Microwave Needle Research Articles

Targeted microwave ablation of localised prostate cancer: Initial results of VIOLETTE trial

AbstractObjectiveThe aim of this study was to assess the precision and safety of targeted microwave ablation (TMA) using organ‐based tracking (OBT) fusion, in patients with intermediate risk prostate cancer.Patients and methodWe conducted a prospective, multicentric trial. Eligible patients had a prostate‐specific antigen (PSA) < 20 ng/mL, a magnetic resonance imaging (MRI)‐visible index tumour of Gleason score 3 + 4, with largest axis ≤15 mm and distant of at least 5 mm from the rectum and apex. TMA was performed with microwave needle applicator using OBT fusion, with a transperineal or a transrectal approach. In this interim analysis, we evaluated precision, safety, urinary and sexual outcomes, and PSA density kinetics.ResultsAt this point, 37 patients were treated in five centres. Median (interquartile range) age is 68 (63–72) years. Baseline median prostate volume and PSA are of 45 (34–57) mL and 8 (6.2–10.8) ng/mL, respectively. Median largest tumour axis on T2W MRI is of 11 mm (10–13). Patients were treated under general anaesthesia or conscious IV sedation in an outpatient setting. Anaesthesia had a median duration of 78 (66–90) min. A median number of 3 (2–4) 12‐W ablations of 2 to 5 min were performed per patient. After a median follow‐up of 6 (2.4–10) months, we observed 58 adverse events (AE) in 22 patients. These were of Common Terminology Criteria for Adverse Events (CTCAE) grade 1, 2 and 3 in 43 (74%), 13 (22%) and 2 (4%) cases. Six (15%) patients had an acute urinary retention, five of which considered as severe AE because of rehospitalisation. We did not observe any significant difference in International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire‐ejaculatory dysfunction (MSHQ‐EjD) and International Index of Erectile Function (IIEF5) from baseline to last follow‐up. Median PSA density evolved from 0.2 (0.1–0.3) at baseline to 0.1 (0.07–0.16) at 12 months.ConclusionsThese preliminary results suggest that TMA using OBT fusion is precise and safe in patients with intermediate risk localised prostate cancer. Further inclusions and follow‐up are needed to assess oncological outcome.

Generating sub-diffraction microwave needle beam for nondestructive testing by multifunctional transmissive metasurfaces

Sub-diffraction needle beams with high intensity, sub-diffraction focal size, and long depth of focus (DOF) have attracted many researchers’ attention. However, the traditional methods for needle beam generation typically require many devices, such as phase elements, amplitude filters, and lens, which leads to a complex and bulky system and unfavorable for their integration. To address these challenges, we use a single multifunctional transmissive metasurface to convert a linearly polarized plane wave into a needle beam in the microwave range. The guided wave inspired unit cells of the proposed metasurface is designed to simultaneously and independently modulate the polarization and phase of transmitted waves. By imposing the desired polarization and phase distributions on the metasurface, the proposed multifunctional transmissive metasurface can efficiently generate a needle beam with subdiffraction size and extended DOF at 10 GHz when it is illuminated by an x-polarized wave. The proposed metasurface is fabricated, and a sub-diffraction needle beam with good performance is obtained in our measurements. In addition, a proof-of-concept of a high-resolution nondestructive testing experiment based on our designed metasurface is accomplished. Our work is expected to have potential applications in nondestructive testing of materials and structures.

Development of a novel MR‐conditional microwave needle for MR‐guided interventional microwave ablation at 1.5T

To develop an MR-conditional microwave needle that generates a spherical ablation zone and clear MRI visibility for MR-guided microwave ablation. An MR-conditional microwave needle consisting of zirconia tip and TA18 titanium alloy tube was investigated. The numerical model was created to optimize the needle's geometry and analyze its performance. A geometrically optimized needle was produced using non-magnetic materials based on the electromagnetics simulation results. The needle's mechanical properties were tested per the Chinese pharmaceutical industry standard YY0899-2013. The MRI visibility performance and ablation characteristics of the needle was tested both in vitro (phantom) and in vivo (rabbit) at 1.5T. The RF-induced heating was evaluated in ex vivo porcine liver. The needle's mechanical properties met the specified requirements. The needle susceptibility artifact was clearly visible both in vitro and in vivo. The needle artifact diameter (A) was small in in vivo (Ashaft: 4.96 ± 0.18 mm for T1W-FLASH, 3.13 ± 0.05 mm for T2-weighted fast spin-echo (T2W-FSE); Atip: 2.31 ± 0.09 mm for T1W-FLASH, 2.29 ± 0.08 mm for T2W-FSE; tip location error [TLE]: -0.94 ± 0.07 mm for T1W-FLASH, -1.10 ± 0.09 mm for T2W-FSE). Ablation zones generated by the needle were nearly spherical with an elliptical aspect ratio ranging from 0.79 to 0.90 at 30 W, 50 W for 3, 5, 10min duration ex vivo ablations and 0.86 at 30 W for 10min duration in vivo ablations. The designed MR-conditional microwave needle offers excellent mechanical properties, reliable MRI visibility, insignificant RF-induced heating, and a sufficiently spherical ablation zone. Further clinical development of MR-guided microwave ablation appears warranted.

