ablation zone

消融区
  • 文章类型: Journal Article
    由于单晶硅的高脆性和低断裂韧性的特点,其高精度和高质量的切割有很大的挑战。针对晶圆切割高效率的迫切需要,本文研究了不同激光工艺对激光切割坡口尺寸和加工影响区的影响规律。实验结果表明,激光切割单晶硅时,除了产生凹槽,在坡口两侧也会有一个加工影响区,两者的大小将直接影响到切削质量。擦拭材料表面切割产生的热产物后,基本可以消除切缝中的加工影响区和重铸层,以产生更宽的切缝,擦拭后的表面与切割前的表面基本相同。增加激光切割次数将增加材料的加工影响区的宽度和切屑去除后的凹槽宽度。当切割次数小于80时,增加切割次数将同时增加凹槽宽度;但是,切割次数超过80次后,凹槽宽度突然减小,然后缓慢增加。此外,激光扫描速度越低,切屑去除后,材料加工影响区的宽度和凹槽的宽度越大。激光频率的增加会增加裂纹宽度和切屑去除后的裂纹宽度,但会降低加工影响区的宽度。激光脉冲宽度对切割质量有一定的影响,但没有表现出规律性。当脉冲宽度为0.3ns时,切割质量最好,而当脉冲宽度为0.15ns时,切割质量最差。
    Due to the characteristics of high brittleness and low fracture toughness of monocrystalline silicon, its high precision and high-quality cutting have great challenges. Aiming at the urgent need of wafer cutting with high efficiency, this paper investigates the influence law of different laser processes on the size of the groove and the machining affected zone of laser cutting. The experimental results show that when laser cutting monocrystalline silicon, in addition to generating a groove, there will also be a machining affected zone on both sides of the groove and the size of both will directly affect the cutting quality. After wiping the thermal products generated by cutting on the material surface, the machining affected zone and the recast layer in the cutting seam can basically be eliminated to generate a wider cutting seam and the surface after wiping is basically the same as that before cutting. Increasing the laser cutting times will increase the width of the material\'s machining affected zone and the groove width after chip removal. When the cutting times are less than 80, increasing the cutting times will increase the groove width at the same time; but, after the cutting times exceed 80, the groove width abruptly decreases and then slowly increases. In addition, the lower the laser scanning speed, the larger the width of the material\'s machining affected zone and the width of the groove after chip removal. The increase in laser frequency will increase the crack width and the crack width after chip removal but decrease the machining affected zone width. The laser pulse width has a certain effect on the cutting quality but it does not show regularity. When the pulse width is 0.3 ns the cutting quality is the best and when the pulse width is 0.15 ns the cutting quality is the worst.
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  • 文章类型: Journal Article
    构建预后列线图,以预测微波消融(MWA)后甲状腺乳头状微小癌(PTMC)患者的消融区消失。
    从2020年4月至2022年4月,回顾性收集接受MWA治疗的PTMC患者。在第1天进行超声(US)或对比增强超声(CEUS),MWA消融后1、3、6、12、18、24个月不雅察疗效。音量,计算每个时间点消融区的体积减少率(VRR)和完全消失率.单因素和多因素logistic回归分析用于确定MWA后消融区消失的预后因素,并建立和验证了列线图。
    72例接受MWA的PTMC患者被纳入本研究。在MWA之后,无肿瘤进展(残留,复发或淋巴结转移)和发生主要术后并发症。28例(38.89%)患者在随访期间经MWA后消融区未完全消失。三个变量,包括年龄(赔率比[OR]:1.216),钙化类型(OR:12.283),多变量分析发现初始最大直径(OR:2.051)是预测MWA后消融区状态的独立预后因素.上述变量和结果通过列线图(C指数=0.847)可视化。
    MWA是一种安全有效的PTMC治疗方法。具有大钙化和较大大小PTMC的老年患者更不可能获得消融区的完全消失。消融区不完全消失与复发无关。
    To construct a prognostic nomogram to predict the ablation zone disappearance for patients with papillary thyroid microcarcinoma (PTMC) after microwave ablation (MWA).
    From April 2020 to April 2022, patients with PTMC who underwent MWA treatment were collected retrospectively. Ultrasound (US) or contrast-enhanced ultrasound (CEUS) was performed at 1 day, 1, 3, 6, 12, 18 and 24 months after MWA to observe the curative effect after ablation. The volume, volume reduction rate (VRR) and complete disappearance rate of the ablation zone at each time point were calculated. Univariate and multivariate logistic regression analysis were used to determine the prognostic factors associated with the disappearance of the ablation zone after MWA, and the nomogram was established and validated.
