Microwave ablation in a hepatic porcine model: correlation of CT and histopathologic findings

Awad, Michael M.; Devgan, Lara; Kamel, Ihab R.; Torbensen, Michael; Choti, Michael A.

doi:10.1080/13651820701646222

Cited by 62 publications

(54 citation statements)

References 27 publications

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“…The CT appearance of regions of MV ablation revealed areas of hypodensity and lack of perfusion that did not enhance after the injection of medium contrast, similar to that seen with other methods of thermal ablation (19)(20)(21). The tissue vaporization was shown as air density (21).…”

Section: Comparison With Radiological Findingsmentioning

confidence: 73%

“…Investigations on the influence of vascular occlusion on the lesion size confirmed that this manoeuvre increased the ablated area (8,9,13,19), more in peripheral lesions than in those adjacent to major vessels (19). Interestingly, the effects of the blood flow interruption were greater when it was the portal vein rather than the hepatic artery (probably due to the greater flow of the former and the increased heat-sink effect), and even greater when both these vessels were occluded simultaneously (Pringle manoeuvre) (8,9).…”

Section: Macroscopic Anatomymentioning

confidence: 92%

“…In all of them, the ablated area consisted macroscopically of two different zones with a central white pale area and a 1-3 mm brown perilesional capsule (5,9,11,13,16,(19)(20)(21). Within the pale region, small areas of cavitation were noted, being especially numerous closer to the centre of the lesion.…”

Section: Macroscopic Anatomymentioning

confidence: 99%

“…These were probably derived from the tissue vaporization and bubble formation during the treatment (20,21). Far from the major vessels the lesion shape was circular (20), but near the major vessels it was roughly ellipsoid in shape, becoming more spherical with longer ablation times (19).…”

Section: Macroscopic Anatomymentioning

confidence: 99%

“…Numerous studies have investigated the effects of MW on liver parenchyma in in vivo models (Table 1) ( [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In all of them, the ablated area consisted macroscopically of two different zones with a central white pale area and a 1-3 mm brown perilesional capsule (5,9,11,13,16,(19)(20)(21).…”

Section: Macroscopic Anatomymentioning

confidence: 99%

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Hepatic microwave ablation: a review of the histological changes following thermal damage

Gravante

Ong

Metcalfe

et al. 2008

Liver International

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Microwave (MW) ablation therapy is a local treatment by which tumours are destroyed by coagulation from the passage of MWs into cells. The aim of this review is to examine histological results obtained from preclinical and clinical studies. A literature search was undertaken for all studies focusing on MW therapy and in which lesions were excised for a complete histopathological examination after treatment. Two main zones were described after ablative therapy (central and transitional Microwave (MW) coagulation therapy is a form of local ablation where tumours are destroyed by thermal coagulation that develops from the passage of MWs into cells and the production of frictional movement between molecules (1). Initially developed in the early 1980s to achieve haemostasis along the plane of transection during hepatic resections (2), MW coagulation of tissue surfaces proved slower than electrocautery units and produced deeper areas of tissue necrosis. These two characteristics, while making MW unsuitable for operative haemostasis, are potentially useful in the ablation of liver tumours. Like radiofrequency (RF) ablation and laser-induced interstitial thermotherapy, MW is very versatile and can be performed percutaneously using ultrasound or computed tomography (CT) guidance, or at laparoscopy or laparotomy with intra-operative ultrasound guidance.The formation of the thermal lesion during the ablation process is a complex combination of MW energy absorption, heating conduction and possible tissue water evaporation, condensation and movement. In 2002, Izzo (3) suggested that the production of very small zones of coagulative necrosis by the intratumoral MW-emitting needle electrodes would require frequent repositioning at 5-10 mm intervals to create multiple overlapping zones of coagulative necrosis. He also suggested that MW should not be performed near major bile ducts and blood vessels because of the description of vascular and biliary complications in these locations. However, since the appearance of that review, numerous technical advances have been introduced in MW engineering and subsequently evaluated histologically in a number of preclinical and clinical studies.The aim of this review is to examine those studies and determine the factors that influence the production of an area of ablation and the evidence for its use under different circumstances. Materials and methodsA literature search was undertaken for all studies focusing on MW ablative therapy where lesions were excised for a complete histopathological examination after the treatment.Articles were selected from the MEDLINE, EMBASE and Cochrane Library databases, using the key words microwave, ablation or ablative therapy, liver, hepatic, in vivo, ex vivo, clinical, experimental. Only articles published in the English literature were used. We

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