{"title":"Safety and Feasibility of US-guided Microwave Ablation for the Treatment of Bethesda III Thyroid Nodules with Negative Eight-Gene Panel Mutational Profile.","authors":"Qingqing Tang, Jiawei Chen, Dengke Zhang, Qingnan Huang, Yong Chen, Xuexin Liang, Kai Zeng, Yuxian Guo, Mingliang Huang, Yanghui Wei","doi":"10.1148/rycan.240058","DOIUrl":"10.1148/rycan.240058","url":null,"abstract":"<p><p>Purpose To evaluate the safety and efficacy of US-guided thermal ablation in the treatment of Bethesda III thyroid nodules with negative eight-gene panel testing results. Materials and Methods This retrospective single-center study included patients with thyroid nodules diagnosed as Bethesda category III (atypia of undetermined significance) at fine-needle aspiration biopsy and with negative eight-gene testing results who were treated with US-guided microwave ablation (MWA) between July 2020 and September 2023. Incidence of complications, technical success rate (TSR), volume reduction rate (VRR), nodule recurrence, and thyroid function were evaluated over a follow-up period of 2 years. Data before and after MWA were compared using variance analysis and the Cochran-Mantel-Haenszel χ<sup>2</sup> test. Results A total of 101 Bethesda III nodules were detected in 95 patients (mean ± SD age, 47.08 years ±14.63; 79 female patients, 16 male patients), all of which were completely ablated (100% TSR). Two patients experienced mild neck swelling and pressure sensation after the minimally invasive operation, and the incidence of postoperative complications was 2% (two of 95). None of the patients experienced tumor recurrence or progression. At 2-year follow-up, the mean VRR of the ablated area was 90.88% ± 13.59 in 15 patients; 87% (13 of 15) of these patients had a 100% VRR. There was no evidence of a difference in thyroid function before and after MWA from 1 to 24 months (<i>P</i> = .15-.99). Conclusion US-guided MWA was safe and effective for the treatment of Bethesda III thyroid nodules with negative eight-gene panel testing results. <b>Keywords:</b> Ablation Techniques, Radiation Therapy/Oncology, Head/Neck, Thyroid, Safety, Observer Performance Published under a CC BY 4.0 license.</p>","PeriodicalId":20786,"journal":{"name":"Radiology. Imaging cancer","volume":"7 1","pages":"e240058"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer Holter-Chakrabarty, Lacey McNally, John Levine, James Ferrara, Sara K Vesely, Christopher G Kanakry, Tabitha Garwe, Zheng Han, Manu Pandey, Joshua Glover, Yuejin Wen, Ron Gress, Kirsten M Williams
Christian Roest, Thomas C Kwee, Igle J de Jong, Ivo G Schoots, Pim van Leeuwen, Stijn W T P J Heijmink, Henk G van der Poel, Stefan J Fransen, Anindo Saha, Henkjan Huisman, Derya Yakar
Aritrick Chatterjee, Ambereen N Yousuf, Roger Engelmann, Carla Harmath, Grace Lee, Milica Medved, Ernest B Jamison, Abel Lorente Campos, Batuhan Gundogdu, Glenn Gerber, Luke F Reynolds, Parth K Modi, Tatjana Antic, Mihai Giurcanu, Scott Eggener, Gregory S Karczmar, Aytekin Oto
Joshua D Shur, Nuria Porta, Leila Kafaei, Laura Pendower, James McCall, Nasir Khan, Wim Oyen, Dow-Mu Koh, Edward Johnston
{"title":"Evaluation of Local Tumor Outcomes Following Microwave Ablation of Colorectal Liver Metastases Using CT Imaging: A Comparison of Visual versus Quantitative Methods.","authors":"Joshua D Shur, Nuria Porta, Leila Kafaei, Laura Pendower, James McCall, Nasir Khan, Wim Oyen, Dow-Mu Koh, Edward Johnston","doi":"10.1148/rycan.230147","DOIUrl":"10.1148/rycan.230147","url":null,"abstract":"<p><p>Purpose To compare visual versus quantitative ablation confirmation for identifying local tumor progression and residual tumor following microwave ablation (MWA) of colorectal liver metastases (CRLM). Materials and Methods This retrospective study included patients undergoing MWA of CRLM from October 2014 to February 2018. Two independent readers visually assessed pre- and postprocedure images and semiquantitatively scored for incomplete ablation, using a six-point Likert scale, and extracted quantitative imaging metrics of minimal ablative margin (MAM) and percentage of tumor outside of the ablation zone, using both rigid and deformable registration. Diagnostic accuracy and intra- and interobserver agreement were assessed. Results The study included 60 patients (median age, 71 years [IQR, 60-74.5 years]; 38 male) with 97 tumors with a median diameter of 1.3 cm (IQR, 1.0-1.8 cm). Median follow-up time was 749 days (IQR, 330-1519 days). Median time to complete rigid and deformable workflows was 3.0 minutes (IQR, 3.0-3.2 minutes) and 14.0 minutes (IQR,13.9-14.4 minutes), respectively. MAM with deformable registration had the highest intra- and interobserver agreement, with Gwet AC1 of 0.92 and 0.67, respectively, significantly higher than interobserver agreement of visual assessment (Gwet AC1, 0.18; <i>P</i> < .0001). Overall, quantitative methods using MAM had generally higher sensitivity, of up to 95.6%, than visual methods (67.3%, <i>P</i> < .001), at a cost of lower specificity (40% vs 71.1%, <i>P</i> < .001), using deformable image registration. Conclusion Quantitative ablation margin metrics provide more reliable assessment of outcomes than visual comparison using pre- and postprocedure diagnostic images following MWA of CRLM. <b>Keywords:</b> Interventional-Body, Liver, Neoplasms, Ablation Techniques <i>Supplemental material is available for this article</i>. Published under a CC BY 4.0 license.</p>","PeriodicalId":20786,"journal":{"name":"Radiology. Imaging cancer","volume":"7 1","pages":"e230147"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}