| Purpose:（1） To assess the clinical value of radioactive iodine-125seed implantation forliver and retroperitoneal intractable disease.（2） To explore the three dimensionsnavigation in improving the three dimensional space positioning accuracy of seedimplantation under the real time ultrasound patterns, and overcome the problems ofseeds distribution on the three-dimensional space.Methods:1. Clinical study （1）: From July2010to January2012,13patients of17nodules with liver intractable disease received radioactive iodine-125seed implantation.The change of the tumor size, contrasted enhanced image appearances and theassociated complications were observed.（2）: Form July2010to March2012,14patients of19nodules with retroperitoneal intractable disease received radioactiveiodine-125seed implantation. The change of the tumor size, contrasted enhanced imageappearances and the associated complications were observed.2. Experimental study:Aiding by the dynamic three-dimensional images fusion navigation system, a simulationexperimental system was established for the seeds implantation surgery of multi-needlepuncture operations. The preoperative computed tomography （CT） was used for a realpatient by the experiment. Nine doctors （3doctors were resident physician,3doctorswere attending physician and3doctors were botanic physician） performed theexperiment with the aid of two-dimensional images information and the aid ofthree-dimension images respectively. We recorded the operation time, puncture timesand the tumor coverage.Results:1. Clinical study （1）: Iodine-125seed implantations were performedsuccessfully in all patients. Among the17lesions,3obtained complete responses,10obtained partial responses，2obtained no changes and1obtained progressive diseaseduring the follow up.3patients had fever,4patients had bleeding,6patients felt acheand3patients’ hepatic function showed transient increase.（2） Iodine-125seed implantations were performed successfully in all patients. Among the19lesions,5obtained complete responses,9obtained partial responses,2obtained no changes and3obtained progressive disease during the follow up.3patients had fever,4patients hadbleeding,6patients felt ache and3patients’ hepatic function showed transient increase.（2） Iodine-125seed implantation was performed successfully in all patients.Completeresponse3, partial response11, no change2，progressive disease3in19nodules duringthe follow up,4patients had fever,4patients had bleeding and6patients felt ache.2.Experimental study: Navigation experiments for seeds implantation showed that thetumor coverage in the three-dimension group was higher than the two-dimensionalgroup in all classes, however the operation time and the puncture time is prolonged onthe whole. The results of various technical groups’ comparison are that the tumorparameters of three-dimensional navigation assisted implantation （3D） are higher thanthat of two-dimensional ultrasound （2D） guided125I particles implantation. Thenavigation experiments have most obviously assisting effects on the primary group, andpull together the level between junior group and senior group.Conclusions:（1） Iodine-125seed implantation for liver intractable disease with thefailure of other treatment is effective, safe and easy-operated, but the long-term effectremains further follow-up observation.（2） Iodine-125seed implantation is safe,minimally invasive and effective with fewer complications for retroperitonealintractable disease.（3） Navigation experiments for seeds implantation showed that thisdynamic three-dimensional images fusion navigation system could achieve assistantfunction for all practitioners. According to three-dimensional space positioninginformation provided from this dynamic three-dimensional images fusion navigationsystem, tumor coverage is higher than that generated from two-dimensional ultrasoundimages information. This system can help surgeons get a better stereotactic viewingangle in how to uniformly distribute seeds and timely prevent the phenomenon of seedsomission. |
PDF Full Text Request