases. Radiofrequency ablation (RFA) has been shown to be an efficient method and the frequency of local tumor progression (LTP) should be minimized. The objective of this study was to determine the morphological and treatment-related risk factors for LTP after RFA of pulmonary metastases. All patients treated with RFA for pulmonary metastases from 2002 to 2014 were reviewed. All LTPs from 2011 to 2014 were individually matched on the basis of tumor size, number, and histology. In total, 48 LTPs and 112 controls were blindly analyzed for morphological factors including vicinity of bronchus and vessels as well as treatment-related factors such as the size of the ablation zone and ablation margins. In the simple regression analysis, the significant predictive variables were ≤ 5-mm distance to a large bronchus (OR = 4.94; p = 0.0095) or large vessel (OR = 7.09; p 0.36 (OR = 13.83; p = 0.013). In the multiple regression model, only a minimal ablation margin ≤ 5 mm remained a significant risk factor for LTP. Only the minimal ablation margin remains significant in the multiple regression analysis; the other factors are presumably surrogates of an insufficient ablation margin. Improvement of lung RFA outcomes can probably be obtained by immediate post RFA evaluation of ablation margins to ensure a minimal ablation margin of at least 5 mm. • A distance 5 mm after pulmonary RFA is associated with significantly less local tumor progression and should be looked for at the end of treatment session before needle removal in order to decrease local tumor progression. • Tumor location, pleural contact, occurrence of intra-alveolar hemorrhage, pulmonary atelectasis, and pneumothorax are not associated with an increased risk of local tumor progression.
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- 2021
148. An in vivo study of a custom-made high-frequency irreversible electroporation generator on different tissues for clinically relevant ablation zones
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Lujia Ding, Michael A. J. Moser, Zheng Fang, Bing Zhang, Fanning Liu, and Wenjun Zhang
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Cancer Research ,Physiology ,medicine.medical_treatment ,ablation evaluation ,030218 nuclear medicine & medical imaging ,rabbit model ,03 medical and health sciences ,muscle contraction ,0302 clinical medicine ,In vivo ,Physiology (medical) ,medicine ,Medical technology ,R855-855.5 ,Generator (computer programming) ,Chemistry ,Liver and kidney ,Rabbit (nuclear engineering) ,Irreversible electroporation ,high-frequency irreversible electroporation ,Ablation ,030220 oncology & carcinogenesis ,temperature increase ,medicine.symptom ,Muscle contraction ,Ablation zone ,Biomedical engineering - Abstract
Purpose To examine the ablation zone, muscle contractions, and temperature increases in both rabbit liver and kidney models in vivo for a custom-made high-frequency irreversible electroporation (H-FIRE) generator. Materials and Methods A total of 18 New Zealand white rabbits were used to investigate five H-FIRE protocols (n = 3 for each protocol) and an IRE protocol (n = 3) for the performance of the designed H-FIRE device in both liver and kidney tissues. The ablation zone was determined by using histological analysis 72 h after treatment. The extent of muscle contractions and temperature change during the application of pulse energy were measured by a commercial accelerometer attached to animals and fiber optic temperature probe inserted into organs with IRE electrodes, respectively. Results All H-FIRE protocols were able to generate visible ablation zones without muscle contractions, for both liver and kidney tissues. The area of ablation zone generated in H-FIRE pulse protocols (e.g., 0.3–1 μs, 2000 V, and 90–195 bursts) appears similar to that of IRE protocol (100 μs, 1000 V, and 90 pulses) in both liver and kidney tissues. No significant temperature increase was noticed except for the protocol with the highest pulse energy (e.g., 1 μs, 2000 V, and 180 bursts). Conclusion Our work serves to complement the current H-FIRE pulse waveforms, which can be optimized to significantly improve the quality of ablation zone in terms of precision for liver and kidney tumors in clinical setting.
