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EN
Liver is common place where the cancer occurs primary as well as secondary. Liver resection as a potentially healing method can be performed only in about 20% of patients. Prognosis in group of patients treated non-invasively is bad. Using high frequency thermal ablation which damages the neoplastic tissue in liver may lead to prolongation of life expectancy.The aim of the study was to assess the early results of using the high frequency thermal ablation in patients with primary or secondary cancer.Material and methods. During years of 2001-2007 371 patients underwent the 520 procedures of percutaneous RF thermal ablation under US control. Mean age of patients was 62.47 (19-85 ± 11.63). 175 women and 196 men were treated using this method.Results. There were 10 early complications after thermal ablation (1.92% of procedures, 2.7% of patients). Two of them ended fatal (0.38% of procedures, 0.54% of patients). In seven cases absces formation were observed, one of them was the cause of death due to Clostridium perfingens infection. Cholerrhagia from damaged bile duct in cirrhotic liver caused the peritonitis and subsequent death of patient. Two patients suffered from sub-capsular hematoma of liver. 14 patients also suffered from long lasting pain (more than 14 days).Conclusions. Percutaneous thermal ablation in primary or secondary liver tumors is safe and efficient procedure. Long term follow up will give the knowledge about the real value of the procedure.
2
Content available remote Bleeding Liver Tumor in a Patient on Anticoagulation Therapy – Case Report
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EN
Intraabdominal bleeding is a serious surgical problem, particularly in elderly patients following an anticoagulant therapy. It occurs, that abdominal haemorrhage is the first symptom of hepatocellular carcinoma, mostly in Asians and Africans, occasionally in Europeans. The article's author shows a case of an elderly man, treated by Acenocumarolum, in a haemorrhagic shock. During an operation a bleeding liver tumor was revealed. The surgical team performed an effectual tumor resection and stoped the bleeding.
EN
Intraabdominal bleeding is a serious surgical problem, particularly in elderly patients following an anticoagulant therapy. It occurs, that abdominal haemorrhage is the first symptom of hepatocellular carcinoma, mostly in Asians and Africans, occasionally in Europeans. The article's author shows a case of an elderly man, treated by Acenocumarolum, in a haemorrhagic shock. During an operation a bleeding liver tumor was revealed. The surgical team performed an effectual tumor resection and stoped the bleeding.
EN
The segmentation of liver and liver tumor is an essential step for computer-aided liver disease diagnosis, treatment and prognosis. Although deep convolutional neural networks have contributed to liver and tumor segmentation, their architectures can not maintain spatial details and long-range context information. Besides, the fixed receptive fields of these networks limit the segmentation performance of livers and tumors with variant sizes and shapes. To address above problems, we propose a deep attention neural network which contains high-resolution branch and multi-scale features aggregation for cascaded liver and tumor segmentation from CT images. To be specific, the high-resolution branch can maintain the resolution of the input image and thus preserves the spatial details. The multi-scale features exchange and fusion enable the receptive fields of the network to adapt to liver and tumor with variant shapes and sizes. The appended attention module evaluates the similarities between every two pixels to model the long-range dependence and context information so that the network can segment liver and tumor areas located in distant regions. Experimental results on the LiTS and the 3D-IRCADb datasets demonstrate that our method can generate satisfying performance.
EN
Thermal ablation surgery serves as one of the main approaches to treat liver tumors. The pretreatment planning, which highly demands the experience and ability of the physician, plays a vital role in thermal ablation surgery. The planning of multiple puncturing is necessary for avoiding the possible interference, destroying the tumor thoroughly and minimizing the damage to healthy tissue. A GPU-independent pretreatment planning method is proposed based on multi-objective optimization, which takes the most comprehensive constraints into consideration. An adaptive decision method of closing kernel size based on Jenks Natural Breaks is utilized to describe the final feasible region more accurately. It should be noted that the reasonable procedure of solving the feasible region and the use of KD tree based high dimensional search approach are used to enhance the computational efficiency. Seven constraints are handled within 7 s without GPU acceleration. The Pareto front points of nine puncturing tests are obtained in 5 s by using the NSGA-II algorithm. To evaluate the maximum difference and similarity between the planning results and the puncturing points recommended by the physician, Hausdorff distance and overlap rate are respectively developed, the Hausdorff distances are within 30 mm in seven out of nine tests and the average value of overlap rate is 73.0% for all the tests. The puncturing paths of high safety and clinical-practice compliance can be provided by the proposed method, based on which the pretreatment planning software developed can apply to the interns' training and ability evaluating for thermal ablation surgery.
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