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Factors Impacting Microwave Ablation Zone Sizes: A Retrospective Analysis.

René Michael Mathy1, Athanasios Giannakis1,2, Mareike Franke3

  • 1Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, 69120 Heidelberg, Germany.

Cancers
|April 13, 2024
PubMed
Summary

Hepatocellular carcinomas (HCCs) and non-perivascular tumor locations result in larger ablation zone volumes (AZV) after microwave ablation (MWA). The surgical mode of MWA does not significantly increase AZV compared to standard mode.

Keywords:
ablation zonehepatocellular carcinomaliver cirrhosisliver metastasismicrowave ablationthermal ablation

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Area of Science:

  • Interventional Radiology
  • Oncology
  • Medical Physics

Background:

  • Microwave ablation (MWA) is a minimally invasive treatment for liver tumors.
  • Understanding factors influencing ablation zone volume (AZV) is crucial for optimizing MWA efficacy.
  • Intrinsic tumor characteristics and extrinsic factors can affect treatment outcomes.

Purpose of the Study:

  • To evaluate the impact of intrinsic and extrinsic conditions on ablation zone volumes (AZV) following microwave ablation (MWA).
  • To compare AZV achieved with 'standard mode' versus 'surgical mode' MWA.
  • To identify tumor-specific factors influencing MWA effectiveness.

Main Methods:

  • Retrospective analysis of 38 MWA procedures on therapy-naïve liver tumors using the NeuWave PR probe.
  • Ablations were performed in either 'standard mode' (65 W, 10 min) or 'surgical mode' (95 W, 1 min, then 65 W, 10 min).
  • AZV was measured immediately post-ablation using contrast-enhanced computed tomography.

Main Results:

  • AZVs in 'standard mode' were smaller than manufacturer predictions.
  • No significant difference in AZV was observed between 'surgical mode' and 'standard mode' (15.6 ± 7.8 mL vs. 13.9 ± 8.8 mL, p = 0.6).
  • Significantly larger AZVs were found for hepatocellular carcinomas (HCCs) versus metastases (17.8 ± 9.9 mL vs. 10.1 ± 5.1 mL, p = 0.01) and in non-perivascular versus perivascular locations (18.7 ± 10.4 mL vs. 11.7 ± 6.1 mL, p = 0.012).

Conclusions:

  • Hepatocellular carcinomas (HCCs) and non-perivascular tumor locations are associated with larger ablation zone volumes (AZV) in MWA.
  • The 'surgical mode' of MWA does not yield significantly larger AZVs compared to the 'standard mode'.
  • Tumor type and location are significant factors influencing MWA outcomes.