CT-guided Percutaneous Microwave Ablation Research Articles

Efficacy and safety of CT-guided microwave ablation for stage T1a renal cell carcinoma in patients with a solitary kidney

Objective To retrospectively evaluate early clinical outcomes of percutaneous microwave ablation (MWA) for stage T1a renal cell carcinomas (RCCs) in solitary kidney patients. Materials and methods 15 solitary kidney patients with 16 stage T1a N0M0 biopsy-proved RCCs underwent CT-guided percutaneous microwave ablation between October 2016 and July 2020. The patients were followed up with contrast-enhanced computed tomography or magnetic resonance imaging at 1, 3, and 6 months and every 6 months thereafter. Serum creatinine levels of each patient pre MWA, 1 day after MWA and the most recent record were collected. Technical effectiveness, local recurrence, survival rates and complications were accessed. Results Complete ablation was achieved in all 16 tumors (100%) including 13 clear cell carcinomas and 3 papillary carcinomas. Within the follow-up time (median: 24 months) no tumor recurrence or major complication was detected. No significant change in serum creatinine level was noted. The cancer-specific survival rate was 100% (15 of 15), and 1-, 2-, and 3-year overall survival rates were 100%, 93.3%, and 93.3%, respectively. Conclusion Percutaneous MWA is an effective and safe treatment option for stage T1a RCCs in solitary kidney patients; it can achieve high complete ablation rate in selected lesions of appropriate size and location.

CT-Guided Percutaneous Microwave Ablation of Sclerosing Hepatic Carcinoma.

Sclerosing hepatic carcinoma (SHC) is a rare subtype of hepatic carcinoma that can be caused by various pathogeneses. The histological characteristics of SHC demonstrate its high resistance to chemoembolization and thermal ablation; thus, surgical resection represents the primary option for the majority of patients. However, a small proportion of patients who cannot withstand surgery or who have inoperable tumors may not receive adequate treatment, causing the progression of cancer and related high mortality. To overcome the high puncture resistance, high thermal resistance, and poor thermal conductivity of microwave ablation, we developed percutaneous no-touch multiple-site microwave ablation (NTMSWA) to ablate SHC lesions. In this retrospective study, 96 and 41 patients underwent NTMSWA and surgery, respectively. In the NTMSWA group, tumor size and histological classification were determined by medical imaging and tissue biopsy before ablation, and then a personalized ablation regimen was performed. Complete ablation was achieved in a single session in 81 out of 96 (84.4%) patients. The median survival (MS) of the 90 patients who underwent NTMSWA was 51 months, and the overall survival (OS) rate at 5 years was 49.1%. In contrast, the MS in the control group was 57 months, and the OS rate at 5 years was 56.3%. There was no significant difference between the two groups, indicating that SHC <50 mm in size can be effectively ablated with NTMSWA. By adopting no-touch, multiple-site, low-power, intermittent ablation, SHC less than 50 mm in size can be completely ablated.

Percutaneous Microwave Ablation of Category T1a Renal Cell Carcinoma: Intermediate Results on Safety, Technical Feasibility, and Clinical Outcomes of 119 Tumors.

OBJECTIVE. The purpose of this study was to assess the safety, technical results, and clinical outcomes of CT-guided percutaneous microwave ablation of category T1a renal cell carcinoma. MATERIALS AND METHODS. This retrospective study investigated consecutive patients who underwent CT-guided microwave ablation for T1a renal cell carcinoma from October 2015 to May 2019. Patient demographics including tumor characteristics, comorbidities, technical details, and clinical outcomes were evaluated. Local progression-free survival and overall survival rates were estimated using the Kaplan-Meier method. RESULTS. One hundred-six patients including 70 men (mean age, 68.5 ± 8.9 [SD] years; range, 49-86 years) and 36 women (mean age, 69.5 ± 10.0 years; range, 50-88 years) with an overall mean age of 68.8 ± 9.2 years (range, 49-88 years) with 119 T1a renal cell carcinomas were treated with CT-guided microwave ablation. Technical success was achieved for 100% of the tumors. Complete response was achieved in 101 (95.3%) patients and partial response was achieved in five (4.7%) patients. Local progression-free survival was 100.0%, 92.8%, and 90.6% at 1, 2, and 3 years, respectively. Overall survival was 99.0%, 97.7%, and 94.6% at 1, 2, and 3 years, respectively. Six patients (5.7%) had seven complications (five with Clavien-Dindo Grade I, Society of Interventional Radiology [SIR] category A, two with Clavien-Dindo Grade III, SIR category B) within 30 days of the procedure. CONCLUSION. CT-guided percutaneous microwave ablation is associated with high rates of technical success, excellent local progression-free survival and overall survival, and a low complication rate for category T1a renal cell carcinoma.

