For the treatment of vertebral metastases,percutaneous vertebral augmentation can effectively relieve pain,stabilize vertebrae,and prevent and treat pathological fractures.Bone cement leakage is the most common complication of percutaneous vertebral augmentation.Most bone cement leakages are asymptomatic and no special management is required,but close attention should be paid to some rare and serious complications caused by bone cement leakage.This paper aims to make a comprehensive review about the advances in percutaneous vertebral augmentation for vertebral metastases,focusing on the technical features,characteristics of bone cement,types of bone cement leakage,leakage-related factors and their preventive measures,etc.

Objective To investigate the short-term efficacy of CT-guided microwave ablation(MWA)combined with percutaneous vertebroplasty(PVP)for spinal metastases,and to analyze the risk factors for postoperative cement leakage.Methods The clinical data of 50 patients with spinal metastases(74 diseased vertebrae in total),who were treated with CT-guided MW A combined with PVP at the authors'hospital from January 2020 to June 2023,were retrospectively analyzed.Numerical Pain Rating Scale(NRS),daily morphine consumption(DMC)and Activity of Daily Living Scale(ADL)were used to evaluate the short-term efficacy.Regular postoperative CT reexamination was carried out to assess the condition of local tumor control and bone cement leakage.Univariate analysis and multivariate binary logistic analysis of gender,age,maximum diameter of metastatic lesion,type of metastasis,Tomita classification of primary tumor,level of affected vertebrae,injected volume of bone cement,injection side,pathological fracture,and posterior vertebral wall rupture were performed to determine the risk factors for postoperative occurrence of bone cement leakage.Results The preoperative,and the postoperative one-day,one-week,one-month,3-month and 6-month NRS were(7.24±1.41),(4.76±1.45),(3.42±1.34),(2.86±0.90),(2.20±0.57),(1.66±0.72)points respectively.The preoperative,and the postoperative one-day,one-week,one-month,3-month and 6-month DMC were(110.40±94.61),(66.10±51.23),(47.30±37.49),(32.90±22.84),(25.60±18.97),(15.36±13.43)mg respectively.The preoperative,and the postoperative one-week,one-month,3-month and 6-month ADL were(40.80±11.45),(53.20±6.68),(60.40±5.14),(62.90±4.75),(64.80±4.51)points respectively.The differences in NRS,DMC,ADL between their preoperative values and postoperative 6-month values were statistically significant(all P＜0.05).Postoperative 6-month imaging follow-up check revealed that tumor was controlled in 46 patients and the tumor recurrence rate was 8％(4/50),and mild bone cement leakage occurred in 17 of 74 vertebrae(22.97％).Multivariate regression analysis indicated that pathological fracture(OR=9.581,95％CI=2.292-40.055,P=0.002)and rupture of posterior wall of vertebra(OR=5.105,95％CI=1.041-25.022,P=0.044)were the independent risk factors for bone cement leakage,the pathological fracture(OR=35.333,95％CI=4.029-309.840,P=0.001)was the independent risk factor for cortical bone cement leakage.No independent risk factor for vascular bone cement leakage was observed.The rupture of posterior wall of vertebra(OR=48.400,95％CI=4.725-495.753,P=0.001)was the independent risk factor for leakage of bone cement in spinal canal.Conclusion MW A combined with PVP can rapidly relieve pain,improve the ability of daily activity and quality of life of patients with spinal metastases,which can be further improved within 6 months after treatment.The combination use of MW A and PVP carries lower incidence of bone cement leakage.The pathological fracture and posterior wall rupture of vertebra are the independent risk factors for bone cement leakage.

With the development of low-dose chest computed tomography(CT)and artificial intelligence,the detection rate of multiple pulmonary nodules has been increased year by year.Surgical resection is the preferred treatment for high-risk pulmonary nodules,but some multiple pulmonary nodules cannot be treated surgically for various reasons,so ablation therapy can be used as an alternative to surgical procedures.This paper aims to make a comprehensive review about the research progress in the treatment of multiple pulmonary nodules,focusing on the percutaneous ablation,transbronchial ablation,ablation combined with surgery,ablation combined with drug therapy,etc.

Colorectal cancer(CRC)is one of the most common malignant tumors worldwide,metastasizing most commonly to the liver and lung.Local treatment of pulmonary oligometastases from CRC has an important position in the therapeutic course of the disease,sometimes local therapy is the key to achieve a disease-free state.Surgery is the preferred treatment for pulmonary oligometastases from CRC,but some patients are unable to undergo surgery due to physical conditions or lesion's anatomical location limitations.Because of its minimally-invasive manipulation,repeatable adoption,maximum preservation of lung parenchyma and lung function,and the potential to cure new or recurrent lung metastases,percutaneous ablation therapy has emerged as an important surgical alternative,and its clinical application has been increasing in recent years.Percutaneous ablation techniques mainly include radiofrequency ablation(RFA),microwave ablation(MWA),and cryoablation(CA).RFA produces thermal effect through high-frequency electrical current,and it is easy to operate and applicable for a wide range of treatments.MW A uses efficient microwave heating technique and its energy distribution is uniform,suitable for larger lesions.Through repeated freeze-thaw cycles CA destroys tumor tissues,which is particularly suitable for the lesions near important structures.Besides,percutaneous ablation combined with surgery,medication,etc.can be used for the treatment of pulmonary oligometastases from CRC,this kind of combination therapy has synergistic effect to enhance the curative efficacy.This paper aims to make a comprehensive review about the importance of treating pulmonary oligometastases from CRC,the efficacy,prognosis,and influencing factors of various percutaneous ablation techniques,and the application progress of ablation combined with other therapies.