    72 patients with PTMCs underwent MWA were enrolled into this study. After MWA, no tumor progression (residual, recurrence or lymph node metastasis) and major postoperative complications occurred. The ablation zone in 28 (38.89%) patients did not completely disappear after MWA in the follow-up period. Three variables, including age (odds ratio [OR]: 1.216), calcification type (OR: 12.283), initial maximum diameter (OR: 2.051) were found to be independent prognostic factors predicting ablation zone status after MWA by multivariate analysis. The above variables and outcomes were visualized by nomogram (C-index=0.847).
    MWA was a safe and effective treatment for PTMC. Older patients with macrocalcification and larger size PTMCs were more unlikely to obtain complete disappearance of ablation zones. Incomplete disappearance of ablation zone was not related to recurrence.
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  • 文章类型: Journal Article
    UNASSIGNED:消融区(AZ)的范围在微波消融(MWA)的治疗效果中起着至关重要的作用。本研究的目的是分析影响AZ范围的因素。
    UNASSIGNED:包括四个方面的十四个因素:患者相关因素(性别,年龄),疾病相关因素(肿瘤位置,肝硬化),血清学因素(ALT,AST,总蛋白质,白蛋白,总胆红素,直接胆红素,和血小板),和MWA参数(消融时间,电源,和针头类型)。三位放射科医生使用3D切片器使用多序列MRI来描绘AZ。MATLAB用于计算AZ长度,宽度,和面积最大的部分。采用线性回归分析影响因素。此外,对病毒性肝炎患者进行了亚组分析.
    UNASSIGNED:在2010-2021年间纳入了220例患者,其中290例肿瘤。除了MWA参数,肝硬化和肿瘤位置是影响AZ的重要因素(p<0.001)。肝硬化的标准化系数(β)(肝硬化与非肝硬化)呈阳性,这意味着肝硬化会导致AZ范围的降低。肿瘤位置的β(靠近肝门区,中间区,和外围区)为阴性,表明AZ范围随着肿瘤位置接近肝门而降低。对于病毒性肝炎患者,纤维化4(FIB4)评分是影响AZ的显著因素(p<0.001),贝塔是负的,表明AZ范围随着FIB4的增加而降低。
    未经证实:肝硬化,肿瘤位置,和FIB4会影响AZ范围,在规划MWA参数时应予以考虑。
    The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range.
    Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using 3D Slicer. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis.
    220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased.
    Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
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  • 文章类型: Journal Article
    经皮热疗法是一些实体瘤的重要临床治疗方法。使用有效的图像可视化技术来实时监测治疗过程至关重要,因为治疗区的精确控制直接影响肿瘤治疗的预后。超声用于热疗监测,因为它的实时性,非侵入性,非电离辐射,和低成本的特点。本文介绍了自2011年以来,九种基于定量超声的热疗监测方法及其在过去十年中的进展。针对两种应用对这些方法进行了分析和比较:超声测温和消融区识别。比较和讨论了这些方法的优点和局限性。并提出了未来的发展建议。
    Percutaneous thermal therapy is an important clinical treatment method for some solid tumors. It is critical to use effective image visualization techniques to monitor the therapy process in real time because precise control of the therapeutic zone directly affects the prognosis of tumor treatment. Ultrasound is used in thermal therapy monitoring because of its real-time, non-invasive, non-ionizing radiation, and low-cost characteristics. This paper presents a review of nine quantitative ultrasound-based methods for thermal therapy monitoring and their advances over the last decade since 2011. These methods were analyzed and compared with respect to two applications: ultrasonic thermometry and ablation zone identification. The advantages and limitations of these methods were compared and discussed, and future developments were suggested.