Percutaneous microwave ablation of stage T1b renal cell carcinoma: Assessment of technical feasibility, clinical outcomes, and safety.

e17104 Background: The use of percutaneous microwave ablation (MWA) for T1b (4.1-7.0 cm) renal cell carcinoma (RCC) has not yet been widely adopted. Methods: This single-center retrospective study investigated consecutive patients who underwent CT-guided percutaneous MWA for T1b RCC from December 2015 to May 2019. Patient baseline characteristics, tumor biological features, technical parameters, clinical outcomes, and complications were recorded and evaluated. Local progression-free and overall survival (OS) rates were estimated using the Kaplan-Meier method. Results: This study included 23 patients (18 men [mean age ± standard deviation, 74.6 y ± 10.2; range, 58–89 y] and 5 women [mean age, 71.6 y ±10.1; range, 62–86 y]; overall mean age, 74.0 y ± 10.0; range, 58-89 y) with 23 T1b tumors. Technical success was achieved in all of tumors. Local progression-free survival was 94.7%, 86.1%, and 86.1% at 1-, 2-, and 3-year respectively. OS was 95.2%, 85.7%, and 71.4% at 1-, 2-, and 3-year respectively. Of the 2 (8.7%) complications, both were classified as Clavien-Dindo grade I complication. Conclusions: CT-guided percutaneous MWA was associated with high rates of technical success, excellent local progression-free survival and OS, and a low complication rate for stage T1b RCC.

Percutaneous microwave ablation therapy of renal cancer local relapse after radical nephrectomy: a feasibility and efficacy study.

Renal cell carcinoma (RCC) local recurrence after radical nephrectomy is uncommon. When feasible, surgical removal remains the primary treatment strategy; nevertheless, local RCC relapse management is controversial, and less invasive procedures may represent an attractive option to achieve oncologic control. The aim of our study was to assess the feasibility, safety, and clinical outcomes of image-guided percutaneous microwave ablation (MWA) for RCC local recurrence in patients initially treated with nephrectomy with curative intent. 10 consecutive patients underwent CT-guided percutaneous MWA of a total of 10 retroperitoneal nodules. Inclusion criteria were: histologically verified retroperitoneal metastases, previous radical nephrectomy, lesion no larger than 3cm, no other metastatic site elsewhere. All the procedures were performed under moderate sedation choosing the most favorable patient decubitus. If deemed necessary, pneumodissection was induced before ablation. After the antenna placement inside the target lesion, thermal ablation was achieved by maintenance of a power of 100W for a total time between 2 and 4min. All patients were observed overnight and discharged the following day if clinically stable. Technical success was obtained in 100% of patients. One patient was re-treated to complete oncologic response with repeat MWA. No major complications were observed. No patients demonstrated local recurrence at a mean follow-up of 26months. MWA is a safe and effective treatment strategy for loco-regional relapse of RCC following radical nephrectomy. This technique may represent a valuable approach for patients who are not eligible for surgery.

A feasibility and safety study of computed tomography-guided percutaneous microwave ablation: a novel therapy for multiple synchronous ground-glass opacities of the lung

Purpose The present study retrospectively evaluated the feasibility, safety, and short-term efficacy of computed tomography (CT)-guided percutaneous microwave ablation (MWA) to treat multiple synchronous ground-glass opacities (GGOs) of the lung. Materials and Methods From October 2016 to May 2019, 33 patients (9 males and 24 females, mean age: 59.6 ± 10.0 years) with multiple GGOs (103 GGOs with mean size 12.3 ± 6.3 mm) were enrolled in this study. Patients underwent 66 procedures of CT-guided percutaneous MWA. The feasibility, safety, local progression-free survival, and overall survival were evaluated. Results The technical success and technique efficacy rate were 100% and no MWA procedure-related deaths were reported. The median follow-up period was 18.1 (range: 6.8–37.7) months. Major complications included pneumothorax (11/66, 16.7%), pleural effusion (2/66, 3.0%), pneumonia (3/66, 4.5%), and nerve injury (1/66, 1.5%), which were well controlled by appropriate treatment. Minor complications included pneumothorax (38/66, 57.6%), pleural effusion (43/66, 65.2%), hemoptysis (13/66, 19.7%), subcutaneous emphysema (4/66, 6.1%), and hemothorax (2/66, 3.0%). Currently, all patients are alive without local progression or tumor recurrence, despite the relatively insufficient follow-up time. Conclusion CT-guided percutaneous MWA for the treatment of multiple synchronous lung GGOs is feasible, safe, and efficacious over short-term follow-up. It may also be employed as an alternative approach for nonsurgical candidates. A longer follow-up is warranted to evaluate the oncologic outcomes.

