Chemical Constituents from Soft Coral Clavularia spp. Demonstrate Antiproliferative Effects on Oral Cancer Cells.

Five new eudensamane-type sesquiterpene lactones, clasamanes A-E (1-5), three new dolabellane-type diterpenes, clabellanes A-C (6-8), and fifteen known compounds (9-23) were isolated from the ethanolic extract of Taiwanese soft coral Clavularia spp. The structures of all undescribed components (1-8) were determined by analysis of IR, mass, NMR, and UV spectroscopic data. The absolute configuration of new compounds was determined by using circular dichroism and DP4+ calculations. The cytotoxic activities of all isolated marine natural products were evaluated. Compound 7 showed a significant cytotoxic effect against oral cancer cell line (Ca9-22) with an IC50 value of 7.26 ± 0.17 µg/mL.

Imaging features of microwave-ablated lesions of the VX2 tumors in rabbit lungs on computed tomography and magnetic resonance images and their correlations with pathological examination.

PURPOSE: This study aimed to explore the accuracy of different imaging methods for lesion volume estimation pre- and post-microwave ablation (MWA) as compared with that of pathological examination. METHODS: We used the VX2 cell line to establish the VX2 lung tumor model in rabbits, followed by MWA of the tumor. The imaging features of the VX2 tumors were documented. The volume of the tumors and the ablated lesions were measured and compared across imaging methods, using the pathological examination as reference. RESULTS: Tumors were successfully developed in 11 rabbits (age, 13.91 ± 1.38 weeks; weight, 2.15 ± 0.56 kg). The mean volume of the tumors was 2.05 ± 1.88 cm3. CT showed the strongest correlation with the pathologic examination results (r = 0.998, p<.001). MWA created three-layered structures that were delineated on MRI. The mean volume of the post-ablation lesion was 10.39 ± 8.93 cm3, and the measurement of the post-ablation volume on 3D-VIBE-T1WI showed the strongest correlation with the pathologic examination results (r = 0.991, p<.001). CONCLUSION: Both CT and MRI are capable of depicting lung tumors. In terms of post-ablation evaluation, MR images could provide more versatile information. The 3D-VIBE-T1WI sequence provides more precise lesion volume evaluation after ablation compared with other methods.

Magnetic resonance-guided thermal ablation for small liver malignant tumor located on segment II or IVa abutting the heart: a retrospective cohort study.

OBJECTIVE: This study aimed to evaluate the clinical safety and efficacy magnetic resonance (MR)-guided percutaneous thermal ablation for the treatment of small liver malignant tumors of segment II and IVa (≤3.0 cm) abutting the heart. METHOD: The enrollment of 24 patients with 25 malignant liver lesions located on the II or IVa segment abutting the heart who underwent MRI-guided thermal ablation between August 2010 and February 2020 were retrospectively analyzed. Follow-up MRI was performed to evaluate the curative effect. Local tumor progression-free survival and overall survival rates were also calculated. RESULTS: The procedures including radiofrequency ablation (RFA) for 15 patients and microwave ablation (MWA) for 9 patients were successfully accomplished (technical success rate of 100%) without major complications. The mean duration time was 78.4 ± 29.4 min (40-140 min), and mean follow-up time was 31.5 ± 22.2 months (6-92 months). The technical efficacy was 100% following one ablation session with MRI assessment after one month. Local tumor progression was observed in one patient with a metastatic lesion located in segment II at 18 months follow-up. The progression-free survival time was 20.1 ± 16.9 months (median: 15 months). The 1-, 3-, and 5-year local tumor progression-free survival rates of this patient were 100%, 94.7%, and 94.7%, respectively. With regards to all the patients, the 1-, 3-, and 5-year estimated overall survival rates were 91.7%, 80.6%, and 50.1%, respectively. CONCLUSION: MR-guided thermal ablation is safe and effective for the treatment of small liver malignant tumors located on the II or IVa segment abutting the heart.

Feasibility and efficacy study of microwave ablation of recurrent small HCC guided by enhanced liver-specific magnetic resonance imaging contrast agent.

