Observation of the effect of targeted therapy of 64-slice spiral CT combined with cryoablation for liver cancer.

AIM: To observe the effect of targeted therapy with 64-slice spiral computed tomography (CT) combined with cryoablation for liver cancer. METHODS: A total of 124 patients (142 tumors) were enrolled into this study. According to the use of dual-slice spiral CT or 64-slice spiral CT as a guide technology, patients were divided into two groups: dual-slice group (n = 56, 65 tumors) and 64-slice group (n = 8, 77 tumors). All patients were accepted and received targeted therapy by an argon-helium superconducting surgery system. The guided scan times of the two groups was recorded and compared. In the two groups, the lesion ice coverage in diameter of ≥ 3 cm and < 3 cm were recorded, and freezing effective rate was compared. Hepatic perfusion values [hepatic artery perfusion (HAP), portal vein perfusion (PVP), and the hepatic arterial perfusion index (HAPI)] of tumor tissues, adjacent tissues and normal liver tissues at preoperative and postoperative four weeks in the two groups were compared. Local tumor changes were recorded and efficiency was compared at four weeks post-operation. Adverse events were recorded and compared between the two groups, including fever, pain, frostbite, nausea, vomiting, pleural effusion and abdominal bleeding. RESULTS: Guided scan times in the dual-slice group was longer than that in the 64-slice group (t = 11.445, P = 0.000). The freezing effective rate for tumors < 3 cm in diameter in the dual-slice group (81.58%) was lower than that in the 64-slice group (92.86%) (χ2 = 5.707, P = 0.017). The HAP and HAPI of tumor tissues were lower at four weeks post-treatment than at pre-treatment in both groups (all P < 0.05), and those in the 64-slice group were lower than that in the dual-slice group (all P < 0.05). HAP and PVP were lower and HAPI was higher in tumor adjacent tissues at post-treatment than at pre-treatment (all P < 0.05). Furthermore, the treatment effect and therapeutic efficacy in the dual-slice group were lower than the 64-slice group at four weeks post-treatment (all P < 0.05). Moreover, pleural effusion and intraperitoneal hemorrhage occurred in patients in the dual-slice group, while no complications occurred in the 64-slice group (all P < 0.05). CONCLUSION: 64-slice spiral CT applied with cryoablation in targeted therapy for liver cancer can achieve a safe and effective freezing treatment, so it is worth being used.

Assessment of 64-slice spiral computed tomography with perfusion weighted imaging in the early diagnosis of ground-glass opacity lung cancer.

PURPOSE: To evaluate the use of the 64-slice spiral computed tomography (CT) with perfusion-weighted imaging in the early diagnosis of ground-glass opacity lung cancers. METHODS: 412 patients with ground-glass opacities found by conventional CT scan in our hospital, and deemed highly suspected of being lung cancers, were enrolled in the study between February of 2012 and February of 2015. Sixty four-slice spiral CTs with perfusion-weighted imaging were carried out on all patients, and the latest nodular contrast analysis software, MPR2D, 3D reconstruction technology, MIP technology and perfusion scanning technology were used to analyze lesion types, density, blood supply, peripheral signals, doubling time and tissue perfusion characteristics. This was repeated after one month, and the final pathologic diagnosis was used as a reference. RESULTS: There were 350 (84.95%) patients who were ultimately diagnosed with lung cancer. The main lesion type of lung cancer was quasi-circular, the average CT density was 56.7±5.4 HU, bronchial arterial enhancement increased in the nodule, peripheral signals were mainly irregular burrs, and the average doubling time was 1.2±0.3 s. Comparing these parameters with the ones in the non-cancer group, the differences found were with statistical significance (p<0.05). Importantly, tissue perfusion parameters of blood flow, blood volume, mean transit time and permeability surface in the lung cancer group were all significantly higher than those in non-cancer group (p<0.05). CONCLUSION: From the findings in our study, we propose that 64-slice spiral CT with perfusion-weighted imaging can be used to diagnose ground-glass opacity lung cancer early, by taking into account variables such as lesion type, density, blood supply, peripheral signals, doubling time and tissue perfusion characteristics.

The value of 64-slice spiral CT perfusion imaging in the treatment of liver cancer with argon-helium cryoablation.

We analyzed the effectiveness of using 64-slice spiral computed tomography (CT) and perfusion imaging to guide argon-helium cryoablation treatment of liver cancer. In total, 60 cases of advanced hepatocellular carcinoma before surgery treated with argon-helium cryoablation were inlcuded in the present study. Retrospective summary of the 60 cases of metaphase and advanced liver cancer were used as the control group. The control group were treated using cryoablation with argon-helium knife. We used enhanced scanning with 64-slice spiral CT to define the extent of their lesions and prepared a plan of percutaneous cryoablation for the treatment. Intraoperatively, we used the dynamics of CT perfusion imaging to observe the frozen ablation range and decreased the rate of complications. After surgery, the patients were followed-up regularly by 64-slice CT. We used conventional X-ray, CT and magnetic resonance imaging (MRI) for pre-operative lateralization. Intraoperative X-ray or ultrasound guidance and follow-up with CT or MTI were added to determine the clinical effectiveness and prognosis. The results showed that the total effective rate was improved significantly and incidence rate of overall complications decreased markedly in the observation group. Following treatment, AFP decreased significantly while the total freezing area and time were reduced significantly. The median survival time was increased significantly in the observation group. The numeric values of hepatic arterial perfusion, portal vein perfusion and hepatic arterial perfusion index were all markedly lowered after treatment. Differences were statistically significant (P<0.05). In conclusion, the use of 64-slice spiral CT perfusion imaging may considerably improve the effects of liver cancer treatment using the argon-helium cryoablation. It extended the survival time and reduced complications.