Ultrasound-guided percutaneous microwave ablation of central intraductal papilloma: a prospective pilot study

Abstract

Background: Central intraductal papilloma (IDP) has a low risk of cancer evolution; therefore, surgical treatment of IDP is controversial. We sought to validate ultrasound (US)-guided percutaneous microwave ablation (MWA) for minimally invasive treatment of IDP. Methods: Thirteen women with central IDP, including six with nipple discharge, underwent US-guided core needle biopsy and MWA from December 2016 to November 2017. Lesions histologically diagnosed as benign IDP were included. The hydro-dissection technique was used to protect the nipple during the entire ablation procedure. We evaluated and recorded data of complete ablation, volume reduction, and complications. Results: MWA was successfully performed in all patients, with 100% complete ablation, assessed by magnetic resonance imaging or contrast-enhanced US. Mean tumor size was 13.5 ± 4.1 (7.0-20.0) mm; the mean ablation time was 1.4 (0.7-10.3) min. At the median 13.7-month follow-up, mean lesion sizes at 3, 6, and 12 months after MWA were all significantly smaller than that at baseline. Total volume reduction rates were 52.3 ± 18.2% (range, 24.2-81.8%), 72.6 ± 23.1% (range, 39.4-95.9%), and 92.9 ± 7.5% (range, 75.0-100%) at 3-, 6-, and 12-month follow-up, respectively, with significant differences (p < .01). Three lesions with diameters 7 mm, 9 mm, and 12 mm disappeared completely at 3, 6, and 6 months after MWA, respectively, on US imaging. Nipple discharge disappeared immediately after MWA. Cosmetic effects were reported as excellent by all patients and no complications were observed. Conclusion: US-guided MWA of central IDP proved feasible and effective, with considerable volume reduction and satisfactory cosmetic outcomes.

Feasibility of Controlling Metastatic Osseous Pain Using Three Kinds of Image‐Guided Procedures for Thermal Microwave Ablation: A Retrospective Study

“…These two techniques were combined in the present study of 11 patients with osseous metastasis of soft tissue masses. Because tumor tissue destroys the cortical bone, positioning of the ablation needle and change in tumor echogenicity due to high temperatures could be observed in real time under ultrasound guidance 37 . Compared to CT and fluoroscopy alone, the combined thermal monitoring technique provides real‐time intraoperative monitoring of the extent of ablation 35 .…”

Next-Generation Healthcare: Enabling Technologies for Emerging Bioelectromagnetics Applications

“…MWA has been widely performed under the guidance of computed tomography (CT). Alternatively, ultrasound (US) has been used as the guidance to avoid exposure to ionizing radiation and to reduce the cost [254]. However, for these imaging techniques, image contrast may be sometimes insufficient and therefore treatment may not be perfect.…”

Ultrasound‐Guided Breast Biopsies

“…For breast cryoablations, sterile saline is typically injected through a needle into the marginalized area to maintain a specific distance between the ice margin and the skin 20 . Hydrodissection is also used in other therapeutic breast interventions such as percutaneous ablations to protect the nipple/areolar complex 21 . This same technique can be translated into diagnostic breast procedures 22 …”