OBJECTIVES: To investigate the feasibility and efficacy of liver-specific magnetic resonance imaging (MRI) with gadolinium-containing contrast agent guidance for microwave ablation (MWA) of recurrent small hepatocellular carcinoma (HCC). MATERIALS AND METHODS: The Ethics Committee of the First Affiliated Hospital of Fujian Medical University approved this study. Eighteen patients presented with 30 recurrent small HCCs, at least one lesion per patient was undetectable on unenhanced MRI, but this was clearly demonstrated in the hepatobiliary phase after liver-specific MRI contrast agent administration. Gd-BOPTA (16 cases) or Gd-EOB-DTPA (2 cases) were injected half an hour before the procedure, and MWA was performed by percutaneous puncture of the target lesion with a magnetic resonance-compatible microwave antenna under 1.5 T MRI guidance. RESULTS: The technical success rate was 100%. The mean maximum diameter of the lesions was 9.7 ± 2.8 mm (5.0-15.4 mm). The mean follow-up time was 11.6 ± 4.7 months (range, 4-19 months), and no local recurrence was observed. CONCLUSIONS: MWA of small HCCs guided by enhanced liver-specific MRI contrast agent is a safe and effective technique.

Local curative effect of MRI-guided radiofrequency ablation on small hepatocellular carcinoma.

Radiofrequency ablation (RFA) is one of the treatment modes for liver cancer. The trauma caused by RFA is small, and its local curative effect is reliable. Computed tomography (CT) can only be used for axial scans, and parts of the lesion are unclear on plain scans. The aim of this study is to compare the local curative effect of RFA percutaneously guided by MRI and ultrasound for small hepatocellular carcinoma (HCC). This study is a retrospective study. In this study, we examined 60 cases of 88 liver lesions and 50 cases of 52 lesions, in which RFA was guided by MRI and ultrasound, respectively. All cases were clinically diagnosed. The therapeutic effect of ablation lesions was examined by postoperative imaging follow-up. The results indicated that there were 5 (5/88) recurrences of liver lesions with MRI-guided RFA and 14 (14/52) recurrences of liver lesions with ultrasound-guided RFA. The median time to recurrence in the case of recurrent lesions was 7 months. Postoperative ablation lesions showed a low-intensity signal surrounded by a thin high-intensity signal ring on T2WI images. On T1WI images, the ablation lesion showed a concentric pattern and the central area of the original lesion continued to show a low-intensity signal with a clear ring of high-intensity signal that had a clear boundary. In conclusion, the local curative effect of MRI-guided RFA for small HCC is superior to that of ultrasound-guided RFA.

Marine Sponge Aaptos suberitoides Extract Improves Antiproliferation and Apoptosis of Breast Cancer Cells without Cytotoxicity to Normal Cells In Vitro.

The anticancer effects and mechanisms of marine sponge Aaptos suberitoides were rarely assessed, especially for methanol extract of A. suberitoides (MEAS) to breast cancer cells. This study evaluated the differential suppression effects of proliferation by MEAS between breast cancer and normal cells. MEAS demonstrated more antiproliferation impact on breast cancer cells than normal cells, indicating oxidative stress-dependent preferential antiproliferation effects on breast cancer cells but not for normal cells. Several oxidative stress-associated responses were highly induced by MEAS in breast cancer cells but not normal cells, including the generations of cellular and mitochondrial oxidative stress as well as the depletion of mitochondrial membrane potential. MEAS downregulated cellular antioxidants such as glutathione, partly contributing to the upregulation of oxidative stress in breast cancer cells. This preferential oxidative stress generation is accompanied by more DNA damage (γH2AX and 8-hydroxy-2-deoxyguanosine) in breast cancer cells than in normal cells. N-acetylcysteine reverted these MEAS-triggered responses. In conclusion, MEAS is a potential natural product for treating breast cancer cells with the characteristics of preferential antiproliferation function without cytotoxicity to normal cells in vitro.

Novel Aporphine- and Proaporphine-Clerodane Hybrids Identified from the Barks of Taiwanese Polyalthia longifolia (Sonn.) Thwaites var. pendula with Strong Anti-DENV2 Activity.