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  • 文章类型: Journal Article
    目的:评价桥本甲状腺炎(HT)对超声(US)引导下早期甲状腺乳头状微小癌(PTMC)射频消融(RFA)消融区范围的影响。
    方法:我们选择了2017年8月至2020年8月接受RFA治疗的772例PTMC患者。他们分为以下两组:(i)“HTPTMC”组中的216例HT患者(224例PTMC)和(ii)“PTMC”组中的556例甲状腺健康患者(573例PTMC)组。我们立即通过对比增强超声(CEUS)评估消融区的范围(最大直径和体积),有一天,RFA后1周。
    结果:在RFA治疗1周时,“HT+PTMC”组的消融区小于“PTMC”组的消融区(最大直径:14.6±3.1mmvs.15.2±3.2mm,体积:0.932±0.498mLvs.1.028±0.540mL,分别,p<.05)。然而,以前没有区别,立即,RFA后一天(p>0.05)。任何患者均未出现危及生命的并发症。
    结论:在RFA治疗1周时,HT患者接受RFA治疗的PTMC的体积比甲状腺健康患者的小。然而,这种现象的确切机制及其临床意义值得进一步研究。
    OBJECTIVE: To evaluate the effect of Hashimoto\'s thyroiditis (HT) on the extent of ablation zone in ultrasound (US)-guided radiofrequency ablation (RFA) for early stages of papillary thyroid microcarcinoma (PTMC).
    METHODS: We selected 772 patients with 797 PTMCs who underwent with RFA from August 2017 to August 2020. They were subdivided into two groups as follows: (i) 216 patients (224 PTMCs) with HT in the \'HT + PTMC\' group and (ii) 556 patients (573 PTMCs) with healthy thyroid in the \'PTMC\' group. We assessed the extent (maximum diameter and volume) of the ablation zone by contrast-enhanced ultrasound (CEUS) immediately, one day, and 1 week following RFA.
    RESULTS: The ablation zone of the \'HT + PTMC\' group was smaller than that of the \'PTMC\' group at 1 week of RFA (maximum diameter: 14.6 ± 3.1 mm vs. 15.2 ± 3.2 mm and volume: 0.932 ± 0.498 mL vs. 1.028 ± 0.540 mL, respectively, p < .05). However, there were no differences before, immediately, and one day post-RFA (p > .05). Life-threatening complications did not develop in any of the patients.
    CONCLUSIONS: RFA-treated PTMCs were smaller in size in patients with HT than in those with a healthy thyroid at 1 week of RFA. However, the exact mechanism underlying this phenomenon and its clinical significance warrant further investigation.
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  • 文章类型: Journal Article
    肝癌是最常见的癌症之一,基于能量的肿瘤消融是一种被广泛接受的治疗方法。肝肿瘤和消融区的自动和鲁棒分割将有助于治疗成功的评估。这项研究的目的是开发和评估一种基于自动深度学习的方法,用于(1)在动脉和门静脉阶段分割肝脏和肝脏肿瘤,用于治疗前CT,(2)在动脉和门静脉阶段分割肝脏和消融区,以进行消融治疗。
    252张CT图像纳入了在大型大学医院接受肝肿瘤消融术的63例患者;每位患者都有治疗前和治疗后的多期CT图像。肝脏的三维体素手动分割,肿瘤和消融区域由放射科医师提供参考标准。用于肝脏和病变分割的深度学习模型最初在公共肝脏肿瘤分割挑战(LiTS)数据集上训练以获得基础模型。然后,应用迁移学习来适应临床训练集上的基础模型,获取动脉和门静脉期图像的肿瘤和消融分割模型。对于建模,2D残余注意力Unet(RA-Unet)用于肝脏分割,基于多尺度贴片的3DRA-Unet用于肿瘤和消融分割。
    在独立测试装置上,所提出的方法在动脉和门静脉阶段的肝脏分割中实现了0.96和0.95的骰子相似系数(DSC),分别。对于肝脏肿瘤,动脉期模型检测灵敏度达71%,DSC为0.64,门静脉期灵敏度为82%,DSC为0.73。对于>0.5cm3的肝脏肿瘤,性能提高到79%的灵敏度,动脉期的DSC0.65,灵敏度86%,门静脉期DSC0.72。对于消融区,该模型对动脉期的检测灵敏度达到90%,DSC为0.83,对门静脉期敏感性为90%,0.89的DSC。
    所提出的深度学习方法可以在多相(动脉和门静脉)和多时间点(治疗前后)CT上提供肝肿瘤和消融区的自动分割,从而能够定量评估治疗成功。
    OBJECTIVE: Liver cancer is one of the most commonly diagnosed cancer, and energy-based tumor ablation is a widely accepted treatment. Automatic and robust segmentation of liver tumors and ablation zones would facilitate the evaluation of treatment success. The purpose of this study was to develop and evaluate an automatic deep learning based method for (1) segmentation of liver and liver tumors in both arterial and portal venous phase for pre-treatment CT, and (2) segmentation of liver and ablation zones in both arterial and portal venous phase for after ablation treatment.