MR Imaging‒Guided Intervention: Evaluation of MR Conditional Biopsy and Ablation Needle Tip Artifacts at 3T Using a Balanced Fast Field Echo Sequence

PurposeTo systematically investigate artifacts produced by biopsy and ablation needles imaged at various trajectories with respect to the static magnetic field (B0). Materials and MethodsAn acrylic phantom was scanned using a rapid balanced fast field echo sequence with 3.0-T magnetic resonance imaging. A 15-gauge microwave needle, a 17-gauge cryoneedle, and an 18-gauge coaxial biopsy needle were imaged in sagittal and axial planes, in 7 different orientations to B0 (0°, 15°, 30°, 45°, 60°, 75°, and 90°). For 4 angles (15°, 30°, 60°, and 75°), images were acquired with the slice orientation aligned to the needle angulation, resulting in the frequency encoding direction being parallel to the needle’s long axis for the sagittal slice and perpendicular to the needle angulation for the axial acquisition. The artifact length at the needle tip and maximum artifact width were recorded. ResultsNo significant difference was noted in mean artifact length for the cryoneedle (13 mm; 95% confidence interval [CI], 7–19) and coaxial biopsy needle (8 mm; 95% CI, 5–10; P = .08). The mean artifact length was significantly smaller for the microwave ablation needle (1 mm; 95% CI, 0–2; P < .05). The mean artifact width was highest for the coaxial needle (17 mm; 95% CI, 14–19) and significantly higher than the cryoneedle (12 mm; 95% CI, 10–15; P = .024) and microwave ablation needle (8 mm; 95% CI, 6–10; P < .01). The needle tip artifact was significantly smaller when the slice orientation was aligned to the needle angulation for the coaxial and cryoablation needles (P < .01). ConclusionsNeedle tip artifact length and width increase with increasing angulation to the static field. At large angles (>15°), the needle tip position can be predicted better from images acquired when the slice orientation is aligned to the needle’s angulation.

Low-Cost Mini-Invasive Microwave Needle Applicator for Cancer Thermal Ablation: Feasibility Investigation

The design and characterization of a low-cost mini-invasive needle applicator prototype for hyperthermia therapy of cancer are performed, after the investigation of different approaches, focused to increase the device feasibility and miniaturization and to improve patient wellness. The needle applicator is a coaxial antenna operating at frequency f=2.45 GHz in the Industrial, Scientific, and Medical (ISM) frequency band. Many simulations are performed with the aim of investigating different geometries, impedance matching techniques, possible 3D-printing biocompatible materials, and radiating configurations fitting 14-gauge (14G) and 16-gauge (16G) hypodermic tube sizes. Also, a cooling circuit is investigated to maintain the patient healthy tissues at lower temperature, during the ablation session. As last step, prototypes of 14G and 16G applicators have been constructed and characterized.

V14-03 TRANSPERINEAL MICROWAVE NEEDLE THERMOABLATION OF PROSTATE CANCER GUIDED BY MRI ULTRASOUND FUSION AND ORGAN BASED TRACKING TECHNOLOGY

