Objective:To demonstrate the feasibility of CT-CT fusion imaging for assessment of the cryoablation margins in visible hepatocellular carcinoma(HCC)on unenhanced CT images.Methods:This retrospective study analyzed 14 ...Objective:To demonstrate the feasibility of CT-CT fusion imaging for assessment of the cryoablation margins in visible hepatocellular carcinoma(HCC)on unenhanced CT images.Methods:This retrospective study analyzed 14 patients with 14 HCC lesions treated with CT-guided cryoablation.Nine lesions in nine patients who developed local tumor progression(LTP)during the follow-up period of at least8 months were reviewed.The unenhanced CT data were used to retrospectively create fusion images of the intraoperative CT images on a workstation.The minimal ablative margin(MAM)was assessed on the fusion images.The concordance between the site of LTP and the MAM area was also assessed.Results:Eight of the nine lesions with LTP were in the subcapsular region of the liver.Seven of the nine cases were treated by cryoablation combined with transcatheter arterial chemoembolization.The median time required to fuse the images for the nine lesions was 5:17 min(range,5:04-7:37 min).The site of LTP relative to the HCC lesion was craniocaudal in nine,dorsoventral in six,and lateral in seven lesions.In all lesions,the site of LTP was congruent with the MAM area.Conclusions:CT-CT fusion imaging enables a real-time intraoperative treatment evaluation for HCC lesions visible on unenhanced CT images.Fused imaging evaluation has proved to be an accurate and useful tool for assessment of the cryoablation margins.展开更多
AIM:To investigate the feasibility and clinical value of magnetic resonance imaging(MRI)-MRI image fusion in assessing the ablative margin(AM) for hepatocellular carcinoma(HCC).METHODS:A newly developed ultrasound wor...AIM:To investigate the feasibility and clinical value of magnetic resonance imaging(MRI)-MRI image fusion in assessing the ablative margin(AM) for hepatocellular carcinoma(HCC).METHODS:A newly developed ultrasound workstation for MRI-MRI image fusion was used to evaluate the AM of 62 tumors in 52 HCC patients after radiofrequency ablation(RFA).The lesions were divided into two groups:group A,in which the tumor was completely ablated and 5 mm AM was achieved(n = 32);and group B,in which the tumor was completely ablated but 5 mm AM was not achieved(n = 29).To detect local tumor progression(LTP),all patients were followed every two months by contrast-enhanced ultrasound,contrast-enhanced MRI or computed tomography(CT) in the first year after RFA.Then,the follow-up interval was prolonged to every three months after the first year.RESULTS:Of the 62 tumors,MRI-MRI image fusion was successful in 61(98.4%);the remaining case had significant deformation of the liver and massive ascites after RFA.The time required for creating image fusion and AM evaluation was 15.5 ± 5.5 min(range:8-22 min) and 9.6 ± 3.2 min(range:6-14 min),respectively.The follow-up period ranged from 1-23 mo(14.2 ± 5.4 mo).In group A,no LTP was detected in 32 lesions,whereas in group B,LTP was detected in 4 of 29 tumors,which occurred at 2,7,9,and 15 mo after RFA.The frequency of LTP in group B(13.8%;4/29) was significantly higher than that in group A(0/32,P = 0.046).All of the LTPs occurred in the area in which the 5 mm AM was not achieved.CONCLUSION:The MRI-MRI image fusion using an ultrasound workstation is feasible and useful for evaluating the AM after RFA for HCC.展开更多
Objective: To investigate the effect of bcr-abl fusion gene on CML cell apoptosis. Methods: Apoptosis of ex-vivo cultured K562 cells were observed after exposure to synthetic 18 mer antisense oligodeoxynucleotide comp...Objective: To investigate the effect of bcr-abl fusion gene on CML cell apoptosis. Methods: Apoptosis of ex-vivo cultured K562 cells were observed after exposure to synthetic 18 mer antisense oligodeoxynucleotide complementary to the bcr-abl junction (b3a2). Results: Apoptosis of K562 cells was significantly increased associated with inhibition of bcr-abl expression. Conclusion: bcr-abl fusion gene formation due to chromosome translocation may be the major mechanism of CML via inhibition of apoptosis.展开更多