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- 2021
149. Water-cooled microwave ablation array for bloodless rapid transection of the liver
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Qiang Yang, Zhen-Yu Lei, Yu-Xin Du, Zi Ye, Wei Li, Zubing Chen, Liang Lang, Duidui Chen, Shiqiang Shen, and Si-Qi Zhang
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Cancer Research ,Materials science ,Swine ,Physiology ,medicine.medical_treatment ,microwave ablation device ,pig liver ablation ,Imaging phantom ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Blood loss ,Physiology (medical) ,Medical technology ,medicine ,Animals ,Hepatectomy ,R855-855.5 ,Microwaves ,Water cooled ,Microwave ablation ,Water ,Ablation ,Clamp ,Liver ,microwave ablation ,030220 oncology & carcinogenesis ,liver resection ,Catheter Ablation ,finite-element method (fem) ,tissue-mimicking phantom ,Pig liver ,Biomedical engineering ,Ablation zone - Abstract
Background Microwaves (MWs) deliver relatively high temperatures into biological tissue and cover a large ablation zone. This study aims to evaluate the efficacy and effectiveness of water-cooled double-needle MW ablation arrays in assisting the hepatic transection of an in vivo pig model. Methods Our research program comprised computer modeling, tissue-mimicking phantom experiments, and in vivo pig liver experiments. Computer modeling was based on the finite element method (FEM) to evaluate ablation temperature distributions. In tissue-mimicking phantom and in vivo pig liver ablation experiments, the performances of the water-cooled MW ablation array and conventional clamp crushing liver resection were compared. Results FEM showed that the maximum lateral ablation diameter at 100 W output and a duration of 60 s was 3 cm (assessed at 50 °C isotherm). In the phantom, the maximum transverse ablation diameter of the double-needle MW ablation increased rapidly to 3 cm in 60 s at 50 W. The blood loss and blood loss per transection area in Group A were significantly lower than those in Group B (18 (7–26) ml vs. 34 (19–57) ml, and 2.4 (2–3.1) ml/cm2 vs. 6.9 (3.2–8.3) ml/cm2, respectively) (p
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- 2021
150. Early experience with laparoscopic treatment of liver tumors using a separable cluster electrode with a no-touch technique
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Mi Yeon Lee, Hyun Pyo Hong, Byung Ho Son, Sung Ryol Lee, Byung Ik Kim, Jun Ho Shin, Kyung Uk Jung, and Jee Youn Lee
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medicine.medical_specialty ,Percutaneous ,Radiofrequency ablation ,Urology ,medicine.medical_treatment ,laparoscopic radiofrequency ablation ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,medicine ,Contraindication ,Original Paper ,cluster electrodes ,Bile duct ,business.industry ,Gallbladder ,Gastroenterology ,Obstetrics and Gynecology ,hepatocellular carcinoma ,medicine.disease ,Ablation ,·radiofrequency ablation ,surgical procedures, operative ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Medicine ,030211 gastroenterology & hepatology ,Surgery ,Radiology ,business ,therapeutics ,Ablation zone - Abstract
Introduction Radiofrequency ablation (RFA) is one of the best curative treatments for hepatocellular carcinoma in selected patients, and this procedure can be applied either percutaneously or laparoscopically. Laparoscopic RFA has the benefit of direct visual control of the RFA procedure. Cluster electrodes (Octopus RF electrodes) can create a common ablation zone. Aim Using these two methods (laparoscopic approach and no touch technique), this present study evaluated the technical and clinical outcomes of early experience with laparoscopic RFA and a no-touch technique. Material and methods Between November 2015 and November 2018, 21 patients underwent laparoscopic RFA for hepatocellular carcinoma with a no-touch technique using cluster electrodes. Laparoscopic RFA is recommended for patients with a contraindication for surgical resection, patients wants and a relative contraindication for conventional percutaneous RFA, such as lesions adjacent to the gastrointestinal tract, gallbladder, bile duct, or heart. Results In the 21 tumors, 2 were treated with a single electrode, 12 with 2 electrodes, and 7 tumors with 3 electrodes. The mean time of ablation per lesion was 20.43 ±8.77 min. There was no mortality, local tumor progression, delayed destructive biliary damage, or liver abscess at the follow-up computed tomography. No technical failures occurred. Conclusions Laparoscopic RFA can access lesions for which percutaneous RFA is contraindicated or risky. Cluster electrodes can create sufficient ablation zones without contact and can achieve a sufficient margin with a low complication rate and no tumor dissemination. Therefore, laparoscopic RFA with a no-touch technique might be a safe and feasible treatment for HCC tumor in selected patients.
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- 2021
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