You have accessJournal of UrologyProstate Cancer (V14)1 Apr 2020V14-03 TRANSPERINEAL MICROWAVE NEEDLE THERMOABLATION OF PROSTATE CANCER GUIDED BY MRI ULTRASOUND FUSION AND ORGAN BASED TRACKING TECHNOLOGY Peter Ka-Fung Chiu*, Jeremy Yuen-Chun Teoh, Sui Yan Lau, Chi Hang Yee, Ka Lun Lo, Kai Man Li, Suk Yin Li, Sze Wan Kwok, Chi Kwok Chan, See Ming Hou, Carmen Chi Min Cho, and Chi Fai Ng Peter Ka-Fung Chiu*Peter Ka-Fung Chiu* More articles by this author , Jeremy Yuen-Chun TeohJeremy Yuen-Chun Teoh More articles by this author , Sui Yan LauSui Yan Lau More articles by this author , Chi Hang YeeChi Hang Yee More articles by this author , Ka Lun LoKa Lun Lo More articles by this author , Kai Man LiKai Man Li More articles by this author , Suk Yin LiSuk Yin Li More articles by this author , Sze Wan KwokSze Wan Kwok More articles by this author , Chi Kwok ChanChi Kwok Chan More articles by this author , See Ming HouSee Ming Hou More articles by this author , Carmen Chi Min ChoCarmen Chi Min Cho More articles by this author , and Chi Fai NgChi Fai Ng More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000982.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The objective of this video is to show the technique of a novel transperineal microwave needle thermoablation of localized prostate cancer (PCa) guided by MRI-Ultrasound fusion and Organ-based tracking (OBT) technology. METHODS: The case was an obese 70 year-old man with history of diabetes, hypertension, hyperlipidemia, and radiological cerebral infarcts without symptom. He has excellent performance status. His PSA was 5.7 ng/mL and Prostate Health Index (PHI) was 42.8. MRI prostate showed a 15x10 mm PI-RADS 5 lesion at left anterior transitional zone in a 35ml prostate without extra-capsular extension. Transperineal MRI-Ultrasound fusion biopsy of the target lesion showed Gleason 3+3 PCa in all 3 cores with 70% core involvement. 15 Systematic biopsy cores in other sectors were all benign. Focal therapy using microwave needle ablation was planned. Before treatment, fleet enema and a dose of IV antibiotic was given. The patient received spinal anaesthesia and was placed in lithotomy position. The MRI images marked with the target lesion were displayed on the screen of the MRI-Ultrasound fusion machine. The 3D side-fire transrectal probe was inserted, positioned at prostate level and fixed with a probe holder. A full grid was applied to the probe. MRI and Ultrasound fusion was performed with automatic 3D ultrasound scanning and OBT technology to provide accurate prostate tracking and target localization. The expected ellipsoid treatment zones of multiple Microwave needle ablations were planned on screen. A 17G microwave needle was inserted at the planned path in the fullgrid and the exact needle position was confirmed with repeated 3D ultrasound scanning and OBT image fusion. In the current case, 3 sequential needle ablations (Two 5-minute and one 3-minute) at 12 Watts were done to cover the lesion with margin. The whole treatment including planning took 65 minutes. A Foley’s catheter was inserted at the end. RESULTS: The Foley’s catheter was removed the next day and he was discharged home. MRI prostate with contrast was repeated on day 12 and the necrotic foci correlated well with the planned ellipsoid ablation zones without residual tumor seen. Individual needle tracks were also visualized on MRI images. Microwave needle ablation therapy has so far been successfully performed in 3 patients and all tolerated the procedure well. CONCLUSIONS: Transperineal microwave needle ablation of prostate cancer can be precisely and safely performed under the guidance of MRI-Ultrasound fusion and Organ based tracking. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1306-e1307 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peter Ka-Fung Chiu* More articles by this author Jeremy Yuen-Chun Teoh More articles by this author Sui Yan Lau More articles by this author Chi Hang Yee More articles by this author Ka Lun Lo More articles by this author Kai Man Li More articles by this author Suk Yin Li More articles by this author Sze Wan Kwok More articles by this author Chi Kwok Chan More articles by this author See Ming Hou More articles by this author Carmen Chi Min Cho More articles by this author Chi Fai Ng More articles by this author Expand All Advertisement PDF downloadLoading ...

The application of magnetic resonance imaging-guided microwave ablation for lung cancer.

