| Purpose:1. To assess the clinical value of three dimensional visualizationtechnology in radioactive iodine-125seed implantation for liver and retroperitonealintractable disease.2. To assess the clinical value of contrast-enhanced ultrasound(CEUS) technology in evaluating the effect of radioactive iodine-125seedimplantation in malignant tumors.Methods:1.(1) a. Divided the patients with liver tumors who receiced implantedradioactive iodine-125seed implantation into three-dimensional (3D) visualizationpreoperative planning group (20patients with24lesions) and two-dimensional (2D)regular group (40patients with46lesions). Compare and analyes the indexes of thetwo groups, such as the needle number, the number of particles and the effective rate,etc. And evaluate the advantages of3D visualization preoperative planning method inradioactive iodine-125seed implantation for liver tumors. b. Divided the patients withretroperitoneal tumors who receiced implanted radioactive iodine-125seedimplantation into3D visualization preoperative planning group (15patients with16lesions) and2D regular group (20patients with30lesions). Compare and analyes theindexes of the two groups, such as the needle number, the number of particles and theeffective rate, etc. And evaluate the advantages of3D visualization preoperativeplanning method in radioactive iodine-125seed implantation for retroperitonealtumors.(2) Postoperative curative effect evaluation system applied to the patients (35patients with40lesions) who received radioactive iodine-125seed implantation for liver and retroperitoneal tumors. Results from this system were compared to theresults from experts. Finaly, estimate the accuracy of the results through postoperativeenhanced image.2. Patients received radioactive iodine-125seed implantation weredivided into effective group and ineffective group according to the result of enhancedCT. Observing and analyzing the CEUS’s pattern and imaging parameters of the twogroups to assess the clinical value of CEUS technology in evaluating the effect ofradioactive iodine-125seed implantation in malignant tumors.Results:1.(1) a. Iodine-125seed implantations were performed successfully in allpatients of the two groups with liver tumors. There were no serious complicationsoccurred. The effective rate of3D group and2D group were83.3%and71.7%respectively. There were no obvious differences in the needle number and the numberof particles between the two groups(P>0.05). But3D group is higher than2D group ineffective rate(P<0.05). Inthe proportion of added particle number and total number ofimplanted particles,3D group is lower than2D group(P<0.05). b. Iodine-125seedimplantations were performed successfully in all patients of the two groups withretroperitoneal tumors. There were no serious complications occurred. The effectiverate of3D group and2D group were81.3%and66.7%respectively. There were noobvious differences in the needle number and the number of particles between the twogroups(P>0.05). But3D group is higher than2D group in effective rate(P<0.05). Inthe proportion of added particle number and total number of implanted particles,3Dgroup is lower than2D group (P<0.05).(2) Among the40lesions,32were completelycovered and8were considered leaving "cold area" according to the postoperativecurative effect evaluation system. And the judging result from experts was that33were completely covered and7were considered leaving "cold area". The1、2、4、6months after implantation, the32completely covered lesions judged from both thesystem and experts were not found progressing. But the1lesion acquired different judge result from the system and experts was found no progress through enhancedimage after the treatment6months.2.In the time intensity curve of the two groups,there were a steep rise branch and a moderate decline branch. Quantitative parametersin time-intensity curve were analyzed, the results indicated there were no difference inrise time(RT) of contrast and time to peak(TTP) between effective group andineffective group. However, the maximum intensity(Imax) in effective group is lowerthan those of the ineffective group(P<0.05).Conclusions:1.(1) a. Three dimensional visualization preoperative planning inIodine-125seed implantations for liver tumors can optimize the treatment plan andincrease the doctor’s confidence in the treatment. High clinical application value hasbeen found. b. Three dimensional visualization preoperative planning in Iodine-125seed implantations for retroperitoneal tumors has high clinical application value. Itcan optimize the treatment plan and improve the effective rate.(2) Postoperativecurative effect evaluation system has high clinical application value in the Iodine-125seed implantation for liver and retroperitoneal disease. It can reduce the dependencyon experienced doctors.2.CEUS is expected to become one of the practiceexamination in evaluating the effect of radioactive iodine-125seed implantation inmalignant tumors. |
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