Percutaneous radiofrequency versus microwave ablation for management of hepatocellular carcinoma: a randomized controlled trial

Kamal, Ahmed; Elmoety, Amr Aly Abd; Rostom, Yousri; Shater, Mohamed Said; Lashen, Sameh A

doi:10.21037/jgo.2019.01.34

Cited by 68 publications

(81 citation statements)

References 25 publications

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“…In accordance with inclusion and exclusion criteria, 26 studies with 4396 patients were finally enrolled. [ 25 – 27 , 11 , 28 , 13 , 29 – 36 , 14 , 37 – 43 , 12 , 44 – 46 ] The flowchart is shown in Fig. 1 .…”

Section: Resultsmentioning

confidence: 99%

Radiofrequency ablation versus microwave ablation for early stage hepatocellular carcinoma

Han

Yong-sheng²,

Wang³

2020

Medicine

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Background: Several randomized control trials (RCTs) were conducted to compare microwave ablation (MWA) and radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) over the years. The purpose of this study was to compare the efficacy of RFA and MWA for early stage HCC. Methods: Studies were systematically searched on Emabse, Ovid Medline, PubMed, and Cochrane Library until March 20, 2020. Continuous variables and dichotomous variables were compared using weighted mean difference (WMD) and odds ratio (OR), respectively. For the comparison of overall survival (OS) and disease-free survival (DFS), the hazard ratio (HR) and 95% confidence interval (CI) were extracted from univariate analysis or survival plots. Results: A total of 26 studies (5 RCTs and 21 cohorts) with 4396 patients (2393 patients in RFA and 2003 patients in MWA) were included in our study. Of these patients, 47% received treatment under general anesthesia in the MWA group and 84% in the RFA group (OR = 0.529, P < .001). The median ablation time was reduced in the MWA group (12 minutes) compared with RFA group (29 minutes) (WMD = –15.674, P < .001). In total, 17.6% patients exhibited progression during follow-up in the MWA group compared with 19.5% in the RFA group (OR = 0.877, P = .225). No statistically significant differences were observed between MWA and RFA groups in terms of OS and DFS (HR = 0.891 and 1.014, P = .222 and .852, respectively). Conclusions: MWA exhibited similar therapeutic effects as RFA in the treatment of early stage HCC. Given the shorter ablation time, MWA can be performed under local anesthesia.

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Section: Resultsmentioning

confidence: 99%

Radiofrequency ablation versus microwave ablation for early stage hepatocellular carcinoma

Han

Yong-sheng²,

Wang³

2020

Medicine

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“…Registering the pre-and post-ablation images has been a promising alternative to conventional side-by-side assessment for AMs, which has many advantages as follows (21)(22)(23): (1) faster and more accurate measurement of safety boundaries and (2) clearer observation of the spatial relationship between the tumor and ablation zone. Therefore, an increasing number of registration methods have emerged for evaluating AMs.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration

Jiang

Huang

et al. 2020

Front. Oncol.

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Aim: To assess the ablative margin (AM) after microwave ablation (MWA) for hepatocellular carcinoma (HCC) with a deep learning-based deformable image registration (DIR) technique and analyze the relation between the AM and local tumor progression (LTP). Patients and Methods: From November 2012 to April 2019, 141 consecutive patients with single HCC (diameter ≤ 5 cm) who underwent MWA were reviewed. Baseline characteristics were collected to identify the risk factors for the determination of LTP after MWA. Contrast-enhanced magnetic resonance imaging scans were performed within 1 month before and 3 months after treatment. Complete ablation was confirmed for all lesions. The AM was measured based on the margin size between the tumor region and the deformed ablative region. To correct the misalignment, DIR between images before and after ablation was achieved by an unsupervised landmark-constrained convolutional neural network. The patients were classified into two groups according to their AMs: group A (AM ≤ 5 mm) and group B (AM > 5 mm). The cumulative LTP rates were compared between the two groups using Kaplan-Meier curves and the log-rank test. Multivariate analyses were performed on clinicopathological variables to identify factors affecting LTP. Results: After a median follow-up period of 28.9 months, LTP was found in 19 patients. The mean tumor and ablation zone sizes were 2.3 ± 0.9 cm and 3.8 ± 1.2 cm, respectively. The mean minimum ablation margin was 3.4 ± 0.7 mm (range, 0-16 mm). The DIR technique had higher AUC for 2-year LTP without a significant difference compared with the registration assessment without DL (P = 0.325). The 6-, 12-, and 24month LTP rates were 9.9, 20.6, and 24.8%, respectively, in group A, and 4.0, 8.4, and 8.4%, respectively, in group B. There were significant differences between the two groups (P = 0.011). Multivariate analysis showed that being >65 years of age (P = 0.032, hazard ratio (HR): 2.463, 95% confidence interval (CI), 1.028-6.152) and AM ≤ 5 mm (P = 0.010, HR: 3.195, 95% CI, 1.324-7.752) were independent risk factors for LTP after MWA. An et al. Using Deep Learning for Registration Conclusion: The novel technology of unsupervised landmark-constrained convolutional neural network-based DIR is feasible and useful in evaluating the ablative effect of MWA for HCC.

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“…Microwaves have a higher thermal e ciency than radiofrequency ablation [11] .This is mainly due to the different ways in which microwaves and radiofrequencies interact with tissues. The heat-generating component of radiofrequency ablation is mainly located within a few millimeters around the electrode and is susceptible to tissue carbonization.…”

Section: Discussionmentioning

confidence: 99%

TAE Combined with Microwave Ablation in the Treatment of Rare Giant Hepatic Hemangioma:Case Report and Literature Review

Feng¹,

Chen²,

Mo³

et al. 2020

Preprint

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Background: hepatic hemangioma is the most common benign tumor of the liver. However, patients with large hemangiomas that cause compression symptoms or that are at risk of rupture may need further intervention. It is necessary to explore additional minimally invasive and personalized treatment options.Case presentation: A 47-year-old female was diagnosed with right hepatic hemangioma for more than 10 years. Abdominal contrast-enhanced CT and CEUS revealed that there was a large hemangioma in the right liver, with a size of approximately 95x97x117 mm. Due to the patient's refusal of surgical treatment, hepatic artery embolization was performed in the first stage, then after 25 days of liver protection treatment, the liver function indexes decreased to normal levels. Then, B-ultrasound-guided microwave ablation of the giant hepatic hemangioma was performed. Ten days after the surgery, hepatobiliary ultrasonography showed that the hemangioma of the right liver was smaller than the previous size (the volume was reduced by approximately 30%). Then the patient was discharged from the hospital, and CT suggested that the hepatic hemangioma is significantly smaller two months after discharge. Because of COVID-19, the patient's CT examination was delayed.Conclusions: TAE combined with microwave ablation is a safe and effective minimally invasive treatment for hepatic hemangioma.

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Percutaneous radiofrequency versus microwave ablation for management of hepatocellular carcinoma: a randomized controlled trial

Cited by 68 publications

References 25 publications

Radiofrequency ablation versus microwave ablation for early stage hepatocellular carcinoma

Radiofrequency ablation versus microwave ablation for early stage hepatocellular carcinoma

Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration

TAE Combined with Microwave Ablation in the Treatment of Rare Giant Hepatic Hemangioma:Case Report and Literature Review

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