Hypothesis: Radiofrequency thermal ablation (RFA) can be performed safely and effectively to control local disease in patients with advanced, unresectable liver tumors. Design, Setting, and Patients: Prospective study of 76 patients with unresectable liver tumors who underwent RFA at a private tertiary referral hospital. Interventions: Ninety-nine RFA operations were performed to ablate 328 tumors. Main Outcome Measures: Complications and local recurrence.Results: There was 1 death (1%), major complications occurred in 7 operations (7%), and minor complications occurred in 10 operations (10%). Local recurrence was identified in 30 tumors (9%) at a mean follow-up of 15 months. Size (PϽ.001), vascular invasion (PϽ.001), and total volume ablated (PϽ.001) were associated with recurrence but the number of tumors was not (P=.39).
Conclusion:Radiofrequency thermal ablation provides local control of advanced liver tumors with low recurrence and acceptable morbidity.
Quantitative imaging methods using high-frequency ultrasound (HFU) offer a means of characterizing biological tissue at the microscopic level. Previously, high-frequency, threedimensional (3D) quantitative-ultrasound (QUS) methods were developed to characterize 46 freshly-dissected lymph nodes of colorectal-cancer patients. 3D ultrasound radio-frequency data were acquired using a 25.6-MHz center-frequency transducer and each node was inked prior to tissue fixation to recover orientation after sectioning for 3D histological evaluation. Backscattered echo signals were processed using 3D cylindrical regions-of-interest (ROIs) to yield four QUS estimates associated with tissue microstructure (i.e., effective scatterer size, acoustic concentration, intercept, and slope). These QUS estimates, obtained by parameterizing the backscatter spectrum, showed great potential for cancer detection. In the present study, these QUS methods were applied to 112 lymph nodes from 77 colorectal and gastric cancer patients. Novel QUS methods parameterizing the envelope statistics of the ROIs using Nakagami and homodyned-K distributions also were developed; they yielded four additional QUS estimates. The ability of these eight QUS estimates to classify lymph nodes and detect cancer was evaluated using ROC curves. An area under the ROC curve of 0.996 with specificity and sensitivity of 95% were obtained by combining effective scatterer size and one envelope parameter based on the homodyned-K distribution. Therefore, these advanced 3D QUS methods potentially can be valuable for detecting small metastatic foci in dissected lymph nodes.
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