Computed tomography-guided percutaneous microwave ablation with artificial ascites for problematic hepatocellular tumors

Background The aim of this study was to assess the feasibility, safety and efficacy of computed tomography (CT)-guided percutaneous microwave ablation with artificial ascites for problematic hepatocellular tumors. Methods Forty-eight patients with 61 problematic hepatocellular carcinomas who underwent CT-guided percutaneous microwave ablation with artificial ascites were reviewed retrospectively. Lesions less than 5 mm away from the gastrointestinal system, diaphragm, pericardium or kidney were defined as problematic tumors with the potential risk of thermal damage. Microwave ablation was performed after artificial ascites was established between tumors and the adjacent high-risk organs. The technical effectiveness of microwave ablation, local tumor progression and complications was assessed. Results Microwave ablation with artificial ascites was successfully performed in all 61 tumors. The technical effectiveness rate was 100% with contrast-enhanced CT performed immediately after the ablation procedure. Local tumor progression occurred in three (6%) of the 48 patients during the follow-up period (mean, 15 months; range, 6–24 months). No major complications related to the procedure occurred. Conclusion CT-guided percutaneous microwave ablation with artificial ascites is a feasible, safe and effective choice for treating problematic hepatocellular tumors, avoiding potential thermal damage to the adjacent high-risk organs.

Safety and clinical outcomes of computed tomography-guided percutaneous microwave ablation in patients aged 80 years and older with early-stage non-small cell lung cancer: A multicenter retrospective study.

BackgroundPrevious studies have documented the therapeutic value of computed tomography (CT)‐guided percutaneous microwave ablation (MWA) for early‐stage non‐small cell lung cancer (NSCLC). However, few studies have focused on patients aged 80 years and older. This retrospective study aimed to evaluate the safety and clinical outcomes of CT‐guided percutaneous MWA in patients aged 80 years and older with early‐stage peripheral NSCLC.MethodsA retrospective analysis of 63 patients aged 80 years and older with cT1a‐2bN0M0 peripheral NSCLC who underwent CT‐guided percutaneous MWA was performed between January 2008 and January 2018 at 11 hospitals in Shandong Province, China.ResultsThe median follow‐up time was 21.0 months. The overall median survival time was 50 months. The cancer‐specific median survival time was not reached in five years. The one‐, two‐, three‐, four‐, and five‐year overall survival rates were 97.1%, 92.6%, 63.4%, 54.4%, and 32.6%, respectively. The one‐, two‐, and three‐year cancer‐specific survival (CSS) rates were 97.9%, 97.9%, and 69.4%, respectively. The four‐ and five‐year CSS rates were not achieved. A total of 14 patients (22.2%) had local progression. The one‐, two‐, three‐, four‐, and five‐year local control rates were 88.8%, 78.8%, 70.3%, 63.9%, and 63.9%, respectively. The mortality rate was 0% within 30 days after the procedure. Major complications included pneumothorax requiring drainage (21.1%), pulmonary infection (4.2%), and pleural effusions requiring drainage (2.8%).ConclusionsCT‐guided percutaneous MWA is a safe and effective modality for treating patients aged 80 years and older with early‐stage peripheral NSCLC.

