Argon Harrow And CTPI Combined Therapy For Liver Cancer

?Background and Purpose?Hepatic cell cancer(HCC),a disease severely threatens human health,has become a global burden that gets heavier every year.Unfortunately,patients can easily ignore their own illness for the disease lacks early stage symptoms.Only when they had clear signs and symptoms did they turn to clinical help but usually that's when they had passed the early stage or at the middle/late stage of the disease.Surgical intervenes are usually inappropriate option then.Many patients are unwilling to undergo surgeries for varies reason,which invokes the emergence of many minimally invasive treatments.Among them,the minimally invasive cryoablation of argon-helium knife shows satisfying effect on treating HCC.Some researchers believe that its curative outcomes can be comparable to open surgeries.In the treating process of argon helium knife,the choice of guiding systems,and even puncture points are all closely related to the postoperative outcomes,complications and recurrence rate.Therefore,an optimized surgical approach is critical.Computed Tomography(CT),as an easily operated,accurate and reusable guiding system that exceeded many others,plays an important role in the treating process of argon helium knife.CT perfusion imaging(CTPI),a novel functional imaging which not only clarifies the morphology of tumors,but also shows the blood supply of tumors,is now widely used in clinical practice.We speculated that CTPI-guided argon-helium treatment on HCC should increase the accuracy and outcomes of this procedure,and provides similar positive effects on HCC follow-ups.?Materials and Methods?Experimental group includes 30 patients with confirmed HCC who had no distant metastases and were eligible for the treatment of argon helium.Preoperative GE 64-slice spiral CT scans were performed to determine the morphological scope of the lesions,the number of argon helium blades and the position of the patient;intraoperative CTPI was used to determine the puncture point;Enhanced CT was performed to evaluate the local efficacy 1 month postoperatively.One-year follow-up was performed including the comparison of recurrence detection rates between enhanced CT and CTPI.Control group includes 30 patients with HCC who were treated with argon helium knife in the past 5 years.Conventional CT scans were performed pre and intraoperatively.Enhanced CT was used to evaluate the local curative effect postoperatively.Observation index:1.Local curative outcomes at 1 month after surgery between experimental group and control group;2.Comparison of adverse reactions at 1 month after surgery between experimental group and control group;3.Comparison of the recurrence detection rate between CTPI and enhanced CT scan in the experimental group 1 year after surgery.All data was analyzed using SPSS17.0,P<0.05 was considered statistically significant.?Main results?1.The local curative outcomes of the experimental group was better than the control group,the result show statistical significance;2.The percentage of postoperative complications in the experimental group was lower than control group;3.The recurrence rate of the experimental group detected by CTPI group was higher,but no statistical significance revealed.?discuss?CT perfusion imaging plays an important role in the treatment of HCC with argon helium.CTPI is a functional imaging technique that analyzes lesions and guides treatment from the angle of blood perfusion.The technique improves the local curative outcomes and reduces postoperative complications.There were no statistically significant difference observed between CTPI and enhanced CT in detection of follow-up recurrence rate.The probable reason might be: the Z-axis coverage of 64-slice spiral CT was only 4cm,which is too narrow for the whole liver perfusion scan covered;patients had unsatisfying respiratory control;and limited the sample size.