Background: Minimally invasive transforaminal lumbar interbody fusion (MI TLIF) is a widely known and performed technique, however its versatility among different physicians continues to hinder its replication and res...Background: Minimally invasive transforaminal lumbar interbody fusion (MI TLIF) is a widely known and performed technique, however its versatility among different physicians continues to hinder its replication and results. Therefore, this study aimed to provide a step-by-step surgical guide to perform a safe MI-TLIF, based on the results obtained in patients operated on by a single surgeon over a period of 12 years. Patients and methods: A retrospective, single center, longitudinal, and observational cohort study was conducted with 931 patients who underwent MI TLIF by a single surgeon between 2010 and 2022 using the technique described on this paper, each with a minimum follow-up of 12 months. Criteria included Schizas classification, listhesis according to Meyerding classification, number of levels treated, cage size, and complications (screw repositioning or cerebrospinal fluid leak). Patient clinical outcomes were assessed using the Oswestry Disability Index (ODI), Visual Analog Scale (VAS) for pre- and postoperative radicular pain. Thin slice CT scans were used to assess the progression of the fusion using the Bridwell classification. In the statistical analysis, percentages, median, and interquartile range (IQR) were calculated. Results: Nine hundred and thirty one patients underwent MI TLIF using the technique described, eight hundred and eighty (94.5%) had a single level treated and fifty one (5.5%) had a 2 level procedure (982 levels), an 8mm cage was placed on five hundred and seventeenlevels (52.7%), six hundred and sixty three levels(67.6%) achieved grade I fusion, two hundred and sixty six levels (27.1%) achieved grade II fusion, 52 levels (5.3) achieved grade III fusion and one level (0.1) achieved a grade IV fusion or non-union. Revision surgery was performed on 3 patients (0.3%) for screw repositioning, cerebrospinal fluid leak was present on 2 patients during surgery and treated before closure. VAS scores and ODI were improved at 12 months postop (VAS from 8.70 to 2.30 and ODI from 34.2 to 14.1, (p = 0.001). Conclusions: The MI TLIF technique described could be a safe and easy to replicate way to achieved lumbar interbody fusion, providingclinical and radiological benefits.展开更多
基金supported by the National Key Research and Development Program of China(No.2016YFC0106203)the Program of Shanghai Hospital Development Center(No.SHDC22017102).
文摘Objective:To demonstrate the feasibility of CT-CT fusion imaging for assessment of the cryoablation margins in visible hepatocellular carcinoma(HCC)on unenhanced CT images.Methods:This retrospective study analyzed 14 patients with 14 HCC lesions treated with CT-guided cryoablation.Nine lesions in nine patients who developed local tumor progression(LTP)during the follow-up period of at least8 months were reviewed.The unenhanced CT data were used to retrospectively create fusion images of the intraoperative CT images on a workstation.The minimal ablative margin(MAM)was assessed on the fusion images.The concordance between the site of LTP and the MAM area was also assessed.Results:Eight of the nine lesions with LTP were in the subcapsular region of the liver.Seven of the nine cases were treated by cryoablation combined with transcatheter arterial chemoembolization.The median time required to fuse the images for the nine lesions was 5:17 min(range,5:04-7:37 min).The site of LTP relative to the HCC lesion was craniocaudal in nine,dorsoventral in six,and lateral in seven lesions.In all lesions,the site of LTP was congruent with the MAM area.Conclusions:CT-CT fusion imaging enables a real-time intraoperative treatment evaluation for HCC lesions visible on unenhanced CT images.Fused imaging evaluation has proved to be an accurate and useful tool for assessment of the cryoablation margins.