Hybrid natural products produced via mixed biosynthetic pathways are unique and often surprise one with unexpected medicinal properties in addition to their fascinating structural complexity/diversity. In view of chemical structures, hybridization is a way of diversifying natural products usually through dimerization of two similar or dissimilar subcomponents through a C-C or N-C covalent linkage. Here, we report four structurally attractive diterpene-alkaloid conjugates polyalongarins A-D (1-4), clerodane-containing aporphine and proaporphine alkaloids, the first of its kind from the barks of Taiwanese Polyalthia longifolia (Sonn.) Thwaites var. pendula. In addition to conventional spectroscopic analysis, single crystal X-ray crystallography was employed to determine the chemical structures and stereo-configurations of 1. Compounds 1-4 were subsequently subjected to in vitro antiviral examination against DENV2 by evaluating the expression level of the NS2B protein in DENV2-infected Huh-7 cells. These compounds display encouraging anti-DENV2 activity with superb EC50 (2.8-6.4 µM) and CC50 values (50.4-200 µM). The inhibitory mechanism of 1-4 on NS2B was further explored drawing on in-silico molecular docking analysis. Based on calculated binding affinities and predicted interactions between the functional groups of 1-4 and the allosteric-site residues of the DENV2 NS2B-NS3 protease, our analysis concludes that the clerodane-aporphine/proaporphine-type hybrids are novel and effective DENV NS2B-NS3 protease inhibitors.

Spatiotemporal evolution characteristics of the late frost damage risk to shrubby tea trees in tea region, southwest China from 1971 to 2020.

Understanding the spatiotemporal evolution characteristics of the risk of late frost damage has scientific guiding significance for optimizing the regional agricultural production layout and varie-ty tuning. Based on the daily meteorological data of 65 weather stations in the southwest China tea region from 1971 to 2020, we analyzed variation characteristics of the last frost date (LFD), tea bud open date (BOD), and their relationships, constructed frost damage probability index and frost damage severity index of spring shoots of shrubby tea trees, and analyzed the spatiotemporal evolution chara-cteristics of the late frost damage risk of shrub tea trees in the southwest tea region. The results showed that both the BOD and LFD had a significant ahead of trend from 1971 to 2020 and the early rate of the LFD was relatively faster than that of the BOD in the southwest tea region. The number of days that the tea buds were exposed to late frost damage after germination showed an non-significant declining trend. The risk of late frost damage of shrubby tea trees in most parts of the southwest tea region showed a declining trend, but Guizhou tea planting region showed an insignificant increasing trend. The risk of late frost damage to shrubby tea trees was high in the western marginal mountai-nous areas of Sichuan tea region, and the junction of Guizhou and Yunnan tea region. The risk of late frost damage was at low level in Sichuan Basin, southern Yunnan tea region, and southern Guizhou tea region. The risk of late frost damage to shrubby tea trees in the northern and central-eastern parts of Yunnan tea region showed an obvious decreasing trend, but increased significantly in the central and eastern parts of Guizhou tea region.

New secondary metabolite with cytotoxicity from spawning soft coral Asterospicularia laurae in Taiwan.

We have conducted a long-term research on the Taiwanese soft coral Asterospicularia laurae, which resulted in many xenicane-type diterpenoids such as asterolaurins A-M from A. laurae coral tissues during the non-spawning period were isolated. Here, we report a new xenicane diterpenoid, asterolaurin N (1), along with three known xenicane-type monocarbocyclic diterpenes [13-epi-9-desacetylxenicin (2), xeniolide-B 9-acetate (3) and asterolaurin I (4)] from A. laurae during the spawning period. The structures of the new secondary metabolite were established with an extensive spectroscopic analysis. The 1D and 2D nuclear magnetic resonance (NMR) data of the compounds were discussed. We discovered that the C-15 of 1 contains two methyl groups on a carbon bearing an acetyl group, which has not been reported previously. In addition, Compounds 1, 3, and 4 showed selective cytotoxic activity against Molt 4, while 2 exhibited significant cytotoxicity against Molt 4, K562, Sup-T1 and U937 cell lines.

