Abstract
BackgroundWe evaluated a magnetic resonance (MR)-conditional high-power microwave ablation system.MethodsAn exvivo 1.5-T evaluation was conducted by varying the sequence (T1-weighted volume interpolated breath-hold examination, T1w-VIBE; T1-weighted fast low-angle shot, T1w-FLASH; T2-weighted turbo spin-echo, T2w-TSE), applicator angulation to B0 (A-to-B0), slice orientation, and encoding direction. Tip location error (TLE) and artefact diameters were measured, and influence of imaging parameters was assessed with analysis of variance and post hoc testing. Twenty-four exvivo ablations were conducted in three bovine livers at 80 W and 120 W. Ablation durations were 5, 10, and 15 min. Ablation zones were compared for short-axis diameter (SAD), volume, and sphericity index (SI) with unpaired t test.ResultsThe artefact pattern was similar for all sequences. The shaft artefact (4.4 ± 2.9 mm, mean ± standard deviation) was dependent on the sequence (p = 0.012) and the A-to-B0 (p < 0.001); the largest shaft diameter was measured with T1w-FLASH (6.3 ± 3.4 mm) and with perpendicular A-to-B0 (6.7 ± 2.4 mm). The tip artefact (1.6 ± 0.7 mm) was dependent on A-to-B0 (p = 0.001); TLE was -2.6 ± 1.0 mm. Ablation results at the maximum setting (15 min, 120 W) were SAD = 42.0 ± 1.41 mm; volume = 56.78 ± 3.08 cm3, SI = 0.68 ± 0.05. In all ablations, SI ranged 0.68–0.75 with the smallest SI at 15 min and 120 W (p = 0.048).ConclusionThe system produced sufficiently large ablation zones and the artefact was appropriate for MR-guided interventions.
Highlights
We evaluated a magnetic resonance (MR)-conditional high-power microwave ablation system
With radiofrequency (RF) ablation being the most common representative in the “toolbox” of local therapies, studies have shown that tumour location close to large vessels and size greater
In comparison to RF ablation, MW ablation (MWA) is not limited by desiccation around the applicator, allowing for higher ablation temperatures in larger ablation zones in a shorter time with a single applicator [8, 9]
Summary
We evaluated a magnetic resonance (MR)-conditional high-power microwave ablation system. With radiofrequency (RF) ablation being the most common representative in the “toolbox” of local therapies, studies have shown that tumour location close to large vessels and size greater. In comparison to RF ablation, MWA is not limited by desiccation around the applicator, allowing for higher ablation temperatures in larger ablation zones in a shorter time with a single applicator [8, 9]. Studies have shown that MWA is less susceptible to the heat-sink effect of larger hepatic vessels [10]. A recent meta-analysis has shown lower local recurrence rates after MWA of larger tumours in comparison to RF ablation [11]
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