在拟人甲状腺结节模型中进行射频消融的三维超声引导。

IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Tim Boers, Sicco J Braak, Wyger M Brink, Michel Versluis, Srirang Manohar
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引用次数: 0

摘要

背景:使用二维(2D)超声引导甲状腺良性结节的射频消融(RFA)有其局限性,包括无法监测整个治疗体积和操作者对电极定位的依赖性。我们比较了在拟人甲状腺结节模型中使用矩阵超声换能器和传统二维超声引导的三维(3D)射频消融:方法:由一名经验丰富的放射科医生使用二维或三维超声引导,制作了24个模型,模型中有48个结节,并进行了消融。消融后的 T2 加权磁共振成像扫描用于确定模型中最终的消融温度分布。这些数据用于分析消融参数,如结节消融百分比。此外,还记录了其他手术参数,如惯用手/非惯用手的使用情况:结果:3D引导下的消融术在结节内(74.4±9.1%(中位数±四分位数间距)对78.8±11.8%)和结节外(0.35±0.18 mL对0.45±0.46 mL)的消融量均呈下降趋势,且性能差异较小。就总消融率而言,二维引导下的优势手消融效果优于二维引导下的非优势手消融(81.0% 对 73.2%,p = 0.045),而三维引导下的消融在手的比较中没有显著影响。使用三维引导时,操作者对消融手的依赖性明显降低。有必要对使用三维超声进行 RFA 进行进一步研究:使用三维超声进行甲状腺结节 RFA 可改善临床效果。创建三维数据的平台可用于甲状腺诊断、治疗计划和导航工具:要点:构建了 24 个内部开发的甲状腺结节模型,包含 48 个结节。RFA在二维或三维超声引导下进行。三维和二维超声引导下的RFA效果相当。实时双平面成像可提供更好的消融区概览并帮助电极定位。惯用手和非惯用手在三维超声引导下进行的射频消融术效果相当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
3D ultrasound guidance for radiofrequency ablation in an anthropomorphic thyroid nodule phantom.

Background: The use of two-dimensional (2D) ultrasound for guiding radiofrequency ablation (RFA) of benign thyroid nodules presents limitations, including the inability to monitor the entire treatment volume and operator dependency in electrode positioning. We compared three-dimensional (3D)-guided RFA using a matrix ultrasound transducer with conventional 2D-ultrasound guidance in an anthropomorphic thyroid nodule phantom incorporated additionally with temperature-sensitive albumin.

Methods: Twenty-four phantoms with 48 nodules were constructed and ablated by an experienced radiologist using either 2D- or 3D-ultrasound guidance. Postablation T2-weighted magnetic resonance imaging scans were acquired to determine the final ablation temperature distribution in the phantoms. These were used to analyze ablation parameters, such as the nodule ablation percentage. Further, additional procedure parameters, such as dominant/non-dominant hand use, were recorded.

Results: Nonsignificant trends towards lower ablated volumes for both within (74.4 ± 9.1% (median ± interquartile range) versus 78.8 ± 11.8%) and outside of the nodule (0.35 ± 0.18 mL versus 0.45 ± 0.46 mL), along with lower variances in performance, were noted for the 3D-guided ablation. For the total ablation percentage, 2D-guided dominant hand ablation performed better than 2D-guided non-dominant hand ablation (81.0% versus 73.2%, p = 0.045), while there was no significant effect in the hand comparison for 3D-guided ablation.

Conclusion: 3D-ultrasound-guided RFA showed no significantly different results compared to 2D guidance, while 3D ultrasound showed a reduced variance in RFA. A significant reduction in operator-ablating hand dependence was observed when using 3D guidance. Further research into the use of 3D ultrasound for RFA is warranted.

Relevance statement: Using 3D ultrasound for thyroid nodule RFA could improve the clinical outcome. A platform that creates 3D data could be used for thyroid diagnosis, therapy planning, and navigational tools.

Key points: Twenty-four in-house-developed thyroid nodule phantoms with 48 nodules were constructed. RFA was performed under 2D- or 3D-ultrasound guidance. 3D- and 2D ultrasound-guided RFAs showed comparable performance. Real-time dual-plane imaging may offer an improved overview of the ablation zone and aid electrode positioning. Dominant and non-dominant hand 3D-ultrasound-guided RFA outcomes were comparable.

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来源期刊
European Radiology Experimental
European Radiology Experimental Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
6.70
自引率
2.60%
发文量
56
审稿时长
18 weeks
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