Clinically,polycystic liver disease(PLD)is a rare genetic disease.Most patients have no clinical symptoms,and a few patients with symptomatic PLD complicated by serious complications need to be treated.Liver transplantation is the only radical treatment for patients with symptomatic PLD.However,most patients are not able to receive liver transplantation due to a lack of donors,expensive surgical cost,and high risk.Because of its many advantages such as less trauma,fast recovery,repeatable,high safety and fewer complications,the minimally-invasive interventional techniques,represented by percutaneous cyst sclerotherapy and transcatheter arterial embolization,have been successfully employed for the treatment of symptomatic PLD in recent years,moreover,its clinical effect has been recognized by both doctors and patients.Therefore,as it can improve the local symptoms and the quality of life of patients,the therapy using minimally-invasive interventional technique will become the development direction for the treatment of symptomatic PLD.This article aims to make a comprehensive review concerning the principle,mechanism,guiding mode,clinical application,advantages and disadvantages,and related complications of percutaneous cyst sclerotherapy and transcatheter arterial embolization therapy in the treatment of symptomatic PLD.

Large hepatocellular carcinoma,of which diameter is considered to be ≥ 5 cm,has mostly invaded vascular system or been liver function reserve loss when found,resulting in opportunities to surgical therapy are lost.Combined interventional therapy based on transcatheter arterial chemoembolization (TACE) has become one of the main treatments for the surgically unresectable large hepatocellular carcinoma.In particular,TACE combined local ablation has gradually replaced the interventional therapy model of TACE alone.The current combination therapy is mainly sequential combination.With the development of imaging equipment,real-time synchronization is becoming increasingly important and has become one of the current research hotspots.This article focuses on the research status and perspectives of image guidance,local ablation methods,the order of the joint,the number of times and the timing of the joint situation of TACE combined local ablation in treatment of large hepatocellular carcinoma.

Hepatocellular carcinoma is a commonly-seen malignant tumor with high morbidity and mortality all over the world.With the rapid development of molecular biology and scientific technology,in treating HCC the use of nano knife technology,which is developed on the principle of irreversible electroporation,has come into clinicians' consideration.The authors are hereby making a comprehensive review about nano knife,focusing on the principles of nano knife therapy for liver cancer,the advantages of nano knife,and the latest developments in clinical practice and researches,etc.

Objective: To investigate the clinical effect of ultraselective transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC) originating from the caudate lobe. Methods: A retrospective analysis was performed for 13 patients with solitary HCC originating from the caudate lobe who were admitted to Department of Interventional Radiology in PLA General Hospital from March 2013 to December 2016. A 2.6-F microcatheter was used to perform ultraselective TACE, and the embolization material was ultra-liquefied iodinated oil. The number of tumor-feeding arteries, success rate and short-term efficacy of ultraselective technique, and long-term survival were evaluated after surgery. Results: Of all patients, 8 (61.5%) had a single tumor-feeding artery and 5 (38.5%) had multiple tumor-feeding arteries. The success rate of ultraselective technique was 84.6% (11/13). The complete remission rate at 1 month after ultraselective TACE was 63.6% (7/11). During the follow-up period after the expiration date, 10 out of 11 patients who underwent successful ultraselective TACE survived, and one out of two patients who underwent failed ultraselective TACE survived. Conclusion Ultraselective TACE has good feasibility, clinical effect, and safety in the treatment of HCC originating from the caudate lobe, with an important clinical significance in the prognosis of such disease.

Objective To discuss the method, therapeutic effect and safety of CT-guided 125I radioactive seed implantation for the treatment of cervical lymph node metastasis. Methods CT-guided 125I radioactive seed implantation was performed in 32 patients with pathologically proved cervical lymph node metastasis Results The local effective control rates of the cervical lymph node metastasis at one, 3, 6 and 12 months after the treatment were 81.3%(26/32), 84.4%(27/32), 93.7%(30/32) and 87.5%(28/32) respectively. Conclusion For the treatment of cervical lymph node metastasis, CT-guided 125I radioactive seed implantation is technically simple and clinically safe with reliable curative effect; this treatment is very effective in improving local tumor control rate.

Objective To evaluate the CT appearances and diagnostic value of calcific metastases originated from the alimentary system mucous carcinoma.Methods CT appearances of calcific metastases originated from the alimentary system mucous carcinoma confirmed by surgery and pathology were retrospectively analysed.Results Calcification inside the metastatic tumors could be seen in all 9 patients.The calcification was multiple in 6,single in 3;4 lesions were in the brain and 5 in the liver.The calcific rate of tumors was 100%.Conclusion The metastases originated from malignant tumors of alimentary system are easy appearing calcification,CT scanning plays an important role in diagnosing the calcific metastases.