    METHODS: 252 CT images from 63 patients undergoing liver tumor ablation at a large University Hospital were retrospectively included; each patient had pre-treatment and post-treatment multi-phase CT images. 3D voxel-wise manual segmentation of the liver, tumors and ablation region by the radiologist provided reference standard. Deep learning models for liver and lesion segmentation were initially trained on the public Liver Tumor Segmentation Challenge (LiTS) dataset to obtain base models. Then, transfer learning was applied to adapt the base models on the clinical training-set, to obtain tumor and ablation segmentation models both for arterial and portal venous phase images. For modeling, 2D residual-attention Unet (RA-Unet) was employed for liver segmentation and a multi-scale patch-based 3D RA-Unet for tumor and ablation segmentation.
    RESULTS: On the independent test-set, the proposed method achieved a dice similarity coefficient (DSC) of 0.96 and 0.95 for liver segmentation on arterial and portal venous phase, respectively. For liver tumors, the model on arterial phase achieved detection sensitivity of 71%, DSC of 0.64, and on portal venous phase sensitivity of 82%, DSC of 0.73. For liver tumors >0.5cm3 performance improved to sensitivity 79%, DSC 0.65 on arterial phase and, sensitivity 86%, DSC 0.72 on portal venous phase. For ablation zone, the model on arterial phase achieved detection sensitivity of 90%, DSC of 0.83, and on portal venous phase sensitivity of 90%, DSC of 0.89.
    CONCLUSIONS: The proposed deep learning approach can provide automated segmentation of liver tumors and ablation zones on multi-phase (arterial and portal venous) and multi-time-point (before and after treatment) CT enabling quantitative evaluation of treatment success.
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  • 文章类型: Journal Article
    To explore the differences in ablation zone between liver cirrhosis and normal liver background and investigate the effect of hepatic blood flow on ablation zone of RFA.
    Between 2017 and 2019, 203 patients who had liver malignancies and underwent percutaneous RFA with Celon bipolar electrodes enrolled into this study. There were 90 patients had liver cirrhosis and 113 patients had normal liver background. They were 63 females and 140 males with average age of 59.0 ± 10.9 years old. Contrast-enhanced CT/MRI was used to evaluate the ablation zone in one month after RFA. The hepatic flow measurements on CDFI and CEUS were performed before RFA. Correlations between ablation zone versus hepatic flow were assessed using multiple linear regression analysis.
    The average ablation zone in cirrhotic liver was significantly larger than those in normal liver background with 3 cm tip of RF electrodes (length 3.5 ± 0.5 vs 3.1 ± 0.4 cm, p = 0.001; width 2.6 ± 0.3 vs 2.2 ± 0.3 cm, p < 0.001; thickness 2.5 ± 0.3 vs 2.0 ± 0.2 cm, p < 0.001). The similar result was found with three 4 cm tip of RF electrodes (width 3.6 ± 0.5 vs 3.1 ± 0.5 cm, p = 0.019; thickness 3.3 ± 0.5 vs 2.7 ± 0.5 cm, p = 0.002). The multiple linear regression analysis showed arrive time of hepatic vein and portal vein was statistically associated with ablation zone with 3 cm electrodes (p < 0.001, p = 0.001), but explained part of the variance (Adjusted R2=0.294, adjusted R2=0.212).
    The ablation zones of RFA with multi-bipolar electrodes in liver cirrhosis were significantly larger than those in normal liver background, being up to 6 mm in thickness. The hepatic flow parameters partly contributed to the ablation zone.
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  • 文章类型: Comparative Study
    OBJECTIVE: To evaluate the ablation zone diameter (AZD) using six modes of corneal topography after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia and to compare the programmed and postoperative AZDs METHODS: This retrospective comparative study included 86 right eyes in 86 patients who underwent SMILE or FS-LASIK at the Shandong Eye Institute between June 2016 and August 2017. Data were collected preoperatively and at 1, 3, and 6 months postoperatively using the Pentacam system. The AZD was determined using six modes of corneal topography: postoperative axial curvature topography (PACT), postoperative tangential curvature topography (PTCT), difference-axial curvature topography (DACT), difference-tangential curvature topography (DTCT), postoperative front elevation topography (PFET), and difference-corneal thickness topography (DCTT). The difference between the programmed and postoperative AZDs was compared between the groups of two surgical procedures.