Analysis of imaging-guided thermal ablation puncture routes for tumors of the hepatic caudate lobe.

AIMS: The goal of this study was to analyze the puncture routes of imaging-guided thermal ablation for tumors of the hepatic caudate lobe. MATERIALS AND METHODS: The imaging-guided thermal ablation puncture routes of 12 cases of hepatic caudate lobe tumors were collected in our hospital from January 2013 to February 2019. The puncture routes were retrospectively analyzed, and the experience of thermal ablation therapy for hepatic caudate lobe tumors was summarized. RESULTS: Among the 12 cases of hepatic caudate lobe tumors, puncture routes were divided into the anterior (through the left lobe of the liver) approach (six cases), the right hepatic approach (five cases), and the transthoracic approach (one case). Different ablation electrodes were selected according to the puncture route and method of guiding. No serious postoperative complications were noted. CONCLUSION: The hepatic caudate lobe is surrounded by the inferior vena cava, hepatic vein, and hepatic hilum, leading to great difficulties and risks in performing minimally invasive treatment of hepatic caudate lobe malignancies. Therefore, selecting an appropriate puncture route is an important factor in the success of the treatment.

Evaluation of the correlation between infrared thermal imaging-magnetic resonance imaging-pathology of microwave ablation of lesions in rabbit lung tumors.

PURPOSE: This study aimed to evaluate the correlation between infrared thermal imaging-magnetic resonance imaging (MRI)-pathology of microwave ablation (MWA) of lesions in rabbit lung tumors. MATERIALS AND METHODS: MR-guided MWA was performed in nine VX2 tumor-bearing rabbits. Infrared thermal imaging, postoperative MRI, and pathological presentation were obtained and analyzed. The differences between the infrared thermal imaging-MRI-pathology of MWA were compared. RESULTS: The center of the ablated lesion exhibited a high signal on T1-Vibe, and an isointense envelope was observed; the center of the ablated lesion exhibited a low signal on fat-suppressed turbo spin-echo T2-weighted imaging (TSE-T2WI-FS) and bands of high signal surrounding it compared with before MWA. No statistically significant difference existed between the maximum diameter of the central low-signal area of the ablation zone on TSE-T2WI-FS after MWA, the high-signal area of the ablation zone on T1-Vibe after MWA, and the maximum diameter of the pathological coagulation necrosis area, as well as between the maximum diameter of the isointense signal area peripheral to the ablation zone on T1-Vibe after MWA, the high-signal area peripheral to the ablation zone on TSE-T2WI-FS, the maximum diameter at the 41°C isothermal zone on infrared thermal imaging, and the maximum diameter of the pathological thermal injury zone. CONCLUSIONS: MWA of malignant lung tumors had specific MRI characteristics that were comparable with postoperative pathology. Infrared thermal imaging combined with MRI can be used to evaluate the extent of thermal damage to lung VX2 tumors.

Evaluating the effectiveness of computed tomography-guided 125I seed interstitial implantation in patients with secondary adrenal carcinoma.

AIM: This study aimed to evaluate the feasibility, safety, and clinical efficacy of computed tomography (CT)-guided 125 I seed interstitial implantation in patients with secondary adrenal carcinoma. MATERIALS AND METHODS: Twenty patients with secondary adrenal carcinoma received CT-guided 125 I seed interstitial implantation. A three-dimensional treatment planning system was used to calculate the dose distribution before 125 I seed interstitial implantation. CT scans were performed every 2 months after the treatment to evaluate local therapeutic efficacy according to the Response Evaluation Criteria in Solid Tumors. RESULTS: The mean follow-up time was 23.65 months (5-102 months). The mean maximum tumor diameter was 34.16 ± 18.94 mm at the beginning of follow-up and 14.42 ± 24.07 mm at the end of follow-up. Eleven patients had complete response (CR), seven had partial response (PR), one had stable disease, and one had progressive disease. Local control rate (CR + PR) was 90% (18/20). The median survival time was 19 months (5-71 months). The 1-, 2-, 3-, and 5-year overall survival rates were 83.70%, 46.8%, 20.80%, and 20.80%, respectively. CONCLUSION: CT-guided 125 I radioactive seed interstitial implantation may be a feasible, safe, effective, and minimally invasive treatment for secondary adrenal carcinoma.

