肺癌随访概论CT MRI PET-CT
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肺癌消融治疗后随访:CT

时间:2021-07-02 21:23来源:www.ynjr.net 作者:杨宁介入医学网
Main findings - CT follow up CT: availability [velblt], cost-effective, easy to repeat Most often used technique for FU after ablation of a lung tumor Ablation zone: increase in size in the early postoperative period inflammatory changes,
Main findings - CT follow up

CT: availability [əˌveɪlə'bɪlətɪ], cost-effective, easy to repeat
Most often used technique for FU after ablation of a lung tumor 
Ablation zone: increase in size in the early postoperative period
inflammatory changes, hemorrhagic phenomenon, … and safety margins
 
病变 术后第二天: inflammatory changes

安全边界

safety margins

消融的直径对生存率有影响。

651 lung tumors , 12 ± 7 mm (range, 2–42 mm)  The difference between electrode array diameter  and tumor diameter (DAT) median DAT 12 mm
Ihara H. JVIR 2016; 27:87–95
 


The difference between electrode array diameter  and tumor diameter (DAT) is very important for OS. Ihara H. JVIR 2016; 27:87–95


Before 6 months: RF or MW ablation zone is supposed to exceed  the size of the initial tumor (complete ablation).
 

before day 2


M1 M3


Month 3 Month 6




Follow-up after lung ablation


肺癌射频或微波消融后CT的主要发现

After 6 months: the scar decreases in size (complete ablation),  But may remain stable. Long term FU: scar equal or bigger than the initial tumor.
 


  RF


48H M1  Atelectasis


M6 M9

Palussiere J1Lagarde PAupérin ADeschamps FChomy Fde Baere TPercutaneous lung thermal ablation of non-surgical clinical N0 non-small cell lung cancer: results of eight years' experience in 87 patients from two centers.Cardiovasc Intervent Radiol. 2015 Feb;38(1):160-6. 


before D2

 

M1 M3

After 6 months: the scar decreases in size (complete ablation),

M6 M9



Long term FU: scar equal or bigger than the initial tumor.
 
BEFORE M12



  D2



   
   


M1 M3



M3 M3


FIBROSIS

M18 M18

Main issue: Diagnosis of local recurrence
Choice of the reference image is crucial
 
RECIST evaluation: not effective
Best reference image: one month CT
 


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