04:12 PM Abstract No. 187 Efficacy and outcomes following percutaneous microwave ablation of hepatocellular carcinomas (HCC) measuring between 3 and 5 cm

Tumors greater than 3 cm have been considered less favorable for local percutaneous treatment, due to association with vascular invasion and higher histologic grade. The purpose of this study was to evaluate technical success and clinical outcomes of patients with HCC between 3-5 cm treated with CT-guided percutaneous microwave ablation (MWA). An institutional database was used to identify adult patients with HCC between 3-5 cm that were treated with CT-guided percutaneous MWA between August 2008 and December 2017. Patient demographics, tumor characteristics, and patient performance status were recorded. The diagnosis of HCC was established by biopsy or imaging criteria (OPTN). Primary efficacy rate was defined as the percentage of treated tumors that showed complete ablation of macroscopic tumor on the first follow-up scan. Secondary efficacy rate was defined as the percentage of residual tumors identified on post-procedure imaging (< 60 days) that were successfully re-treated. Once primary or secondary efficacy was achieved, patients were re-imaged at approximately 3-month intervals until they were censored due to loss of follow-up, death or transplantation. 367 patients underwent 544 MWA procedures over the study period. 61 patients (50 male, 11 female), had a diagnosis of HCC and lesion size of between 3 and 5 cm. Hydrodissection was performed in 27 cases. Mean follow-up was 822 days (range 27-3191). Of 61 lesions treated, no recurrence developed in the treated lesion in 41 cases. In the remaining 20 cases, recurrence developed, with mean time to recurrence of 335 days (range 24 – 1000 days). Recurrent tumor was managed with repeat ablation and/or intra-arterial therapy. Early recurrence (< 60 days) occurred in 3 cases, and was successfully treated with repeat ablation in two patients. 15 patients went on to subsequent liver transplantation, with analysis of the explants revealing no viable residual tumor in that area in 8 cases. There were 7 minor and no major complications. Advances in thermal ablation technology now allow for treatment of larger HCCs, with this study showing primary and secondary efficacy rates of 95.1% and 98.3%, respectively.

Efficacy and safety of CT-guided percutaneous thermal ablation for hepatocellular carcinoma adjacent to the second porta hepatis

Purpose: This study assessed the efficacy and safety of computed tomography (CT)-guided percutaneous thermal ablation for hepatocellular carcinoma adjacent to the second porta hepatis.Methods: From January 2011 to June 2018, 59 consecutive patients (51 men and 8 women aged 29–85 years) with 65 tumors (mean maximum tumor diameter: 20.5 ± 1.2 mm; range: 5–50 cm) adjacent to the second porta hepatis underwent percutaneous CT-guided thermal ablation. The complete ablation rate, local progression-free survival (LPFS), progression-free survival (PFS), prognostic factors for local progression, and safety of this technique were assessed.Results: No more than three sessions were performed to complete a patient’s treatment. Technical success was achieved for all tumors. In the median follow-up of 18.5 months, local tumor progression occurred in 32.2% (19/59) of patients, while tumor progression occurred in 71.2% (42/59). The median LPFS was 37.4 months. The 1-, 2-, and 3-year LPFS rates were 86.2%, 66.5%, and 66.5%, respectively. The median PFS was 11.0 months. The 1-, 2-, and 3-year PFS rates were 47.9%, 27.0%, and 20.2%, respectively. The tumor size (P = .007) and distance between the tumor and inferior vena cava (P = 0.018) were the independent prognostic factors for local tumor progression.Conclusion: We showed that CT-guided percutaneous microwave ablation and radiofrequency ablation are effective and safe treatments for tumors adjacent to the second porta hepatis, particularly in patients with lesions less than 3 cm and a distance between the tumor and inferior vena cava of more than 5 mm.

Predictive value of the albumin-bilirubin grade on long-term outcomes of CT-guided percutaneous microwave ablation in intrahepatic cholangiocarcinoma

Purpose: To assess the efficacy of the albumin-bilirubin (ALBI) grade on assessing long-term outcomes of computed tomography (CT)-guided percutaneous microwave ablation (CT-PMWA) in the treatment of patients with intrahepatic cholangiocarcinoma (ICC).Methods: Between April 2011 and March 2018, 78 patients who underwent CT-PMWA were enrolled in this study. Overall survival (OS) and recurrence-free survival (RFS) were compared in the groups stratified by the ALBI grade and Child–Pugh score. Cox proportional hazard regression analyses were performed to determine independent predictors of OS and RFS.Results: After a median follow-up of 22.7 months (range 1–86.7 months), 67 patients had died. The cumulative 1-, 3-, and 5-year OS rates were 89.5%, 52.2%, and 35.0%, respectively. Stratified by the ALBI grade, the cumulative 1-, 3-, and 5-year OS rates were 100%, 69.2%, and 25.6% for patients with the grade 1, respectively. For patients with the ALBI grade 2, the cumulative 1-, 3-, and 5-year OS rates were 41.0%, 10.3%, and 10.3%, respectively. Patients with a hepatic function of the ALBI grade 1 had significantly higher OS rates than patients with the ALBI grade 2 (p < .001). The multivariate analysis showed tumor size (Hazard Ratio[HR] 95% Confidence Interval[CI]:9.03[1.01–80.52], p = .049) and the ALBI grade (HR[95%CI]:9.56[1.58–58.00], p = .014) were associated with OS, and tumor size (HR: 2.03[0.69–8.04], p = .049) was associated with RFS.Conclusions: The preliminary data of this study showed the ALBI grade was effective to predict long-term outcomes of CT-PMWA in ICCs. Further study is necessary to validate our results by a large, multi-center patient cohort.

