What is the difference in ablation zone of multi-bipolar radiofrequency ablation between liver cirrhosis and normal liver background? – a prospective clinical study

Hong, Wang; Lee, Jung‐Chieh; Cao, Kejiang; Tang, He-Wen; Wang, Song; Zhang, Zhong-Yi; Wu, Wei; Yan, Kun; Yang, Wei

doi:10.1080/02656736.2020.1838627

Cited by 6 publications

(4 citation statements)

References 40 publications

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“…This increase in ablation volume with increasing fat has been clinically observed and has often been called the "oven effect" with surrounding low thermally conducting tissue retaining high temperatures near the probe-enhancing ablation. These results are consistent with recent clinical findings demonstrating increased ablative critical diameters in both MWA and RFA in fibrosis and fatty liver disease (Amabile et al, 2017;Heerink et al, 2018;Wang et al, 2020;Young et al, 2020;Tsochatzis et al, 2021) as compared to a liver without these conditions. When comparing the simulations with a tumor to that without a tumor, the ablation volumes with the tumor present increased by approximately 4.6%.…”

Section: Ablation and Fatty Liver Diseasesupporting

confidence: 92%

Fat Quantification Imaging and Biophysical Modeling for Patient-Specific Forecasting of Microwave Ablation Therapy

et al. 2022

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Computational tools are beginning to enable patient-specific surgical planning to localize and prescribe thermal dosing for liver cancer ablation therapy. Tissue-specific factors (e.g., tissue perfusion, material properties, disease state, etc.) have been found to affect ablative therapies, but current thermal dosing guidance practices do not account for these differences. Computational modeling of ablation procedures can integrate these sources of patient specificity to guide therapy planning and delivery. This paper establishes an imaging-data-driven framework for patient-specific biophysical modeling to predict ablation extents in livers with varying fat content in the context of microwave ablation (MWA) therapy. Patient anatomic scans were segmented to develop customized three-dimensional computational biophysical models and mDIXON fat-quantification images were acquired and analyzed to establish fat content and determine biophysical properties. Simulated patient-specific microwave ablations of tumor and healthy tissue were performed at four levels of fatty liver disease. Ablation models with greater fat content demonstrated significantly larger treatment volumes compared to livers with less severe disease states. More specifically, the results indicated an eightfold larger difference in necrotic volumes with fatty livers vs. the effects from the presence of more conductive tumor tissue. Additionally, the evolution of necrotic volume formation as a function of the thermal dose was influenced by the presence of a tumor. Fat quantification imaging showed multi-valued spatially heterogeneous distributions of fat deposition, even within their respective disease classifications (e.g., low, mild, moderate, high-fat). Altogether, the results suggest that clinical fatty liver disease levels can affect MWA, and that fat-quantitative imaging data may improve patient specificity for this treatment modality.

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Section: Ablation and Fatty Liver Diseasesupporting

confidence: 92%

Fat Quantification Imaging and Biophysical Modeling for Patient-Specific Forecasting of Microwave Ablation Therapy

et al. 2022

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“…In essence, the sclerotic tissue surrounding the tumor may act as an insulator, increasing the heat inside the tumor and preventing heat loss to the outside, which is known as the "oven effect" (15). An in vitro study also observed that heat is more likely to be deposited inside liver tumors surrounded by cirrhosis (14). Histopathologically, HT is characterized by the destruction of normal thyroid follicular cells due to lymphocytic infiltration, which is responsible for HT-induced hypothyroidism (10).…”

Section: Discussionmentioning

confidence: 99%

“…A cohort study with a short-term (1-week) follow-up reported some differences in the effectiveness of US-guided radiofrequency ablation (RFA) for the treatment of papillary thyroid microcarcinoma (PTMC) between patients with and without HT ( 13 ). Previous studies have also indicated that thermal ablation may achieve better efficacy in the treatment of liver tumors individuals with comorbid liver cirrhosis ( 14 ). This phenomenon can be attributed to the low thermal conductivity of cirrhotic liver tissue, resulting in a higher temperature of the ablated area, known as the “oven effect” ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided microwave ablation for benign thyroid nodules results in earlier and faster nodule shrinkage in patients with Hashimoto's thyroiditis than in those with normal thyroid function

Chen

Liu²,

Jin³

et al. 2023

Front. Surg.

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ObjectivesGiven that the histological features of the thyroid parenchyma in patients with Hashimoto's thyroiditis (HT) differ from those of the normal thyroid gland, HT may affect the effectiveness of ultrasound-guided microwave ablation (MWA) for benign thyroid nodules (BTNs). The present study aimed to compare the effectiveness of MWA for the treatment of BTNs in patients with both BTNs and HT and those with BTNs and normal thyroid function, based on changes in the volume reduction ratio (VRR) of the BTNs.MethodsPatients who had achieved a VRR ≥50% after MWA for BTN (July 2020–June 2021), followed up for 12 months, and their data were retrospectively analyzed.ResultsA total of 213 nodules were identified in 185 patients, including 167 in the “BTN” group and 46 in the “BTN + HT” group. A comparison of the fitting curves for VRR–follow-up time revealed that the VRR increased with time after MWA, although the relationship was nonlinear. Piece-wise linear regression model analysis of the threshold effect of VRR and follow-up time in the two groups indicated that the inflection point of the “BTN” group occurred at 2.1 months: VRR increased fastest within 2.1 months of MWA (rate of change: 32.9% per month; P < 0.001), following which the rate of change was slower and maintained at 1.0% per month (P = 0.006). In the “BTN + HT” group, the inflection point occurred 1.5 months after MWA, with the most significant increase occurring in this period (rate of change: 41.5% per month; P < 0.001), followed by a rate of 2.8% per month (P < 0.001) after 1.5 months.ConclusionsThe relationship between VRR and follow-up time for ultrasound-guided MWA for BTN is nonlinear and exhibits a threshold effect. The current results indicated that the VRR in both groups increased before and after the inflection point, although the rate of change was greater before than after the inflection point. The inflection point occurs earlier in patients with BTN + HT than in those with BTN yet normal thyroid function, and this difference may be related to the “oven effect” involved in the development of HT.

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“…They hypothesized that the fibrotic liver parenchyma functions as a thermal insulator which concentrates heating in the tumor tissue. However, this feature initially confirmed in ex-vivo experimental systems and with computer modelling reported contrasting results in clinical settings [25,26]. Previous prognostic scores [27,28] have been proposed in routine clinical practice for improving the best choice of treatment based on the characteristics of each patient, even if mainly focused on overall and disease free survival.…”

Section: Discussionmentioning

confidence: 99%

Ablation Difficulty Score: Proposal of a new tool to predict success rate of percutaneous ablation for hepatocarcinoma

Conci

D’Onofrio

Bianco

et al. 2022

European Journal of Radiology

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What is the difference in ablation zone of multi-bipolar radiofrequency ablation between liver cirrhosis and normal liver background? – a prospective clinical study

Cited by 6 publications

References 40 publications

Fat Quantification Imaging and Biophysical Modeling for Patient-Specific Forecasting of Microwave Ablation Therapy

Fat Quantification Imaging and Biophysical Modeling for Patient-Specific Forecasting of Microwave Ablation Therapy

Ultrasound-guided microwave ablation for benign thyroid nodules results in earlier and faster nodule shrinkage in patients with Hashimoto's thyroiditis than in those with normal thyroid function

Ablation Difficulty Score: Proposal of a new tool to predict success rate of percutaneous ablation for hepatocarcinoma

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