Application of the transosseous approach for computed tomography-guided radioactive 125-iodine seed implantation for the treatment of thoracic and abdominal lymph node metastases.

AIM: This study aimed to investigate the technical procedure, safety, and clinical value of the transosseous approach for computed tomography (CT)-guided radioactive 125-iodine (125I) seed implantation for the treatment of thoracic and abdominal lymph node metastases. SUBJECTS AND METHODS: This was a retrospective study that Nine lymph node metastases in nine patients were treated in our hospital between January 2010 and August 2018. Under CT guidance, at least one puncture path was made through the transosseous approach. The seeds were planted according to the TPS. CT/MRI scans were performed every 2 months after the treatment to evaluate local therapeutic efficacy according to the Response Evaluation Criteria in Solid Tumors. RESULTS: The transosseous approach was successfully established in all patients. The median follow-up time was 11 months (6-36 months). At 2, 4, 6, 8, 10 and 12 months after operation, the objective effective rate and clinical benefit rate were 66.67%, 77.78%, 77.78%, 71.43%, 66.67% and 50.00%; and 88.89%, 88.89%, 88.89%, 71.43%, 66.67% and 50.00%, respectively. The survival rate of the patients at 6, 12, 18, 24, 30 and 36 months after operation was 53.00%, 26.00%, 26.00%, 13.00%, 13.00% and 13.00%, respectively. CONCLUSIONS: The transosseous approach for CT-guided radioactive 125I seed implantation was safe, effective, and minimally invasive for the treatment of thoracic and abdominal lymph node metastases.

Clinical efficacy of endovascular radiofrequency ablation in the treatment of portal vein tumor thrombus of primary hepatocellular carcinoma.

OBJECTIVE: The objective of this study is to investigate the clinical efficacy and safety of Habib™ VesOpen, a new intravascular radiofrequency ablation (RFA) catheter in percutaneous puncture of portal vein tumor thrombus (PVTT) in patients with primary hepatocellular carcinoma. MATERIALS AND METHODS: Collected data of patients with primary hepatocellular carcinoma with portal vein trunk or main branch who were treated by the RFA of portal vein tumor ablation with Habib™ VesOpen, a new intravascular RFA catheter. The postoperative success rate, complications, liver and kidney function, alpha-fetoprotein (AFP), portal vein patency, and tumor thrombus were analyzed, and the survival status of patients was analyzed by Kaplan-Meier survival analysis, and the COX proportional hazards regression model was used to analyze the factors influencing the clinical prognosis of patients. RESULTS: All the 44 patients were operated successfully without complications such as vascular perforation, infection, liver abscess, and intraperitoneal hemorrhage. The liver function index, alanine aminotransferase, aspartate aminotransferase, and serum albumin (ALB) were significantly different before and after surgery at 2 weeks and 4 weeks after operation (P < 0.05); AFP before and after surgery, the difference was statistically significant (P < 0.05). Doppler ultrasonography showed blood flow through the original portal vein after 4 weeks of surgery; enhanced computed tomography examination or magnetic resonance examination on the abdomen suggested patients with varying degrees of tumor thrombosis or disappearance after 8 weeks of surgery. The overall survival time was 284.72 ± 27.20 days (95% confidence interval: 231.42-338.02 days). The cumulative survival rates of 90, 180, and 360 days were 97.7%, 72.7%, and 17.2%, respectively. Cox multivariate regression analysis showed that tumor size and the size of ALB before RFA treatment was an independent factor in the prognosis of hepatocellular carcinoma with PVTT ablation (P < 0.05). CONCLUSIONS: The use of Habib™ VesOpen intravascular RFA catheter percutaneous puncture of the portal vein tumor RFA has positive clinical effect which is safe and reliable, expected to become one of the effective means in treatment of primary hepatocellular carcinoma with PVTT.

