Utilizing pre-operative MR imaging and adapting optimal needle puncture approach to improve radiofrequency ablation fraction of thoracic dorsal root ganglia

AbstractThis experimental study evaluates the location of thoracic dorsal root ganglions (DRGs) through magnetic resonance imaging (MRI) scans, and evaluates the radiofrequency ablation (RFA) fraction of different puncture approaches on distinct DRG locations. Eight normal adult corpse specimens were used as thoracic spine specimens. An MRI examination was performed on each specimen using the following MRI sequences: STIR T2WI, fs-FRFSE T2WI, and 3D FIESTA-c. Then thoracic spine specimens (n = 14) were divided into three groups for RFA: Group A, using a transforaminal approach irrespective of DRG location; Group B, using a transforaminal, trans-lateral-zygapophysial or translaminar approach according to the DRG location; and Group C using a combination of puncture approaches. The quality of visualization of thoracic DRGs on STIR T2WI, fs-FRFSE T2WI, and 3D FIESTA-c scans were 53.5% (77/144), 88.2% (127/144), and 93.1% (134/144), respectively. In group A, the RFA fractions of the extraforaminal DRGs (N = 29), intraforaminal DRGs (N = 12) and intraspinal DRGs (N = 7) via a transforaminal approach were 72.6 ± 18.9%, 54.2 ± 24.8% and 32.9 ± 28.1% respectively. In group B, RFA of extraforaminal DRGs via a transforaminal approach (N = 43) or a trans-lateral zygapophysial approach (N = 45) led to ablation fractions of 71.9 ± 15.2% and 72.0 ± 17.9%, respectively; RFA of intraforaminal DRGs via a transforaminal approach (N = 14) or a translaminar approach (N = 16) led to ablation fractions of 57.1 ± 18.0% and 52.5 ± 20.6%, respectively; RFA of intraspinal DRGs via a transforaminal approach (N = 12) or a translaminar approach (N = 14) led to ablation fractions of 34.8 ± 24.6% and 71.8 ± 16.0%, respectively. In group C, the combined approach led to an ablation fraction for extraforaminal DRGs (N = 69) of 82.5 ± 14.1%, for intraforaminal DRGs (N = 39) of 81.5 ± 11.8%, and for intraspinal DRGs (N = 36) of 80.8 ± 13.3%. MRI can accurately assess DRG location before RFA. Adopting different and combined puncturing approaches tailored to different DRG locations can significantly increase the DRG RFA fraction.

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Radiofrequency ablation for markedly incompetent perforators versus compression therapy in the management of post-phelebtic venous ulcers: A randomized controlled trial

Vascular ◽

10.1177/17085381211010022 ◽

2021 ◽

pp. 170853812110100

Author(s):

Mohamed Shukri Abdelgawad ◽

Amr M El-Shafei ◽

Hesham A Sharaf El-Din ◽

Ehab M Saad ◽

Tamer A Khafagy ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Radiofrequency Ablation ◽

Controlled Trial ◽

Compression Therapy ◽

Randomized Controlled ◽

Venous Ulcers ◽

Group A ◽

Group B ◽

To Receive

Background Venus ulcers developed mainly due to reflux of incompetent venous valves in perforating veins. Patients and methods In this randomized controlled trial, 119 patients recruited over two years, with post-phelebtic venous leg ulcers, were randomly assigned into one of two groups: either to receive radiofrequency ablation of markedly incompetent perforators (Group A, n = 62 patients) or to receive conventional compression therapy (Group B, n = 57 patients). Follow-up duration required for ulcer healing continued for 24 months post randomization. Results Statistically significant shorter time to healing (ulcer complete healing or satisfactory clinical improvement) between both groups (56 patients, 90.3% of cases in Group A versus 44 patients 77.2% of cases in Group B) over the follow-up period of 24 months was attained ( p = 0.001). Also, significantly different ulcer recurrence was recorded between both groups, 8 patients (12.9%) in Group A versus 19 patients (33.3%) in Group B ( p = 0.004). Conclusion In absence of deep venous obstruction, the monopolar radiofrequency ablation for incompetent perforators is a feasible and effective method that surpasses the traditional compression protocol for incompetent perforator-induced venous ulcers in terms of time required for healing even in the presence of unresolved deep venous valvular reflux.

