On Efficacy of Microwave Ablation in the Thermal Treatment of an Early-Stage Hepatocellular Carcinoma.

Abstract

Simple SummaryHepatocellular carcinoma accounts for around 75% of all liver cancers, and represents the fourth most common cause of cancer-related deaths worldwide. Microwave ablation is a worldwide-diffused treatment of hepatocellular carcinoma. According to the literature, the success rate for completely eliminating small liver tumors in patients treated with microwave ablation is greater than 85%. Microwave ablation is also highly recommended for COVID-19 patients with liver tumors as a fast treatment with a short recovery time. The involvement of the temperature dependence of the heat capacity, the thermal conductivity, and blood perfusion, is pivotal for establishing the correct ablation process and preserving the healthy tissue. The obtained simulation results clearly show that precisely localized heating distributions and heating efficiency can be achieved by using a multislot antenna probe. Deeper knowledge in this area would aid in the prediction and planning of patient-individual procedures.Microwave ablation at 2.45 GHz is gaining popularity as an alternative therapy to hepatic resection with a higher overall survival rate than external beam radiation therapy and proton beam therapy. It also offers better long-term recurrence-free overall survival when compared with radiofrequency ablation. To improve the design and optimization of microwave ablation procedures, numerical models can provide crucial information. A three-dimensional model of the antenna and targeted tissue without homogeneity assumptions are the most realistic representation of the physical problem. Due to complexity and computational resources consumption, most of the existing numerical studies are based on using two-dimensional axisymmetric models to emulate actual three-dimensional cancers and surrounding tissue, which is often far from reality. The main goal of this study is to develop a fully three-dimensional model of a multislot microwave antenna immersed into liver tissue affected by early-stage hepatocellular carcinoma. The geometry of the tumor is taken from the 3D-IRCADb-01 liver tumors database. Simulations were performed involving the temperature dependence of the blood perfusion, dielectric and thermal properties of both healthy and tumoral liver tissues. The water content changes during the ablation process are also included. The optimal values of the input power and the ablation time are determined to ensure complete treatment of the tumor with minimal damage to the healthy tissue. It was found that a multislot antenna is designed to create predictable, large, spherical zones of the ablation that are not influenced by varying tissue environments. The obtained results may be useful for determining optimal conditions necessary for microwave ablation to be as effective as possible for treating early-stage hepatocellular carcinoma, with minimized invasiveness and collateral damages.