Expert consensus on image-guided radiofrequency ablation of pulmonary tumors: 2018 edition.

Lung cancer ranks first in incidence and mortality in China. Surgery is the primary method to cure cancer, but only 20-30% of patients are eligible for curative resection. In recent years, in addition to surgery, other local therapies have been developed for patients with numerous localized primary and metastatic pulmonary tumors, including stereotactic body radiation therapy and thermal ablative therapies through percutaneously inserted applicators. Percutaneous thermal ablation of pulmonary tumors is minimally invasive, conformal, repeatable, feasible, cheap, has a shorter recovery time, and offers reduced morbidity and mortality. Radiofrequency ablation (RFA), the most commonly used thermal ablation technique, has a reported 80-90% rate of complete ablation, with the best results obtained in tumors < 3 cm in diameter. Because the clinical efficacy of RFA of pulmonary tumors has not yet been determined, this clinical guideline describes the techniques used in the treatment of localized primary and metastatic pulmonary tumors in nonsurgical candidates, including mechanism of action, devices, indications, techniques, potential complications, clinical outcomes, post-ablation surveillance, and use in combination with other therapies. In the future, the role of RFA in the treatment of localized pulmonary tumors should ultimately be determined by evidence from prospective randomized controlled trials comparing sublobar resection or stereotactic body radiation therapy.

Magnetic resonance imaging evaluation after radiofrequency ablation for malignant lung tumors.

OBJECTIVE: The objective of this study was to investigate magnetic resonance imaging (MRI) assessment of the therapeutic response in small lung malignancies (<3 cm) immediately after radiofrequency ablation (RFA). MATERIALS AND METHODS: This is a retrospective analysis of MRI performance in 24 cases of small lung tumors (16 primary, 8 metastatic; 20 patients) immediately, post-RFA, and at follow-up. Variables measured included maximum diameters of tumors on pre-RFA MRI, central areas of low signal intensity (SI) on post-RFA T2-weighted images (T2WIs), and central areas of high SI on post-RFA T1WIs. Additional post-RFA measurements included the maximum diameters for areas of ground-glass opacities (GGOs) on computed tomography (CT), high SI on T2WIs, and isointense SI on T1WIs. Mean values were used for statistical analysis. RESULTS: Before RFA, 16 primary and seven metastatic lung tumors showed isointense signals on T1WIs and hyperintense signals on T2WIs. Immediately after RFA, the ablated lesions showed central low signals and peripheral high annular signals on T2WIs and central high signals and peripheral annular isointense signals on T1WIs, with reduced SI on diffusion-weighted images. Significant differences were found between the preoperative MRI maximum tumor diameter and post-RFA diameters of central low SI areas on T2WIs and central high SI areas on T1WIs. Furthermore, there were significant differences between the post-RFA maximum diameter of circumferential high signals on T2WIs and the post-RFA maximum diameters of both GGOs on CT and circumferential isointense signals on T1WIs. There were three cases of local recurrence (two pulmonary metastases and one primary) during follow-up. CONCLUSIONS: MRI evaluation of the therapeutic response of RFA for small malignant lung tumors (<3 cm) was precise and reliable.

Treatment of recurrent mediastinal lymph node metastasis using CT-guided nontranspulmonary puncture interstitial implantation of (125)I seeds: Evaluation of initial effect and operative techniques.

PURPOSE: To evaluate the initial effects and operative techniques for treating recurrent mediastinal lymph node metastasis using CT-guided nontranspulmonary puncture interstitial implantation of (125)I seeds. METHODS AND MATERIALS: Thirteen patients (eight men and five women) with a total of 14 recurrent mediastinal lymph node metastatic lesions underwent CT-guided nontranspulmonary puncture interstitial implantation of (125)I seeds. RESULTS: We used the transpleural cavity approach for six cases (air injection of 200-600 mL), the transsternal approach for three cases, the supersternal approach for one case, and the parasternal/paraspinal approach for the remaining cases (including two cases using the salinoma window technique). All patients had good operational tolerance. Mean followup was 16.3 months, with 12 complete response lesions and 2 partial response lesions. CONCLUSIONS: Treating recurrent mediastinal lymph node metastasis using CT-guided nontranspulmonary puncture interstitial implantation of (125)I seeds is safe and effective, with minimal trauma, evident local therapeutic effects, and does not damage lung tissue. However, comprehensive application of multiple puncture assistive technologies, and skill, is required due to the important, anatomically complex structures in the mediastinum.