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Magnetic resonance imaging (MRI) scans in patients with dorsal root ganglion stimulation

Pain Practice ◽

10.1111/papr.13067 ◽

2021 ◽

Author(s):

Marco Reining ◽

Dirk Winkler ◽

Joachim Boettcher ◽

Juergen Meixensberger ◽

Michael Kretzschmar

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Dorsal Root Ganglion ◽

Dorsal Root ◽

Resonance Imaging ◽

Mri Scans ◽

Magnetic Resonance Imaging Mri

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Evaluation of hepatectomy, radiofrequency ablation, and transarterial chemoembolization for the local treatment of liver metastases in gastric cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.200 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 200-200

Author(s):

Lin Chen ◽

Jiyang Li ◽

Jianxin Cui ◽

Hongqing Xi ◽

Aizhen Cai ◽

...

Keyword(s):

Overall Survival ◽

Radiofrequency Ablation ◽

Survival Rate ◽

Liver Metastases ◽

Transarterial Chemoembolization ◽

Local Treatment ◽

R0 Resection ◽

Curative Gastrectomy ◽

Group A ◽

Group B

200 Background: The optimal local treatment for liver metastases remains controversial. Except for hepatectomy, radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) are both effective and low risk treatment modality with more expanded indications in patients with liver metastases. Thus, the aim of this study is to evaluate the efficacy of different methods for the local treatment of GCLM. Methods: From January 2006 to December 2015, 97 consecutive patients were eligible and included in a prospective database. They all received multidisciplinary treatments based on curative gastrectomy and local treatments (hepatectomy, RFA and TACE) for liver metastases. The 97 patients enrolled in a cohort study were divided into two groups, Group A (37 patients, curative hepatectomy with or without other local treatments) and Group B (60 patients, palliative RFA and/or TACE).The primary endpoints were overall survival (OS) and 5-year survival rate. Results: Baseline characteristics in the two groups were comparable. Correlation analysis found that interval time of metachronous, neutrophil to lymphocyte ratio and body mass index were not significantly linear associated with survival, with ρ = 0.051, ρ = 0.014 and ρ = 0.056, respectively. The overall survival time between the two groups were 94.1 months and 57.2 months, with 1-year, 3-year and 5-year survival rate 83.3%, 50.0% and 30.6% in Group A, respectively; and 83.7%, 28.6% and 18.4% in Group B, respectively (P = 0.049). Furthermore, subgroup analyses proved that among these three local treatments, hepatectomy was the most effective method (P = 0.014), with significantly difference from RFA (P = 0.001). Nevertheless, combination with RFA and/or TACE did not improve patients’ benefits (P = 0.062). And TACE has a similar (P = 0.227) efficacy with RFA, but significantly less costs. Conclusions: Hepatectomy is the optimal local treatment for liver metastases when the surgical R0 resection was intended. And it is not necessary to combine with other local treatments. As palliative local treatment, TACE is an acceptable method with relatively high cost-effective.