Pain control for patients with hepatocellular carcinoma undergoing CT-guided percutaneous microwave ablation

BackgroundHepatic percutaneous microwave ablation (MWA) is usually performed in patients under conscious sedation. Nonetheless, many patients reported pain during the procedure. The current study investigated the safety and effectiveness of analgesia given at personalized dosage during the MWA procedure.MethodsA total of 100 patients with hepatocellular carcinomas (HCCs) were included in this study. These patients underwent CT-guided percutaneous MWA between February and October 2017. Patients were randomized into two groups: Experimental group (n = 50) and Control group (n = 50). Patients in the Control group were given 5 mg of morphine intravenously, followed by 10 mg of morphine injected subcutaneously 30 min before surgery. Patients in the Experimental group were given a personalized dosage of morphine during the procedure when the Visual Analogue Scale (VAS) was ≥4. Other clinical and treatment parameters were also analysed.ResultsA significantly less amount of morphine (p < 0.001) was used in the experimental group (7.18 ± 1.65 mg) than in the control group (17.40 ± 2.52 mg). No significant differences were found in the number of patients who needed to discontinue the surgery (p = 0.242). Other clinical parameters including heart rate, systolic and diastolic blood pressures at various time points were comparable. Importantly, a lower VAS was reported in the experimental group, indicating a lower pain intensity experienced by patients during the procedure.ConclusionThe administration of personalized dosage of morphine to HCC patients undergoing percutaneous MWA is an effective and safe procedure for pain control.

Risk Assessment of Chronic Kidney Disease following Microwave Ablation for Stage T1 Renal Cell Carcinoma

PurposeTo assess safety and renal-function outcomes after microwave (MW) ablation of localized stage T1 renal cell carcinoma (RCC). Materials and MethodsA retrospective review was conducted of 38 patients (28 men; mean age, 69 y; range, 51–88 y) who underwent computed tomography (CT)–guided MW ablation for stage T1N0M0 RCC. Baseline and follow-up renal function surrogates including creatinine level and estimated glomerular filtration rate (eGFR) were statistically compared. Peri- and postoperative complication rates, technical success, and treatment response were also assessed. ResultsA total of 44 biopsy-proven stage T1N0M0 RCCs measuring 1.2–6.9 cm (mean, 2.5 cm) were treated, and renal function was measured 1 mo after treatment. Mean eGFRs were 60 mL/min/1.73 m2 at baseline and 59 mL/min/1.73 m2 at 1 month after ablation. At 1-year and last follow-ups, the means of difference were 3.3% (95% confidence interval, −4.4 to 4.3; P = .99) and 3.3% (95% confidence interval, −4.3 to 4.8; P = .91), respectively. The 2-years freedom from eGFR decrease to < 60 mL/min/1.73 m2 was 2% (P = .91). Among the 5 patients (13%) with preexisting stage 4 chronic kidney disease (CKD; eGFR < 30 mL/min/1.73 m2) before ablation, there was no significant postablative onset of decline or CKD upstaging (P = .001). There were no major complications, and 5 patients (13%) had small asymptomatic perinephric hematomas (Society of Interventional Radiology minor complication, class A/B) that were managed conservatively. ConclusionsAt 2-year follow-up, CT-guided percutaneous MW ablation is safe and well-tolerated and achieves nephron preservation similar to existing ablative modalities.

Computed tomography-guided percutaneous microwave ablation for treatment of peripheral ground-glass opacity-Lung adenocarcinoma: A pilot study.

