New progress in interventional ultrasound

Interventional ultrasound refers to the diagnostic or therapeutic operations performed under the real-time guidance and monitoring of ultrasound. With the development of modern real-time ultrasound imaging technology, the application of minimally invasive interventional ultrasound diagnosis and treatment technology has blossomed everywhere, involving in many fields such as ultrasound-guided puncture biopsy, drainage, drug injection, tumor ablation treatment, radiation particle implantation and many other fields. At the same time, the means of interventional ultrasound coverage are constantly expanding, from simple ultrasound image-guided to multimodal image fusion to robotic intraoperative ultrasound-guided. 

At present, how to ensure the accuracy and safety of ultrasound-guided tumor ablation therapy is the research frontier and application hotspot of interventional ultrasound, among which the application expansion of contrast-enhanced ultrasound (CEUS) in interventional ultrasound is of important value. The continuous innovation and improvement of ablation technique is also a new trend of future development, and it is an important support to improve the efficacy and safety.

New progress in interventional ultrasound

CEUS facilitates the precision of interventional therapy: 

CEUS assessment can cover the preoperative diagnosis, intraoperative monitoring and evaluation, and postoperative follow-up of tumor ablation therapy in the whole cycle. Preoperative CEUS examination can provide pathological changes about the true size, boundary and internal vascularization of the target lesion, improve the detection rate of lesions and the ability to distinguish benign and malignant lesions, and reduce unnecessary biopsies. In tumor ablation therapy, CEUS can detect the area of residual tumor survival immediately after ablation, thus enabling rapid retreatment and reducing the number of subsequent ablation procedures. After ablation, the measurement and calculation of the lesion volume and reduction rate can evaluate the tumor necrosis and the size change of the lesion area after ablation, detect the local tumor progression and determine the outcome. Thyroid interventional therapy study showed that the one-way complete ablation rate of benign thyroid nodules of different sizes during CEUS ablation was 61.1% (> 3 cm), 70.3% (2~3 cm), and 93.4% (<2 cm), respectively; the ablation volume measured by conventional ultrasound was significantly greater than the follow-up time after ablation (23.17 ± 12.70), and CEUS was an effective means for efficacy assessment.

Safety and innovation of ultrasound-guided ablation:

 In the field of tumor thermal ablation, interventional ultrasound doctors have made a series of technical improvements and innovations, including improving the ablation thermal field, improving the ablation cloth needle strategy, multi-needle combined application, artificial water isolation and other technical means to improve the efficacy and reduce the occurrence of complications. In the field of thyroid cancer ablation, Professor Yu Ming'an and his team from China-Japan Friendship Hospital published a multi-center study of 847 patients with papillary thyroid cancer, and the results showed that the success rate of ablation technology could reach 100%, and the disease progression rate after ablation was only 1.1%. In the field of renal cancer ablation, Professor Yu Jie's team from the General Hospital of the Chinese People's Liberation Army showed for 10 years that microwave ablation is safe and effective in the treatment of T1 renal cancer, and can protect the renal function of patients while inactivating tumors.

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Post time: Feb-15-2023