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Ganglioglioma: comparison with other low-grade brain tumors

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000400018 ◽

2006 ◽

Vol 64 (3a) ◽

pp. 613-618 ◽

Cited By ~ 13

Author(s):

Paulo Thadeu Brainer-Lima ◽

Alessandra Mertens Brainer-Lima ◽

Hildo Rocha Azevedo-Filho

Keyword(s):

Refractory Epilepsy ◽

Young Patients ◽

Low Frequency ◽

Surgical Removal ◽

Dysembryoplastic Neuroepithelial Tumor ◽

Low Grade ◽

Complex Partial Seizures ◽

Group A ◽

Magnetic Resonance Imaging Mri ◽

Group B

METHOD: Forty-two patients with low-grade brain tumor and refractory epilepsy were studied. The mean age was 22.3 years. They were divided into two groups: Group A, patients with ganglioglioma (n=19) and group B, patients with other low-grade tumors (n=23) (14 astrocytoma, 6 oligodendroglioma, 2 dysembryoplastic neuroepithelial tumor, and 1 xanthoastrocytoma). RESULTS: Age at seizure’s onset was 7 years or less in 73% of the patients in group A and in 30.4% of the patients in group B (p=0.045). Complex partial occurred frequently in group A and B (94.7% versus 82%, respectively). Seizure’s frequency was higher in group B (p=0.002).Computerized tomography (CT) was normal in 36.8% of group A patients and abnormal in all group B patients. Magnetic resonance imaging (MRI) was abnormal in all patients. Surgical removal was complete in 89.5% of the patients in group A and in 78.2% of the patients in group B. CONCLUSION: The association of refractory epilepsy and complex partial seizures, at a relatively low frequency, in young patients potentially normal CT and a MRI hypointense temporal lobe lesion in T1-weighed slices were habitual image findings in ganglioglioma, rather than other low-grade tumor.

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Phase II/III Study of Radiofrequency Ablation Combined with Cytokine-Induced Killer Cells Treating Colorectal Liver Metastases

Cellular Physiology and Biochemistry ◽

10.1159/000452531 ◽

2016 ◽

Vol 40 (1-2) ◽

pp. 137-145 ◽

Cited By ~ 9

Author(s):

Xiaodong Li ◽

Xichao Dai ◽

Liangrong Shi ◽

Yong Jiang ◽

Xuemin Chen ◽

...

Keyword(s):

T Cells ◽

Radiofrequency Ablation ◽

Liver Metastases ◽

Phase Ii ◽

Colorectal Liver Metastases ◽

Survival Rates ◽

T Cell Response ◽

Cik Cells ◽

Group A ◽

Group B

Purpose: This phase II/III, non-randomized clinical trial aimed to determine the efficacy and safety of the combination of radiofrequency ablation (RFA) and cytokine-induced killer (CIK) cells transfusion for patients with colorectal liver metastases (CRLMs). Experimental Design: A total of 60 eligible patients with CRLMs were enrolled and divided into Group A (RFA alone, n = 30) and Group B (RFA plus CIK, n = 30), and following enzyme-linked immunosorbent spot assay was performed in 8 patients with CEA > 50 ng/mL pre-RFA and 7 days post-RFA and CIK treatment, respectively. Results: The median progression-free survival (PFS) times of Group A and Group B were 18.5 months and 23 months, respectively (P = 0.0336). The 3-year progression-free rates were 13.3% in Group A and 20.3% in Group B, respectively. The median overall survival time was 43 months in Group A, and not reached in Group B. The 3-year survival rates were 64.6% in Group A and 81.0% in Group B, respectively (P = 0.1187). Among the 8 patients with CEA > 50ng/mL, 6 had increase of circulating CEA-specific T cells after RFA (P = 0.010). After CIK cell therapy, the number of CEA-specific T cells increased in all the 8 patients comparing with that pre-treatment (P = 0.001) and in 7 patients comparing with that post-RFA (P = 0.028). Conclusions: We firstly confirm that the combination of RFA and CIK cells boosts CEA-specific T cell response and shows to be an efficacious and safe treatment modality for patients with CRLMs.

