Combined Biopsy and Imaging-Guided Microwave Ablation by Using a Coaxial Guiding Needle

Yi-Wei Wu,Ivan Kuang Hsin Huang,Uei Pua,Lawrence Han Hwee Quek,Gabriel Chan,Justin Kwan,Gavin Hock Tai Lim

doi:10.5334/jbsr.2345

Yi-Wei Wu, Ivan Kuang Hsin Huang + Show 5 more

Open Access

https://doi.org/10.5334/jbsr.2345

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Abstract

This article demonstrates the technique of using a coaxial guiding needle to perform combined percutaneous biopsy and microwave ablation via a single tract. From May 2019 to July 2020, 14 patients underwent combined biopsy and microwave ablation by using a coaxial guiding cannula. Tumors were in the kidney of six patients (43%), the liver of six patients (43%), and the lung in two patients (14%). The diagnostic yield of biopsy was 86% (12/14). Ablation technical success rate was 100%. In conclusion, using a coaxial guiding needle in microwave ablation and biopsy is safe and effective.

Highlights

In recent years, imaging-guided ablation has been used to treat tumors in different organs
The aim of this article is to describe the technique of using a coaxial guiding needle to perform combined biopsy and microwave ablation (MWA) via a single path and to evaluate its feasibility
Biopsy is performed by a needle with a larger diameter (16G), which may increase the diagnostic yield, as smaller needles (18G) are commonly used in tandem fashion

Summary

Introduction

In recent years, imaging-guided ablation has been used to treat tumors in different organs. Among several modalities of thermal ablation, microwave ablation (MWA) has been proven to be safe and effective in treating tumors in the liver, kidney, and lung [1,2,3]. Combined coaxial biopsy and ablation is such a common practice for radiofrequency ablation (RFA) [4] that an RFA device with an insulated guiding cannula is commercially available (LeVeen, Boston Scientific). There is no commercially available MWA system that provides a guiding cannula compatible with coaxial biopsy and MWA. The aim of this article is to describe the technique of using a coaxial guiding needle to perform combined biopsy and MWA via a single path and to evaluate its feasibility.

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Conclusion