基金National Natural Science Foundation of China,No.81271669,No.81430038 and No.81301931
文摘AIM:To investigate the feasibility and clinical value of magnetic resonance imaging(MRI)-MRI image fusion in assessing the ablative margin(AM) for hepatocellular carcinoma(HCC).METHODS:A newly developed ultrasound workstation for MRI-MRI image fusion was used to evaluate the AM of 62 tumors in 52 HCC patients after radiofrequency ablation(RFA).The lesions were divided into two groups:group A,in which the tumor was completely ablated and 5 mm AM was achieved(n = 32);and group B,in which the tumor was completely ablated but 5 mm AM was not achieved(n = 29).To detect local tumor progression(LTP),all patients were followed every two months by contrast-enhanced ultrasound,contrast-enhanced MRI or computed tomography(CT) in the first year after RFA.Then,the follow-up interval was prolonged to every three months after the first year.RESULTS:Of the 62 tumors,MRI-MRI image fusion was successful in 61(98.4%);the remaining case had significant deformation of the liver and massive ascites after RFA.The time required for creating image fusion and AM evaluation was 15.5 ± 5.5 min(range:8-22 min) and 9.6 ± 3.2 min(range:6-14 min),respectively.The follow-up period ranged from 1-23 mo(14.2 ± 5.4 mo).In group A,no LTP was detected in 32 lesions,whereas in group B,LTP was detected in 4 of 29 tumors,which occurred at 2,7,9,and 15 mo after RFA.The frequency of LTP in group B(13.8%;4/29) was significantly higher than that in group A(0/32,P = 0.046).All of the LTPs occurred in the area in which the 5 mm AM was not achieved.CONCLUSION:The MRI-MRI image fusion using an ultrasound workstation is feasible and useful for evaluating the AM after RFA for HCC.
文摘Objective: To investigate the effect of bcr-abl fusion gene on CML cell apoptosis. Methods: Apoptosis of ex-vivo cultured K562 cells were observed after exposure to synthetic 18 mer antisense oligodeoxynucleotide complementary to the bcr-abl junction (b3a2). Results: Apoptosis of K562 cells was significantly increased associated with inhibition of bcr-abl expression. Conclusion: bcr-abl fusion gene formation due to chromosome translocation may be the major mechanism of CML via inhibition of apoptosis.
文摘Background: Minimally invasive transforaminal lumbar interbody fusion (MI TLIF) is a widely known and performed technique, however its versatility among different physicians continues to hinder its replication and results. Therefore, this study aimed to provide a step-by-step surgical guide to perform a safe MI-TLIF, based on the results obtained in patients operated on by a single surgeon over a period of 12 years. Patients and methods: A retrospective, single center, longitudinal, and observational cohort study was conducted with 931 patients who underwent MI TLIF by a single surgeon between 2010 and 2022 using the technique described on this paper, each with a minimum follow-up of 12 months. Criteria included Schizas classification, listhesis according to Meyerding classification, number of levels treated, cage size, and complications (screw repositioning or cerebrospinal fluid leak). Patient clinical outcomes were assessed using the Oswestry Disability Index (ODI), Visual Analog Scale (VAS) for pre- and postoperative radicular pain. Thin slice CT scans were used to assess the progression of the fusion using the Bridwell classification. In the statistical analysis, percentages, median, and interquartile range (IQR) were calculated. Results: Nine hundred and thirty one patients underwent MI TLIF using the technique described, eight hundred and eighty (94.5%) had a single level treated and fifty one (5.5%) had a 2 level procedure (982 levels), an 8mm cage was placed on five hundred and seventeenlevels (52.7%), six hundred and sixty three levels(67.6%) achieved grade I fusion, two hundred and sixty six levels (27.1%) achieved grade II fusion, 52 levels (5.3) achieved grade III fusion and one level (0.1) achieved a grade IV fusion or non-union. Revision surgery was performed on 3 patients (0.3%) for screw repositioning, cerebrospinal fluid leak was present on 2 patients during surgery and treated before closure. VAS scores and ODI were improved at 12 months postop (VAS from 8.70 to 2.30 and ODI from 34.2 to 14.1, (p = 0.001). Conclusions: The MI TLIF technique described could be a safe and easy to replicate way to achieved lumbar interbody fusion, providingclinical and radiological benefits.