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Clinical efficacy and safety of bone cement combined with radiofrequency ablation in the treatment of spinal metastases

BMC Neurology ◽

10.1186/s12883-020-01998-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Nanning Lv ◽

Rui Geng ◽

Feng Ling ◽

Zhangzhe Zhou ◽

Mingming Liu

Keyword(s):

Radiofrequency Ablation ◽

Bone Cement ◽

Recurrence Rate ◽

Tumor Recurrence ◽

Spinal Metastases ◽

Efficacy And Safety ◽

Significant Difference ◽

Group A ◽

Group B ◽

Tumor Recurrence Rate

Abstract Background To investigate the clinical efficacy and safety of bone cement combined with radiofrequency ablation (RFA) in the treatment of spinal metastases. Methods The medical records of patients with spinal metastatic tumor admitted to our hospital from January 2016 to December 2018 were retrospectively analyzed. Based on different surgical methods, the patients were divided into groups A (treated with RFA combined with bone cement) and B (treated with bone cement only). Group A included 35 patients with 47 segments of diseased vertebral bodies. Group B consisted of 52 patients with 78 vertebral segments. Pain, quality of life score, vertebra height, bone cement leakage, postoperative tumor recurrence, and complications were assessed 3 days and 1 and 6 months after surgery. Results All the patients had smooth operation without paraplegia, spinal cord injury, and perioperative death. Visual analogue scales (VAS) and Oswestry Disability Index (ODI) scores of the two groups significantly improved 3 days and 1 month after surgery compared with those before surgery (P < 0.05), but no significant difference was observed between the two groups (P > 0.05). Six months after surgery, the VAS and ODI scores of patients in group A were lower than those in group B, with statistically significant differences (P < 0.05). The postoperative vertebral body height of the two groups significantly increased compared with that before surgery, and the difference was statistically significant (P < 0.05). Meanwhile, no significant difference was observed between the two groups (P > 0.05). Postoperative bone cement permeability in group A was 6.4%, and postoperative tumor recurrence rate was 11.4%. The permeability of bone cement in group B was 20.5%, and the tumor recurrence rate was 30.8%. The bone cement permeability and tumor recurrence rate in group A were lower than those in group B, with statistically significant differences (P < 0.05). Conclusions Bone cement combined with RFA for the treatment of spinal metastases can achieve good efficacy, desirable analgesic effect, low incidence of complications, small surgical trauma, and high safety. The proposed method has the value of clinical popularization and application.

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Prediction of the relationship of cesarean section scar niche and postmenstrual spotting: is there any relation?

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-022-00699-y ◽

2022 ◽

Vol 53 (1) ◽

Author(s):

Kirollos Wagdy Bandry ◽

Hisham Abou-Taleb ◽

Gehan S. Seifeldein ◽

Mohamad Gaber Taha ◽

Omran Khodary Qenawy

Keyword(s):

Cesarean Section ◽

Gold Standard Method ◽

Group A ◽

Magnetic Resonance Imaging Mri ◽

Group B ◽

Relationship Of ◽

The Relationship ◽

B 31 ◽

Scar Width

Abstract Background Postmenstrual spotting has recently been related to a discontinuation of the myometrium at the site of a previous cesarean section called "CS scar niche". There was no consensus regarding the gold standard method for the assessment of the niche. Recently, Magnetic resonance imaging (MRI) has shown promise in the evaluation of the niche. Our study aims to assess the role of MRI in the evaluation of the CS scar niche characters and its association with post-menstrual spotting. Results A total of 65 patients with CS niche were prospectively included in this study and subdivided into two groups, according to presence or absence of postmenstrual spotting (Group A; 34 patients with postmenstrual spotting and Group B; 31 patients without spotting). All patients were examined using a 1.5 T MRI unit. CS scar niche volume was significantly higher among women with post-menstrual spotting (0.57 ± 0.07 vs. 0.07 ± 0.05 (cm3); P < 0.001). Also, women with post-menstrual spotting have significantly higher scar length (9.38 ± 3.06 vs. 5.02 ± 2.10 (mm); P < 0.001), scar depth (6.95 ± 3.16 vs. 3.23 ± 0.99 (mm); P < 0.001), scar width (15.78 ± 3.94 vs. 9.87 ± 1.84 (mm); P < 0.001) in comparison to those without post-menstrual spotting. Scar depth (> 7.4 mm) had 81% sensitivity and 97% specificity for prediction of post-menstrual spotting with overall accuracy was 88.7%. While scar width (> 12.8 mm) had 71% sensitivity and 97% specificity for prediction of post-menstrual spotting with overall accuracy was 83.3%. Scar volume (> 0.15 cm3) had 97% sensitivity and 100% specificity for prediction of post-menstrual spotting with overall accuracy was 98.4%. Conclusion MRI measures (CS scar volume, depth, and width) are predictors for postmenstrual spotting in patients with CS scar niche, and scar volume is the most powerful predictor.

