Hepatic Microwave Ablation in Challenging Locations

Abstract

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.

Iatrogenic Injuries Related to Thermal Ablation of the Liver and Pancreas

“…4 MWA is typically preferred over RFA due to more rapid and sustained heating of tissues, increased efficacy in tissues with poor thermal conductivity, and less susceptibility to heat-sink effect. 5…”

“…4 MWA is typically preferred over RFA due to more rapid and sustained heating of tissues, increased efficacy in tissues with poor thermal conductivity, and less susceptibility to heat-sink effect. 5 Cryoablation utilizes a closed-loop gas expansion system, wherein room temperature gas travels from a high-pressure area to a low-pressure area at the end of the probe tip, where it rapidly expands. This rapid expansion causes a temperature decrease to less than À40°C via the Joule-Thomson effect.…”

Radiología intervencionista en el tratamiento de hepatocarcinoma y metástasis hepáticas: experiencia inicial en Clínica Internacional

“…Muchas series han demostrado que la supervivencia en HCC tratado con RFA se encuentra entre 33-70% a 5 años, comparable con los resultados de las series de resección hepática 11,12,13,14,15,16,17,18…”

Application and evaluation of hydrodissection in microwave ablation of liver tumours in difficult locations

“…Recent studies have shown that hydrodissection can physically separate tumor lesions from adjacent tissues in patients with liver tumors in difficult locations, achieving optimal ablation margins and protecting nearby organs ( 10 , 11 ). Hydrodissection is an established thermal protection method in percutaneous thermal ablation.…”