It is necessary to explore a minimally invasive, effective, and efficient treatment for those lung cancer patients who are poor candidates for surgery. This study aimed to investigate the application of microwave ablation (MWA) in the treatment of lung cancer. A total of 43 patients with 44 pulmonary lesions were examined following identical procedures before being randomly divided into two groups. The experimental group consists of 17 patients with a total of 18 pulmonary lesions, while the control group consists of 26 patients with a total of 26 pulmonary lesions. The experimental group was treated using magnetic resonance imaging (MRI)-guided MWA while the control group was treated using computer tomography (CT)-guided MWA. A transverse relaxation time-turbo spin echo (T2-TSE) sequence was used for signal collection in the experimental group to determine puncture location and microwave needle position while T2-TSE, T1-turbo field echo, and diffusion-weighted MRI (DWI) sequences were used for timely efficacy evaluation. Whereas in the control group, CT axial scanning was performed to serve similar purposes. A nonparametric Wilcoxon test, median (M [25%, 75%]). All of the 44 lesions were successfully located on the first attempt. The mean time for scanning and locating lung lesions under MRI and CT guidance were 64.53 and 42.96 min, the mean times of positioning were 12 and 18 min, and the mean durations of MWA were 12.48 and 15.06 min, respectively. As a minimally invasive method for treating lung tumors, MRI-guided MWA requires fewer localization scans, a shorter MWA duration, no radiation, real-time observation of the curative effect, and it prevents overtreatment.

Microwave Needle Thermoablation for Treatment of Localized Prostate Cancer

Microwave Needle Thermoablation for Treatment of Localized Prostate Cancer

Fast temperature estimation from undersampled k-space with fully-sampled center for MR guided microwave ablation

PurposeThis study aims to accelerate MR temperature imaging using the proton resonance frequency (PRF) shift method for real time temperature monitoring during thermal ablation. Materials and methodsThe proposed method estimates temperature changes from undersampled k-space with a fully sampled center. This proposed algorithm is based on the hybrid multi-baseline and referenceless treatment image model and can be seen as an extension of the conventional k-space-based hybrid thermometry. The parameters of hybrid model are acquired by utilizing information from low resolution images which are obtained from fully-sampled centers of k-space. Registration is used to correct temperature errors due to the displacement of the subject. Phantom heating simulations, motion simulations, phantom heating and in-vivo experiments were performed to investigate the efficiency of the proposed method. SPIRiT and the conventional k-space estimation reconstruction thermometry were implemented for comparison using the same sampling pattern. ResultsThe phantom heating simulations showed that the proposed method results in lower RMSEs than the conventional k-space hybrid thermometry and SPIRiT at various reduction factors tested. The motion simulations indicated the robustness of the proposed method to displacement of the subject. Phantom heating experiment further demonstrated the ability of the method to reconstruct temperature maps with less computation time and higher accuracy (RMSEs lower than 0.4°C) at a net reduction factor of 3.5 in the presence of large noise caused by a microwave needle. In-vivo experiments validated the feasibility of the proposed method to estimate temperature changes from undersampled k-space (net reduction factor 4.3) in presence of respiratory motion and complicated anatomical structure, while reducing computation time as much as 10-fold compared with the conventional k-space method. ConclusionThe proposed method accelerates the PRF-shift MR thermometry and provides more accurate temperature maps in presence of motion with relatively short computation time, which may make real time imaging for MR-guided microwave ablation possible.

Microwave needle thermal effect enhenced by cisplatin-ferric powder reduced partical suspl in pig liver

Objective To detect the thermal effect of microwave needle enhanced by cisplatin-ferric powder reduced partical suspl in pig liver.Methods One ml of cisplatin-ferric powder reduced partical (Fe content:95.53 g/L,and cisplatin:9.52 g/L) suspl was injected into pig liver,then the microwave needle (30,and 60 W) was used to heat the same site.Five and 10 min later the local temprature and the hot body diameters were measured by using infrared ray temprature detector.Ten min and 24 h later the local cisplatin contents were determined by using high performance liquid chromatography (HPLC).Results After the microwave heating lasted for 5-10 mint,the local temprature in the low (30 W) energy group,the high (60 W) energy group and the control group (cisplatin injection,60 W) was 45-75,55-95,and 45-75 ℃C,and the hot body diameters (over 45℃) were 2.79-3.36,3.10-3.50 and 2.32-2.85 cm,respectively.The local cisplatin contents in the low (30 W) energy group,the high (60 W) energy group and the control group (cisplatin injection,60 W) were (2.19 ±0.17),(2.10 ±0.13) and (2.35 ±0.16) g/L respectively,and 24 h later they were (1.81 ±0.12),(1.98 ±0.10) and (0.54 ±0.19) g/L respectively (P＜0.01).Conclusion The local temprature of cisplatin-ferric powder reduced partical suspl in pig liver can be easily increased to 45-95℃C by the microwave needle,and the hot body diameters were greater and the local cisplatin contents were higher than the usual. Key words: Fe ; Micromave ; Cisplatin ; Liver; Thermal effect