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Complications of Radiofrequency Ablation for Hepatic Hemangioma: A Multicenter Retrospective Analysis on 291 Cases

Frontiers in Oncology ◽

10.3389/fonc.2021.706619 ◽

2021 ◽

Vol 11 ◽

Author(s):

Shilun Wu ◽

Ruize Gao ◽

Tao Yin ◽

Ruhang Zhu ◽

Shigang Guo ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Major Complication ◽

Hepatic Hemangioma ◽

Technical Success ◽

Group A ◽

Major Complication Rate ◽

Delayed Complications ◽

Group B ◽

Hepatic Hemangiomas

PurposeTo report the complications of radiofrequency ablation (RFA) for hepatic hemangioma.Patients and MethodsInvestigators from six centers performed RFA for hepatic hemangioma and used a standardized follow-up protocol. Data were collected from 291 patients, including 253 patients with hepatic hemangioma 5 to 9.9 cm in diameter (group A) and 38 with hepatic hemangioma ≥ 10 cm (group B). Technical success, complete ablation, and complications attributed to the RFA procedure were reported. Analysis of variance was used to determine whether the major complication rate was related to tumor size or clinical experience.ResultsA total of 304 lesions were treated in 291 patients. Technical success was achieved without adverse events in all cases. A total of 301 lesions were completely ablated, including 265 of 265 (100%) lesions in group A, and 36 of 39 (92.31%) in group B. The rate of technology-related complications was similar in groups A and B (5.14% (13/253) and 13.16% (5/38), respectively; P = 0.121). Moreover, all technology-related complications occurred during the early learning curve period. The rate of hemolysis-related complications in two groups were 83.40% (211/253) and 100% (38/38) (P =0.007) and the systemic inflammatory response syndrome-related complications in two groups were 33.99% (86/253) and 86.84% (33/38) (P<0.001). There were no delayed complications in either group.ConclusionRFA is minimally invasive, safe, and effective for hepatic hemangiomas 5 to 9.9 cm in diameter. More clinical data are needed to confirm the safety of RFA for hepatic hemangiomas ≥ 10 cm.

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The Pathophysiology and Progression of Hip Osteoarthritis Accompanied with Joint Pain are Potentially Due to Bone Alterations - Follow-up Study of Hip OA Patients

The Open Rheumatology Journal ◽

10.2174/1874312901408010046 ◽

2014 ◽

Vol 8 (1) ◽

pp. 46-53 ◽

Cited By ~ 6

Author(s):

Mikio Kamimura ◽

Yukio Nakamura ◽

Shigeharu Uchiyama ◽

Shota Ikegami ◽

Keijiro Mukaiyama ◽

...

