■尽管常规计算机断层扫描(cCT)是肺部微波消融(MWA)的主流引导设备,C臂CT可以在8秒内提供从2维(2D)数字减影血管造影(DSA)信息重建的3维(3D)CT样图像,强调其作为一种新的指导工具的实用性。进行了这项回顾性病例对照研究,以评估使用cCT和C臂CT引导经皮MWA治疗肺部肿瘤的临床表现。
■从2015年4月到2020年4月,在我们的单中心连续101例接受经皮MWA的孤立性肺肿瘤患者(郑州,中国)分为2组:cCT组(n=56),徒手穿刺,C臂CT组(n=45),与iGuide导航辅助穿刺。主要终点是技术成功,技术功效,穿刺评分(PS),和完全消融(CA)率。次要终点是并发症,中位无进展生存期(mPFS),和中位总生存期(mOS)。
■C臂CT组和cCT组的技术成功率均为100%。C臂CT组和cCT组的技术有效率分别为93.3%和91.1%,分别,差异无统计学意义(P=0.67)。PS(2.9与2.5,P=0.02),总手术时间(TPT;39.3vs.50.0分钟,P<0.001),穿刺时间(PT;12.6vs.15.7分钟,P=0.001),和辐照有效剂量(ED;15.2vs.20.9mSV,P<0.001)显示C臂CT患者与cCT组患者之间的显着性。消融时间(AT;9.1vs.9.6分钟,P=0.36),CA率(93.3%与92.9%,P=0.93),局部肿瘤进展(LTP)率(11.1%vs.8.9%,P=0.98),并发症,mPFS(9.5vs.10.1个月,P=0.52),和mOS(37.9与38.8个月,P=0.67)显示两组之间无统计学差异。
■C臂CT引导对于肺肿瘤MWA和cCT一样可行和有效,可以提高PS和降低TPT。
UNASSIGNED: Although conventional computed tomography (cCT) is the mainstream guidance equipment for lung microwave ablation (MWA), C-arm CT can provide 3-dimensional (3D) CT-like images reconstructed from 2-dimensional (2D) digital subtraction angiography (DSA) information within 8 seconds, highlighting its utility as a new guidance tool. This retrospective
case-control study was performed to evaluate the clinical performance of percutaneous MWA for lung tumors using cCT and C-arm CT guidance.
UNASSIGNED: From April 2015 to April 2020, 101 consecutive patients with solitary lung tumors who underwent percutaneous MWA at our single center (Zhengzhou, China) were divided into 2 groups: the cCT group (n=56), with unarmed puncture, and the C-arm CT group (n=45), with iGuide navigation-assisted puncture. The primary endpoints were technical success, technical efficacy, puncture scoring (PS), and complete ablation (CA) rate. The secondary endpoints were complications, median progression-free survival (mPFS), and median overall survival (mOS).
UNASSIGNED: The technical success rates were 100% in both the C-arm CT group and cCT group. The technical efficacies were 93.3% and 91.1% in the C-arm CT group and cCT group, respectively, with no statistical difference (P=0.67). The PS (2.9 vs. 2.5, P=0.02), total procedure time (TPT; 39.3 vs. 50.0 min, P<0.001), puncture time (PT; 12.6 vs. 15.7 min, P=0.001), and irradiation effective dose (ED; 15.2 vs. 20.9 mSV, P<0.001) showed significances between patients in the C-arm CT and those in the cCT group. The ablation time (AT; 9.1 vs. 9.6 min, P=0.36), CA rate (93.3% vs. 92.9%, P=0.93), local tumor progression (LTP) rate (11.1% vs. 8.9%, P=0.98), complications, mPFS (9.5 vs. 10.1 months, P=0.52), and mOS (37.9 vs. 38.8 months, P=0.67) showed no statistically significant difference between the 2 groups.
UNASSIGNED: C-arm CT guidance is as feasible and effective as cCT for lung tumor MWA, which can increase PS and decrease TPT.