Abstract
To evaluate efficacy of microwave ablation in a primary clinical study, sixty patients (44 men, 16 women; mean age 53 years) with 96, 1-8 cm (mean 3.20 ± 0.17 cm) liver cancers were treated with 2,450-MHz internally cooled-shaft antenna. Complete ablation (CA) and local tumor progression (LTP) rates as well as complications were determined. CA rates in small (<3.0 cm), intermediate (3.1-5.0 cm) and large (5.1-8.0 cm) liver cancers were 96.4% (54/56), 92.3% (24/26) and 78.6% (11/14), respectively. During a mean follow-up period of 17.17 ∓ 6.52 months, LTP occurred in five (5.21%) treated cases. There was no significant difference in the CA and LTP rates between the HCC and liver metastasis patient subgroups (P<0.05). Microwave ablation provides a reliable, efficient, and safe technique to perform hepatic tumor ablation.
Highlights
Imaging-guided thermal ablation using different energy sources continues to gain favor as a minimally invasive technique for the treatment of primary and metastatic hepatic malignant tumors (Ng et al, 2005; Pacella et al, 2005; Cabassa et al, 2006; Clasen et al, 2006; Shibata et al, 2006).Regardless of the primary energy source, all of these modalities induce cellular destruction by means of the direct effects of heat, with irreversible cellular damage occurring at temperatures above 50°C when applied for 4~6 minutes and almost instantaneously at temperatures above 60°C (Goldberg et al, 2006)
Exponential rises in electrical impedances of tumor tissue may result from the application of high RF current, limiting the total amount of energy that can be delivered into tissue (Goldberg et al, 2000).This limits the amount of coagulation that can be achieved
Compared with RF, few data are available on the extent of tumor destruction possible with microwave ablation, especially at frequencies near 2450 MHz, which are used in conventional microwave ovens given optimal heating profiles (Shock et al, 2004; Hines-Peralta et al, 2006)
Summary
Imaging-guided thermal ablation using different energy sources (such as RF, microwave, or laser) continues to gain favor as a minimally invasive technique for the treatment of primary and metastatic hepatic malignant tumors (Ng et al, 2005; Pacella et al, 2005; Cabassa et al, 2006; Clasen et al, 2006; Shibata et al, 2006).Regardless of the primary energy source, all of these modalities induce cellular destruction by means of the direct effects of heat, with irreversible cellular damage occurring at temperatures above 50°C when applied for 4~6 minutes and almost instantaneously at temperatures above 60°C (Goldberg et al, 2006). Imaging-guided thermal ablation using different energy sources (such as RF, microwave, or laser) continues to gain favor as a minimally invasive technique for the treatment of primary and metastatic hepatic malignant tumors (Ng et al, 2005; Pacella et al, 2005; Cabassa et al, 2006; Clasen et al, 2006; Shibata et al, 2006). The main difference between modalities lies in the ability to translate energy efficiently into heat throughout the entire tumor ablation target volume. Most studies have focused on the potential of radiofrequency (RF) ablation, fueled in part by the substantial morbidity and mortality associated with hepatic resection (Lencioni et al, 2005; Tateishi et al, 2005)
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