The purpose of the study is to retrospectively evaluate the safety and efficacy of microwave ablation (MWA) for the treatment of ground-glass opacity (GGO)-lung adenocarcinoma. From December 2013 to June 2017, a total of 51 patients (22 males and 29 females, mean age of 69.4 ± 10.1 years) were included in this study, with 51 lung adenocarcinoma lesions showing GGO (mean long-axis diameter of 18.7 ± 6.05 mm). They received a total of 52 sessions of percutaneous computed tomography-guided (CT-guided) MWA. First, lung adenocarcinoma with GGO was histologically defined by needle biopsy under the guidance of CT. Second, the efficacy of CT-guided MWA was analyzed, including the feasibility, safety, 3 years local progression-free survival (LPFS), 3 years disease-specific survival, and 3 years overall survival (OS). Final, complications after MWA were also summarized. The technical success rate was 100%, without MWA procedure-related death. At the median follow-up period (27.02, range: 7-45 months), the rates of 3 years LPFS, cancer-specific survival, and OS were 98%, 100%, and 96%, respectively. The complications after MWA included pneumothorax (48.1%, 25/52), hemoptysis (28.8%, 14/52), pleural effusion (23.1%, 12/52), and pulmonary infection (7.7%, 4/52). CT-guided percutaneous MWA was a feasible, safe, and effective therapeutic approach for treating GGO-lung adenocarcinoma.

The safety and efficacy of microwave ablation for the treatment of CRC pulmonary metastases

Purpose: Microwave ablation (MWA) is a recently developed thermal ablation technique that has been used for the treatment of different types of tumours. In the present study, we retrospectively evaluated the safety and efficacy of CT-guided percutaneous MWA for the treatment of colorectal cancer (CRC) pulmonary metastases.Materials and methods: From June 2010 to June 2015, 48 unresectable lesions in 32 patients with CRC pulmonary metastases were subjected to CT-guided MWA. Imaging follow-up was with contrast-enhanced CT and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT.Results: Oncologic imaging showed that 42 (87.5%) of the 48 lesions in the 32 patients were completely ablated. Needle track metastatic seeding was not found, and no patient deaths occurred within 30 d after ablation. The mean hospital stay was 3 d (range, 2–7 d). Pneumothorax was the most frequent complication and occurred in 6 (12.5%) of the 48 lesions. The median survival time was 31 months (95% CI: 15.4–46.6). The 1-, 2- and 3-year survival rates were 79.5%, 63.1% and 44.4%, respectively. Univariate Cox regression analysis showed that tumour size, disease-free interval (DFI) and number of tumours were significantly related to the overall survival time (p = .007, p = .022 and p = .030, respectively). Multivariate analysis showed that tumour size was an independent prognostic factor for survival (p = .017).Conclusion: CT-guided percutaneous MWA is a safe and effective minimally invasive method for treating CRC pulmonary metastases.

Computed tomography-guided percutaneous microwave ablation of hepatocellular carcinoma in challenging locations: safety and efficacy of high-power microwave platforms

Objective: To evaluate the clinical efficacy/safety of CT-guided percutaneous microwave ablation for HCC in challenging locations using high-power microwave platforms.Materials and methods: A retrospective review was conducted in 26 patients with 36 HCC tumours in challenging locations (hepatic dome, subcapsular, close to the heart/diaphragm/hepatic hilum, exophytic) undergoing CT-guided percutaneous microwave ablation in a single centre since January 2011. Two different microwave platforms were used both operating at 2.45 GHz: AMICA and Acculis MWA System. Patient demographics including age, sex, tumour size and location, as well as technical details were recorded. Technical success, treatment response, patients survival and complication rate were evaluated.Results: Treated tumours were located in the hepatic dome (n = 14), subcapsularly (n = 16), in proximity to the heart (n = 2) or liver hilum (n = 2), while two were exophytic tumours at segment VI (n = 2). Mean tumour diameter was 3.30 cm (range 1.4–5 cm). In 3/26 patients (diameter >4 cm), an additional session of DEB-TACE was performed due to tumour size. Technical success rate was 100%; complete response rate was recorded in 33/36 tumours (91.6%). According to Kaplan–Meier analysis, survival rate was 92.3% and 72.11% at 24- and 60-month follow-up, respectively. There were no major complications; two cases of minor pneumothorax and two cases of small subcapsular haematoma were resolved only with observation requiring no further treatment.Conclusion: CT-guided percutaneous microwave ablation for hepatocellular carcinoma tumours in challenging locations and up to 5 cm in diameter can be performed with high efficacy and safety rates.

Clinical Application of CT-Guided Percutaneous Microwave Ablation for the Treatment of Lung Metastasis from Colorectal Cancer.