    RESULTS: At 3 months, the AZDs measured by PTCT, DTCT, and PFET after SMILE showed a significant decrease, while the AZD by DACT revealed an increase (P < 0.001), and the AZDs measured by PACT, PTCT, DACT, DTCT, PFET, and DCTT after FS-LASIK were all significantly decreased (P < 0.001), as compared with the programmed ablation zone values. The AZDs measured by DACT and DTCT after 3 months were larger in the SMILE group (P < 0.001); likewise, the differences between the programmed and postoperative AZDs were lower in the SMILE group (P < 0.001). Furthermore, PACT, PTCT, DACT, DTCT, and PFET indicated acceptable inter-observer reliability (ICC > 0.75).
    CONCLUSIONS: In the treatment of myopia, the achieved topographic ablation zones after FS-LASIK were smaller than the theoretically designed ones. The AZDs after SMILE were larger than those after FS-LASIK, with an equivalent programmed value. The DACT may be more suitable for measuring postoperative ablation zones in clinic with clearer borders and favorable repeatability. This method may be potential for the measurement of ablation zones and further research on the visual quality after refractive surgery.
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  • 文章类型: Journal Article
    在这项研究中,提出了一种基于超声回波去相关成像的微波诱导消融区(热损伤)监测方法。共进行了15例离体猪肝微波消融(MWA)实验。使用具有7.5MHz线性阵列换能器的商用临床超声扫描仪采集MWA期间不同时间的超声射频(RF)信号。计算了两个相邻帧RF数据的瞬时和累积回波去相关图像。基于阈值累积回波去相关图像获得多项式近似图像。实验结果表明,瞬时回波去相关图像在监测微波引起的热损伤方面优于传统的B模式图像。使用大体病理学测量作为参考标准,使用多项式近似图像估计热病变的平均准确率为88.60%.我们得出结论,瞬时超声回波去相关成像能够监测MWA期间热病变的变化,累积超声回波去相关成像和多项式近似成像对于定量描述热病变是可行的。
    In this study, a microwave-induced ablation zone (thermal lesion) monitoring method based on ultrasound echo decorrelation imaging was proposed. A total of 15 cases of ex vivo porcine liver microwave ablation (MWA) experiments were carried out. Ultrasound radiofrequency (RF) signals at different times during MWA were acquired using a commercial clinical ultrasound scanner with a 7.5-MHz linear-array transducer. Instantaneous and cumulative echo decorrelation images of two adjacent frames of RF data were calculated. Polynomial approximation images were obtained on the basis of the thresholded cumulative echo decorrelation images. Experimental results showed that the instantaneous echo decorrelation images outperformed conventional B-mode images in monitoring microwave-induced thermal lesions. Using gross pathology measurements as the reference standard, the estimation of thermal lesions using the polynomial approximation images yielded an average accuracy of 88.60%. We concluded that instantaneous ultrasound echo decorrelation imaging is capable of monitoring the change of thermal lesions during MWA, and cumulative ultrasound echo decorrelation imaging and polynomial approximation imaging are feasible for quantitatively depicting thermal lesions.
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  • 文章类型: Comparative Study
    OBJECTIVE: The aim of this study was to compare the differences between the ablation region and hyperechoic zones in microwave and radio frequency ablation of different tissues.
    METHODS: Microwave and radio frequency ablation were performed on fresh porcine muscle and liver with different power levels for 90 seconds. These 2 ablation methods were then performed on rabbit liver in vivo using 20 W for 60 seconds. The volumes of the ablation and hyperechoic zones were compared following different ablation methods.
    RESULTS: The ablation zones were significantly greater than the hyperechoic zones (P < .05) with the same power and duration when using 2 ablation methods. The differences of the ablation and hyperechoic zones between muscle and liver tissues were significantly different (P < .05). The difference values of the ablation and hyperechoic zones were also significantly different (P < .05) using 2 ablation methods.
    CONCLUSIONS: The hyperechoic zone may have underestimated the extent of ablation using a specified ablation time. In the same tissue, the hyperechoic zone could more accurately estimate the ablation zones using microwave ablation.
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