Needle Slippage From Needle Hub Hardware During Ablation

Dr. Little and his colleagues report successful results for lung tumor microwave ablation. [1] One underappreciated technical pitfall which can be seen with microwave ablation in the lung is needle slippage and stabilization. This may become more relevant with the emergence of microwave and cryoablation needles which often have heavy hubs, hardware and cords exerting forces on the needle, which can change the depth or angle of insertion of the needle when not stabilized by the operator’s hand. This may pull the needle off-angle or deeper than desired, and may be more common in compliant lung tissue. In one patient, while performing microwave ablation of a lung cancer, the microwave needle advanced 2cm further towards the heart, due to the weight of the device and gravity towards the table (Figure 1). A similar phenomenon can also be seen with steep cranio-caudal access for ablations in the liver dome during respiration, with the liver moving along the needle insertion axis (ie- subcostal skin to liver dome). A common simple technique for needle stabilization is propping the needle's handle in position by rolling sterile towels around its hub, however the needle is not absolutely fixed in place. The “stick” feature in cryoablation may also mitigate this pitfall and prevent migration. Figure 1 Cone beam CT before (A) and after (B) needle slippage. Planned needle path and planned treatment volume (C) in navigation and ablation planner software (Allura Xper FD20, Phillips Healthcare, Best, Netherlands) Disposable needle guidance and stabilization devices, such as the SeeStar® (AprioMed, Uppsala, Sweden) [2,3] and the SimpliFY™ (NeoRad, Oslo, Norway), may help address this challenge. These sterile devices are placed on the skin, and the needle is placed into the clamp of the device allowing fixation of the microwave needle in the insertion angle. (Figure 2) Figure 2 SimpliFY™ (A) stabilizing an radio-frequency ablation needle (Covidien, Boulder, CO, USA) and SeeStar® (B) stabilizing a cryo-ablation needle (Endocare , HealthTronics Inc, Austin, TX, USA) Note bending of needle shaft caused by tension ... However, not all guiding devices secure the depth of insertion. The SimpliFY™ has a mobile needle gripper with an adjustable screw/clamp that can subsequently be used to hold the needle in place at the pre-determined depth. (Figure 2a) In contrast, note the similar SeeStar® allows for simultaneous alignment of the needle along both angular axes (Figure 2b), but does not have a mechanism to secure the depth of the needle insertion. Physicians performing percutaneous interventions should be aware of the possibility of needle slippage and theoretical risks posed to surrounding tissue and organs, as well as potential solutions.

Microwave Ablation of Pulmonary Malignancies Using a Novel High-energy Antenna System

To evaluate the technical success, safety, and imaging follow-up of malignant pulmonary nodules treated with a novel high-energy percutaneous microwave ablation (MWA) system. Between July 2010 and September 2011, a total of 23 patients, 12 men, mean age 68 (range 30-87) years with 29 pulmonary malignancies of median diameter 19 (range 8-57) mm, underwent computed tomography (CT)-guided MWA with a 16G microwave needle antenna enabling power up to 180 W. Technical success was defined as needle placement in the intended lesion without death or serious injury. Adequacy of ablation was assessed at 24 h on contrast-enhanced CT. Circumferential solid or ground glass opacification >5 mm was used to define an ideal ablation. Local tumor recurrence was assessed at 1, 3, and 6 months after ablation on contrast-enhanced CT. MWA was technically successful in 93 % (n = 27). Mean ablation duration was 3.6 (range 1-9) min. Ten patients (43 %) developed a pneumothorax as a result of the MWA; only 3 (13 %) required placement of a chest drain. Thirty-day mortality rate was 0 %. The mean hospital stay was 1.5 (range 1-7) days. A total of 22 lesions (75 %) were surrounded by ≥5 mm ground glass or solid opacification after the procedure. At a median follow-up of 6 months, local recurrence was identified in 3 out of 26 lesions, giving a local control rate of 88 %. MWA using a high-power antenna of pulmonary malignancies is safe, technically achievable, and enables fast ablation times.

