Microwave ablation and emerging technologies for liver tumors

Author(s):  
Kwan N. Lau ◽  
David A. Iannitti
2021 ◽  
Vol 11 ◽  
Author(s):  
Simeon J. S. Ruiter ◽  
Pascale Tinguely ◽  
Iwan Paolucci ◽  
Jennie Engstrand ◽  
Daniel Candinas ◽  
...  

BackgroundThree-dimensional (3D) volumetric ablation margin assessment after thermal ablation of liver tumors using software has been described, but its predictive value on treatment efficacy when accounting for other factors known to correlate ablation site recurrence (ASR) remains unknown.PurposeTo investigate 3D quantitative ablation margins (3D-QAMs) as an algorithm to predict ASR within 1 year after stereotactic microwave ablation (SMWA) for colorectal liver metastases (CRLM).Materials and MethodsSixty-five tumors in 47 patients from a prospective multicenter study of patients undergoing SMWA for CRLM were included in this retrospective 3D-QAM analysis. Using a previously developed algorithm, 3D-QAM defined as the distribution of tumor to ablation surface distances was assessed in co-registered pre- and post-ablation CT scans. The discriminatory power and optimal cutoff values for 3D-QAM were assessed using receiver operating characteristic (ROC) curves. Multivariable logistic regression analysis using generalized estimating equations was applied to investigate the impact of various 3D-QAM outputs on 1-year ASR while accounting for other known influencing factors.ResultsTen of the 65 (15.4%) tumors included for 3D-QAM analysis developed ASR. ROC analyses identified i) 3D-QAM <1 mm for >23% of the tumor surface, ii) 3D-QAM <5 mm for >45%, and iii) the minimal ablation margin (MAM) as the 3D-QAM outputs with optimal discriminatory qualities. The multivariable regression model without 3D-QAM yielded tumor diameter and KRAS mutation as 1-year ASR predictors. When adding 3D-QAM, this factor became the main predictor of 1-year ASR [odds ratio (OR) 21.67 (CI 2.48, 165.21) if defined as >23% <1 mm; OR 0.52 (CI 0.29, 0.95) if defined as MAM].Conclusions3D-QAM allows objectifiable and standardized assessment of tumor coverage by the ablation zone after SMWA. Our data shows that 3D-QAM represents the most important factor predicting ASR within 1 year after SMWA of CRLM.


2017 ◽  
Vol 31 (10) ◽  
pp. 4315-4324 ◽  
Author(s):  
Pascale Tinguely ◽  
Matteo Fusaglia ◽  
Jacob Freedman ◽  
Vanessa Banz ◽  
Stefan Weber ◽  
...  

2020 ◽  
Vol 54 (3) ◽  
pp. 295-300
Author(s):  
Jan Schaible ◽  
Benedikt Pregler ◽  
Niklas Verloh ◽  
Ingo Einspieler ◽  
Wolf Bäumler ◽  
...  

AbstractBackgroundThe aim of the study was to assess the primary efficacy of robot-assisted microwave ablation and compare it to manually guided microwave ablation for percutaneous ablation of liver malignancies.Patients and methodsWe performed a retrospective single center evaluation of microwave ablations of 368 liver tumors in 192 patients (36 female, 156 male, mean age 63 years). One hundred and nineteen ablations were performed between 08/2011 and 03/2014 with manual guidance, whereas 249 ablations were performed between 04/2014 and 11/2018 using robotic guidance. A 6-week follow-up (ultrasound, computed tomography and magnetic resonance imaging) was performed on all patients.ResultsThe primary technique efficacy outcome of the group treated by robotic guidance was significantly higher than that of the manually guided group (88% vs. 76%; p = 0.013). Multiple logistic regression analysis indicated that a small tumor size (≤ 3 cm) and robotic guidance were significant favorable prognostic factors for complete ablation.ConclusionsIn addition to a small tumor size, robotic navigation was a major positive prognostic factor for primary technique efficacy.


2018 ◽  
Vol 33 (12) ◽  
pp. 2007-2014 ◽  
Author(s):  
Kento Imajo ◽  
Wataru Tomeno ◽  
Mineo Kanezaki ◽  
Yasushi Honda ◽  
Takaomi Kessoku ◽  
...  

2020 ◽  
Vol 54 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Jan Schaible ◽  
Benedikt Pregler ◽  
Wolf Bäumler ◽  
Ingo Einspieler ◽  
Ernst-Michael Jung ◽  
...  

AbstractBackgroundThe aim of the study was to evaluate the inter- and intrareader variability of the safety margin assessment after microwave ablation of liver tumors using post-procedure computed tomography (CT) images as well as to determine the sensitivity and specificity of identification remnant tumor tissue.Patients and methodsA retrospective analysis of 58 patients who underwent microwave ablation (MWA) of primary or secondary liver malignancies (46 hepatocellular carcinoma, 9 metastases of a colorectal cancer and 3 metastases of pancreatic cancer) between September 2017 and June 2019 was conducted. Three readers estimated the minimal safety margin in millimeters using side-by-side comparison of the 1-day pre-ablation CT and 1-day post-ablation CT and judged whether ablation was complete or incomplete. One reader estimated the safety margin again after 6 weeks. Magnetic resonance imaging (MRI) after 6 weeks was the gold standard.ResultsThe intraclass correlation coefficient (ICC) for estimation of the minimal safety margin of all three readers was 0.357 (95%-confidence interval 0.194–0.522). The ICC for repeated assessment (reader 1) was 0.774 (95%-confidence interval 0.645–0.860). Sensitivity and specificity of the detection of complete tumor ablation, defined as no remnant tumor tissue in 6 weeks follow-up MRI, were 93%/82%/82% and 33%/17%/83%, respectively.ConclusionsIn clinical practice, the safety margin after liver tumor ablation is often assessed using side-by-side comparison of CT images. In the study, we were able to show, that this technique has a poor reliability (ICC 0.357). From our point of view, this proves the necessity of new technical procedures for the assessment of the safety distance.


2018 ◽  
Vol 35 (1) ◽  
pp. 141-149 ◽  
Author(s):  
Min Ding ◽  
Sicong Ma ◽  
Xiaoyin Tang ◽  
Tao Wang ◽  
Xingxing Qi ◽  
...  

Author(s):  
Robert M. Pohlman ◽  
James L. Hinshaw ◽  
Timothy J. Ziemlewicz ◽  
Meghan G. Lubner ◽  
Shane A. Wells ◽  
...  

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