Objective To evaluate the feasibility and accuracy of virtual navigation contrast enhanced sonography in accurately location of small liver tumors which cannot be detected by conventional sonography during microwave ablation therapy. Methods Twenty-three patients with 28 small liver tumors,which could not be detected by conventional sonography but CT/MRI,underwent microwave ablation with virtual navigation contrast enhanced sonography from January 2015 to March 2017 at Nanfang Hospital. After fusion of images from both sonography and CT/MRI,small liver tumors were ablated under the real-time monitoring of navigated sonography. Virtual navigation contrast enhanced sonography was also utilized to evaluate the efficacy of ablation after the ablation.All patients underwent CT/MRI examination at one month post-ablation to evaluate the efficacy of ablation. Results Virtual navigation system successfully provided image fusion for all patients and all lesions(image fusion efficacy was 100%). All patients underwent virtual navigation contrast enhanced sonography monitored microwave ablation.Only one patient received extra ablation since a small proportion of residual tumor checked after the initial ablation. No severe complications occurred in the present study. One-month after ablation,all patients showed complete ablation by further CT/MRI examinations.Conclusion Virtual navigation sonography can precisely target small liver tumors which are undetected by conventional sonography.Evaluation of lesions and ablation efficacy can be performed with the help of virtual navigation contrast enhanced sonography during the ablation period,which have shown satisfactory clinical efficacy.

OBJECTIVE: To explore the strategy of pregnancy-preserving and maternal- fetal management in patients with primary gynecologic neuroendocrine tumors (gNETs) during pregnancy. METHODS: We performed whole genome sequencing (WGS) for analyzing maternal and fetal somatic and germline single nucleotide variations (SNVs) and small insertions and deletions (InDels) for a 29-year-old pregnant woman diagnosed with stage IB2 large cell neuroendocrine carcinoma (LCNEC) and adenocarcinoma in the cervix. A systematic literature review was performed to explore the strategies for treatment of such rare histological type while maintaining pregnancy. RESULTS: Global case analysis of cervical NETs during pregnancy suggested that negative lymph node metastasis and an early FIGO stage were potentially associated with a good prognosis of the patients. In the case presented herein, a pregnancy-preserving strategy was adopted and favorable maternal-fetal outcomes were achieved after neoadjuvant chemotherapy, radical surgery and postoperative systemic chemotherapy. At 35 CONCLUSIONS Although gNETs in pregnancy are rare and highly risky, pregnancy-preserving managements of gNETs can still be considered and favorable maternalfetal outcomes are possible with proper assessment of the clinical indications and implementation of multimodal treatments. Precise treatment and follow-up strategies based on the results of WGS for risk-reducing intervention of cancer recurrence or occurrence can potentially benefit the patient and the neonate.
Adenocarcinoma ; Adult ; Carcinoma, Neuroendocrine/genetics* ; Child ; Female ; Humans ; Infant, Newborn ; Neoplasm Recurrence, Local ; Pregnancy ; Uterine Cervical Neoplasms/genetics*