Internally cooled antenna for microwave ablation: Results in ex vivo and in vivo porcine livers

Purpose To evaluate the performance of microwave ablation with an internally cooled antenna in ex vivo and in vivo porcine livers. Materials and methods Microwave ablations were performed in ex vivo and in vivo porcine livers with a 1.9 mm-diameter 2450 MHz microwave needle antenna. Four power settings (50, 60, 70 and 80 W) were used in this study, while application time was fixed at 10 min. Diameters of the coagulation zone were observed on gross specimens. Results Excessive elongation of coagulation along the needle shaft was not encountered in all ablations. An arrow-shaped charring was observed. As the power increases, the long-axis coagulation diameter for in vivo liver increased significantly ( P < .05). The short-axis coagulation diameter for in vivo liver was significantly smaller than that for ex vivo liver ( P < .05) but not statistically different among the four power settings. After 10 min of ablation at 80 W, the short-axis and long-axis coagulation diameter for in vivo liver was 4.92 ± 0.15 cm and 2.37 ± 0.10 cm, respectively. Conclusion The internally cooled microwave antenna may be advantageous to minimize collateral damages.

前立腺肥大症に対するマイクロ波による経直腸的前立腺超音波ガイド下経会陰的前立腺焼灼術の検討

The aim of this study is to verify whether transperineal needle microwave needle ablation under transrectal prostate sonography is safe and effective for the patients with symptomatic benign prostatic hyperplasia.Three patients having International Prostate Symptom Score (IPSS) above 8 and quality of life (QOL) index above 2 were enrolled in this study. After full explanation of the objective and method of this study, which our Institutional Reviewer Board approved, informed consent was obtained from all patients. The operations were performed under general anesthesia in all cases. The mean operation time was 52 min. Postoperatively, the IPSS and QOL index improved from 14.7 to 10.3 and 6.0 to 4.7, respectively. Furthermore, the maximum urine flow rate increased from 6.3 to 14.3 mL/s, and the volume of prostate decreased from 70.3 to 35.1 cm3 after 3 months. There were no surgical complications. We concluded that transperineal needle microwave needle ablation under transrectal prostate sonography was safe and effective for the patients with symptomatic benign prostatic hyperplasia.

前立腺肥大症に対するｍｉｃｒｏｗａｖｅ ｔｉｓｓｕｅ ｃｏａｇｕｌａｔｏｒ（ＭＴＣ）を用いた高温度治療の開発

Eight male beagle dogs (12-24 months of age, 10-18 kg body weight) were used in this study. All dogs were castrated and then administered 5a-androstane-3α, 17β-diol (3α-diol) plus 17β-estradiol (estradiol) for 24 weeks according to Walsh and Wilson's method. Microwave needle ablation of the prostate using microwave tissue coagulator (MTC) was performed the dog when its prostate become over 25 mL in volume. At the experimental day, 1w, 4w, 12w, dogs were slaughtered and the prostate was harvested. Bladder and external sphincter samples demonstrated no gross abnormalities. Microwave needle ablation can ablates rapidly and constantly. The range which microwave reaches is always exact. The needle position and extend of ablating can be revealed with transrectal ultrasonography. We performed microwave needle ablation of the prostate using MTC to one BPH patient who got his consent. His episode of care was good. The immediate goal is to obtain the fundamental data, and to verify the clinical availability of microwave needle ablation for the treatment of BPH and localized prostate cancer.

Analysis of tissue and arterial blood temperatures in the resting human forearm. 1948.

Analysis of tissue and arterial blood temperatures in the resting human forearm. 1948.

A CASE OF MULTIPLE HEPATIC METASTASES FROM A COLONIC CANCER SUCCESSFULLY TREATED WITH MICROWAVE COAGULATION THERAPY

We report a case of colonic cancer in which multiple hepatic metastases found intraoperatively were treated with microwave coagulation therapy and thereafter those metastases were histologically proved to be completely necrotized. A 58-year-old woman was admitted to the hospital because of colonic obstruction due to an advanced colonic cancer. Preoperative CT scan and ultrasonography revealed no hepatic metastases. When a left colectomy for the colonic cancer was performed, five metastatic lesions in the liver smaller than 1 cm in S4. S5, S6 and S7 segments were found out. A microwave needle electrode was inserted into the hepatic lesions to coagulate them in situ. Seven months after the operation a new metastatic lesion of the liver was detected, and nine months after the operation an extended right hepatectomy including all previously coagulated metastases was performed. Liver specimen histologically showed that coagulated hepatic metastases were completely necrotized. There has been no sign of recurrence, as of 18 months after the hepatectomy. We would stress that multiple hepatic metastses can be controlled with microwave coagulation therapy that offers a possibility of curative hepatic resection.