CT-Guided Percutaneous Microwave Ablation of Tumors in the Hepatic Dome: Assessment of Efficacy and Safety

Asvadi, Nazanin H.; Anvari, Arash; Uppot, Raul N.; Thabet, Ashraf; Arellano, Ronald S.

doi:10.1016/j.jvir.2016.01.010

Cited by 41 publications

(26 citation statements)

References 28 publications

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“…Immediate re-ablation was performed in 48 lesions leading to an overall technical success rate of 96%, which was knowingly not 100% due to safety concerns in the remaining 11 lesions. Comparable technical success rates were shown for lesions in challenging intrahepatic locations, corresponding to previously reported success rates after MWA of tumors in the hepatic dome of between 73 and 94% (20,41). Due to the possibility of navigated positioning of multiple parallel probes, the same technical success rate was also shown when targeting larger lesions.…”

Section: Targeting Errors Might Have Been Minimally Influenced Bysupporting

confidence: 75%

Stereotactic Image-Guided Microwave Ablation for Malignant Liver Tumors—A Multivariable Accuracy and Efficacy Analysis

et al. 2020

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Background: Therapeutic success of thermal ablation for liver tumors depends on precise placement of ablation probes and complete tumor destruction with a safety margin. We investigated factors influencing targeting accuracy and treatment efficacy of percutaneous stereotactic image-guided microwave ablation (SMWA) for malignant liver neoplasms. Materials and methods : All consecutive patients treated with SMWA for malignant liver tumors over a 3-year period were analyzed. A computed tomography-based navigation system was used for ablation probe trajectory planning, stereotactic probe positioning, and validation of probe positions and ablation zones. Factors potentially influencing targeting accuracy [target positioning error (TPE)] and treatment efficacy within 6 months [ablation site recurrence (ASR)] were analyzed in a multivariable regression model, including challenging lesion locations (liver segments I, VII, and VIII; subphrenic location). Results: Three hundred one lesions (174 hepatocellular carcinomas, 87 colorectal liver metastases, 17 neuroendocrine tumors, and 23 others) were targeted in 191 interventions in 153 patients. The median TPE per ablation probe was 2.9 ± 2.3 mm (n = 384). Correction of ablation probe positions by repositioning was necessary in 4 out of 301 lesions (1%). Factors significantly influencing targeting accuracy were cirrhosis (R 0.67, CI 0.22-1.12) and targeting trajectory length (R 0.21, CI 0.12-0.29). Factors significantly influencing early ASR were lesion size >30 mm (OR 5.22, CI 2.44-11.19) and TPE >5 mm (OR 2.48, CI 1.06-5.78). Challenging lesion locations had no significant influence on targeting accuracy or early ASR. Conclusions: SMWA allows precise and effective treatment of malignant liver tumors even for lesions in challenging locations, with treatment efficacy depending on targeting accuracy in our model. Allowing for many tumors to be safely reached, SMWA has the potential to broaden treatment eligibility for patients with otherwise difficult to target tumors.

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Section: Targeting Errors Might Have Been Minimally Influenced Bysupporting

confidence: 75%

Stereotactic Image-Guided Microwave Ablation for Malignant Liver Tumors—A Multivariable Accuracy and Efficacy Analysis

et al. 2020

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“…A subsequent study of nearly 50 hepatic dome tumors undergoing MWA under CT guidance with the use of artificial ascites demonstrated no increased risk of diaphragmatic injury or hernia. 26 These studies demonstrate that, when applied with caution, MWA can be performed safely near the diaphragm.…”

Section: Microwave Ablation Near the Diaphragmmentioning

confidence: 72%

Hepatic Microwave Ablation in Challenging Locations

Smolock

Shaw

2019

Semin intervent Radiol

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In recent years, there has been increased utilization of microwave ablation (MWA) in the treatment of soft tissue tumors. MWA has several theoretical advantages over radiofrequency ablation (RFA) by achieving a more rapid and sustained heating of tissues, increased efficacy in tissues with poor thermal conductivity, and less susceptibility to heat sink effect. While its greater power output has led to appropriate caution when applying this energy to soft tissue tumors, many commonly held beliefs regarding contraindications to MWA are unsupported by data and have been passed along based on experience with RFA. The goal of this article is to review the use of MWA in challenging clinical situations along with the existing evidence for its use.

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“…Microwave ablation is influenced by the tumor's blood supply and if tumors are close to large vessels and the blood supply is richer. This affects the heat transfer and thereby influences the outcome of the microwave ablation (15–17). CEUS can accurately identify the location of feeding vessels and effectively enhance the tumor microwave ablation inactivation rate.…”

Section: Discussionmentioning

confidence: 99%

Comparison of real-time contrast-enhanced ultrasonography and standard ultrasonography in liver cancer microwave ablation

Yan

Zhang

Sun

et al. 2016

Experimental and Therapeutic Medicine

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Primary liver cancer has a high incidence and high mortality rates, and currently the only viable option is surgery, although there are a number of difficulties related to this method. The aim of the present study was to investigate the potential advantages of the real-time contrast-enhanced ultrasonography (CEUS) for microwave ablation of primary liver cancer. One hundred patients with primary liver cancer were included in the study. The patients were divided into the ordinary ultrasonography and the CEUS groups. For the ordinary ultrasonography group, the ordinary ultrasonography-guided microwave ablation method was used, while microwave ablation under the guidance of CEUS was conducted for the CEUS group. The size of lesions and clearness of the tumor boundary prior to surgery in the two groups were compared. Additionally, postoperative complications and the survival rate were monitored. Lesion boundary areas measured by CEUS were significantly larger than those measured with ordinary ultrasonography. The incidence rate of postoperative pain, fever, intra-abdominal hemorrhage and infection and other complications in the ordinary ultrasonography group were significantly higher than that in the CEUS group. The tumor recurrence rate in the CEUS group was significantly lower than that in the ordinary ultrasonography group. Seventy-two percent of patients in the CEUS group showed no progress, compared to 48% of in the ordinary ultrasonography group. The progress-free survival rate in the CEUS group after 6 months was significantly higher than that in the ordinary ultrasonography group. Disease-free survival time in the CEUS group was considerably longer than the control group. In conclusion, the guidance of real-time CEUS on the primary liver cancer microwave ablation treatment can achieve good intra-operative results. It offers a real-time guidance effect, improves survival time and reduces the incidence of complications.

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CT-Guided Percutaneous Microwave Ablation of Tumors in the Hepatic Dome: Assessment of Efficacy and Safety

Cited by 41 publications

References 28 publications

Stereotactic Image-Guided Microwave Ablation for Malignant Liver Tumors—A Multivariable Accuracy and Efficacy Analysis

Stereotactic Image-Guided Microwave Ablation for Malignant Liver Tumors—A Multivariable Accuracy and Efficacy Analysis

Hepatic Microwave Ablation in Challenging Locations

Comparison of real-time contrast-enhanced ultrasonography and standard ultrasonography in liver cancer microwave ablation

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