Keyword(s):

Joint Pain ◽

Hip Osteoarthritis ◽

Pain Scale ◽

Bone Changes ◽

Group A ◽

Signal Changes ◽

Magnetic Resonance Imaging Mri ◽

Group B ◽

Short Time

Objectives : This study examined hip osteoarthritis (OA) patients with joint pain and accompanying signal changes detected by magnetic resonance imaging (MRI). Methods : A total of 19 hip OA patients with suddenly occurring or worsening pain regardless of Kellgren-Lawrence grading were enrolled. The patients were monitored using MRI, plain radiographs, and the Denis pain scale for a minimum of 6 months. The patients were classified into 2 groups: those whose pain improved during conservative treatment (Group A) and those whose pain persisted (Group B). Results : Joint pain disappeared or was markedly improved in all 10 cases in Group A. Radiographic OA progression occurred in 7 of 8 cases with available radiographs. Hip MRI was performed on 7 of 10 patients, among whom bone signal changes disappeared in 6 patients. One patient exhibited persisting bone signal alterations although joint pain had completely disappeared. In Group B, joint pain remained in all 9 cases. Radiographic OA progression occurred in 8 of 9 cases, and local (4 cases) or broad (5 cases) bone signal alterations were present in end-point MRI examinations. Two patients exhibited different regional MRI bone signal changes (local or broad) at the end of follow-up. The mean age of Group B was significantly higher than that of Group A. Conclusion : This study uncovered the following observations: 1) hip OA with joint pain had bone alterations that were detectable by MRI, 2) these bone alterations disappeared when joint pain improved, 3) bone alterations remained when joint pain continued, and 4) radiographic OA progressed to a more advanced stage over a short time period. These findings indicate that the pathophysiology of OA, joint pain, and OA progression may primarily be due to bone changes.

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MLTI-13. RESPONSE ASSESSMENT OF MELANOMA BRAIN METASTASES TREATED BY STEREOTACTIC RADIOTHERAPY OR IMMUNOTHERAPY OR BOTH: A COMPARISON OF RECIST 1.1, RANO AND iRANO CRITERIA

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz014.072 ◽

2019 ◽

Vol 1 (Supplement_1) ◽

pp. i17-i17

Author(s):

Emilie Le Rhun ◽

Fabian Wolpert ◽

Maud Fialek ◽

Patrick Devos ◽

Nicolaus Andratschke ◽

...

Keyword(s):

Brain Metastases ◽

Stereotactic Radiotherapy ◽

Small Sample Size ◽

Response Assessment ◽

Small Sample ◽

Braf Mutations ◽

Recist 1.1 ◽

Mri Scans ◽

Group A ◽

Group B

Abstract BACKGROUND: The evaluation of response for brain metastases (BM) may be challenging in the context of treatment by stereotactic radiotherapy (SRT) or immunotherapy or both. METHODS: We reviewed clinical and neuroimaging data of 62 melanoma patients with newly diagnosed BM treated by the combination of immunotherapy and SRT (n=33, group A), immunotherapy alone (n=10, group B) or SRT alone or in combination with other systemic therapies (n=19, group C). Response was assessed using RECIST 1.1, RANO or iRANO criteria. RESULTS: BRAF mutations were noted in 26 patients. 54 patients (87%) had 1–3 metastases. The median DS-GPA was 3. After a median follow-up of 30.5 months, 39 patients have experienced CNS progression, 16 (48.5%) in group A, 9 (90%) in group B, 14 (73.5%) in group C. Median PFS was 129.5 days (range 82–532) in group A, 75 days (range 35–203) in group B, 136 days (range 59–514) in group C. Forty-seven patients (76%) had died at the time of the analysis, 22 (66.5%) in group A, 7 (70%) in group B, 18 (94.5%) in group C. Median OS was 345 days (range 65–1824) in group A, 174.5 days (range 50–1361) in group B, 409 days (range 102–1244) in group C. 52 MRI scans were available for central review: pseudoprogression was documented in 9 patients (29%) in group A, 0 (0%) in group B, 5 (29.5%) in group C. Response rates were similar with all three sets of response criteria. Progressive disease was less often called when applying iRANO to assess SRT target lesions. CONCLUSIONS: Despite the retrospective nature and the small sample size, these data may indicate that the omission of SRT from first-line treatment may compromise outcome. Pseudoprogression is uncommon with immunotherapy alone; pseudoprogression rates were similar after SRT alone or in combination with immunotherapy or other systemic treatment.

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