Effect of heat sink on the recurrence of small malignant hepatic tumors after radiofrequency ablation.

AIMS: The aim of this study was to investigate the effect of heat sink on the recurrence of hepatic malignant tumors <3 cm after percutaneous radiofrequency ablation (RFA). SUBJECTS AND METHODS: This study included 564 hepatic malignant tumors <3 cm in 381 patients. Preoperative images were used to determine whether these tumors were adjacent to vessels, and the diameter of adjacent vessels was measured. RFA was performed computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US) guidance, and postoperative imaging follow-up was then conducted. STATISTICAL ANALYSIS USED: SPSS software version 17.0 was used for data processing, and the χ2 test was used for comparative analysis. Two-sided P < 0.05 indicated statistical significance. RESULTS: A total of 33 recurrences were found: 15 in the MR group (15/468), 12 in the US group (12/53), and 6 in the CT group (6/43). Of the 101 lesions adjacent to blood vessels larger than 3 mm, 20 showed recurrence: 10 in the MR group (10/77), 7 in the US group (7/17), and 3 in the CT group (3/7). The recurrence rate of perivascular lesions was higher than that of nonperivascular lesions, and the rate in the MR group was lower those in the US and CT groups. CONCLUSIONS: The curative effect of MRI-guided RFA is better than those of US- and CT-guided ablation. The heat sink effect is an important factor affecting recurrence of hepatic malignant tumors after RFA.

Chinese expert consensus workshop report: Guidelines for thermal ablation of primary and metastatic lung tumors.

Although surgical resection is the primary means of curing both primary and metastatic lung cancers, about 80% of lung cancers cannot be removed by surgery. As most patients with unresectable lung cancer receive only limited benefits from traditional radiotherapy and chemotherapy, many new local treatment methods have emerged, including local ablation therapy. The Minimally Invasive and Comprehensive Treatment of Lung Cancer Branch, Professional Committee of Minimally Invasive Treatment of Cancer of the Chinese Anti-Cancer Association has organized multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim at standardizing thermal ablation procedures and criteria for selecting treatment candidates and assessing outcomes; and for preventing and managing post-ablation complications.

Treatment of hepatocellular carcinoma adjacent to large blood vessels using 1.5T MRI-guided percutaneous radiofrequency ablation combined with iodine-125 radioactive seed implantation.

OBJECTIVE: The objective is to study the technology associated with and feasibility of the treatment of hepatocellular carcinoma (HCC) adjacent to large blood vessels using 1.5 T MRI-guided radiofrequency ablation combined with iodine-125 (I-125) radioactive seed implantation. METHODS: Sixteen patients with a total of 24 HCC lesions (average maximum diameter: 2.35±1.03 cm) were pathologically confirmed by biopsy or clinically diagnosed received 1.5 T MRI-guided percutaneous radiofrequency ablation (RFA) treatment. Each patient had one lesion adjacent to large blood vessels (≥3 mm); after the ablation, I-125 radioactive seeds were implanted in the portions of the lesions that were adjacent to the blood vessels. RESULTS: All the ablations and I-125 radioactive seed implantations were successful; a total of 118 seeds were implanted. The ablated lesions exhibited hypointense signals on the T2WI sequence with a thin rim of hyperintense signals; they also exhibited significant hyperintense signals on the T1WI sequence with clear boundaries. The average follow-up period was 11.1±6.2 months. There were 23 complete responses and one partial response in the 24 lesions. The alpha-fetoprotein (AFP) levels of the patients significantly decreased. CONCLUSION: The 1.5 T MRI-guided RFA combined with I-125 radioactive seed implantation for the treatment of HCC adjacent to large blood vessels is an effective technology.