Objective The aim of our research is to explore the clinical efficacy and safety of CT-guided percutaneous microwave ablation (MWA) for the treatment of lung metastasis from colorectal cancer. Materials and Methods CT-guided percutaneous MWA was performed in 22 patients (male 14, female 8, mean age: 56.05 ± 12.32 years) with a total of 36 lung metastatic lesions from colorectal cancer between February 2014 and May 2017. Clinical data were retrospectively analyzed with respect to the efficacy, safety, and outcome. Results Of the 36 lesions, 34 lesions (94.4%) reduced obviously with small cavitations or fibrous stripes formed and had no evidence of recurrence during follow-up. The volume of the other 2 lesions demonstrated local progression after 6 months by follow-up CT. The primary complications included pneumothorax (28%), chest pain (21%), and fever (5%). These symptoms and signs were obviously relieved or disappeared after several-day conservative treatment. The mean follow-up of the patients was 25.54 ± 12.58 months (range 2–41 months). The estimated progression-free survival rate was 94.4%. Conclusion Our results demonstrate that CT-guided percutaneous MWA appears to be an effective, reliable, and minimally invasive method for the treatment of lung metastasis from colorectal cancer. This trial is registered with ChiCTR-ORC-17012904.

Treatment efficacy of CT-guided percutaneous microwave ablation for primary hepatocellular carcinoma

To evaluate the treatment efficacy and potential complications of computed tomography (CT)-guided microwave ablation for primary hepatocellular carcinoma (HCC). Data were collected and analysed from 220 HCC patients treated with CT-guided microwave ablation and followed up for 2 years. Independent risk factors for overall survival and progression-free survival (PFS) were analysed. Among all cases followed, the cumulative overall survival rates at 1 and 2 years were 95.45% and 89.09%. The cumulative 1- and 2-year PFS rates were 80.90% and 62.73%. For patients with Barcelona Clinic Liver Cancer (BCLC) class C (n=60), the cumulative 1- and 2-year overall survival rates were 89.09% and 74.54%. In this group, patients with tumour invasion of blood vessels or tumour-related symptoms suffered a worse overall survival compared to those without (p=0.011). No fatal complications were observed. Child-Pugh score (p=0.030) and BCLC class (p=0.012) were independent risk factors for overall survival. The number of tumour nodules was an independent risk factor for reoccurrence. CT-guided percutaneous microwave ablation could be an effective and safe treatment option for HCC patients.

CT-guided percutaneous microwave ablation of pulmonary malignant tumors.

Microwave ablation (MWA) of lung tumors is a new approach for local tumor control. The purpose of this retrospective study was to evaluate the preliminary results of safety and efficacy of MWA with a dynamic frequency range (902-928 MHz) and power (10-32 W) for local tumor control of thoracic malignancies. From December 1, 2013 to February 1, 2016, there were total 32 lung tumors among 15 patients (7 men, 8 women, age range 43-82 years, mean 57.8±11.1 years of age) receiving MWA of thoracic neoplasms, including lung adenocarcinoma (n=5), metastatic colorectal cancer (n=7), invasive thymoma (n=1), metastatic uterine leiomyosarcoma (n=1), and metastatic ampullary carcinoma (n=1). Mean tumor size was 13.5 mm (range, 3.0-32.0 mm). The mean sequential ablation during each MWA was 2.3±1.1 times (range, 1-5 times). The outcomes of ablation were evaluated by follow-up computed tomography (CT) scans and the complications were assessed by medical records and CT scan after ablation. The mean follow-up interval of each tumor was 446.8 days (range, 196-902 days). Local tumor recurrence was found in 5 of the 32 tumors resulting in a local control rate 84.4%. No MWA-related mortality was noted. After MWA, the incidence of pneumothorax was 37.5% (12/32). Only one patient with pneumothorax required air evacuation. Third-degree skin burn adjacent to the entry site occurred in one patient and required debridement and closure with flap. After appropriate patient selection, MWA with a dynamic frequency range (902-928 MHz) and power (10-32 W) is an effective and safe procedure for local tumor control of recurrent and metastatic lung tumors.

Correlation between amount of applied energy and ablation zone after CT-guided percutaneous microwave – And radiofrequency ablation of colorectal liver metastases

Correlation between amount of applied energy and ablation zone after CT-guided percutaneous microwave – And radiofrequency ablation of colorectal liver metastases