scholarly journals Primary efficacy of percutaneous microwave ablation of malignant liver tumors: comparison of stereotactic and conventional manual guidance

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jan Schaible ◽  
Lukas Lürken ◽  
Philipp Wiggermann ◽  
Niklas Verloh ◽  
Ingo Einspieler ◽  
...  
Keyword(s):  
Microwave Ablation ◽  
Liver Tumors ◽  
Estimating Equation ◽  
Lesion Size ◽  
Efficacy Rate ◽  
Primary Efficacy ◽  
Liver Malignancies ◽  
Dose Length Product ◽  
Stereotactic Guidance ◽  
Percutaneous Microwave Ablation

Abstract In this study, we compare the primary efficacy of computed tomography-navigated stereotactic guidance to that of manual guidance for percutaneous microwave ablation of liver malignancies. In total, 221 patients (140, 17, and 64 with hepatocellular carcinoma, cholangiocellular carcinoma, and liver metastases, respectively) with 423 treated liver lesions underwent microwave ablation (MWA). Manual guidance (M) and stereotactic guidance (S) were used for 136 and 287 lesions, respectively. The primary endpoint was the primary efficacy and the secondary endpoint was the radiation dose. A generalised estimating equation was applied to analyse the correlation between the primary efficacy (lesion basis) and the type of guidance, size and location of lesion. The primary efficacy rate was significantly higher in the S-group (84.3%) than in the M-group (75.0%, p = 0.03). Lesion size > 30 mm was negatively correlated with the efficacy rate (odds ratio 0.38; 95% confidence interval 0.20–0.74). Stereotactic guidance was associated with a significantly lower dose length product (p < 0.01). In this retrospective study, percutaneous microwave ablation under stereotactic guidance exhibited significantly greater primary efficacy than conventional manual guidance.

scholarly journals Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system

2020 ◽  
Vol 54 (3) ◽  
pp. 295-300
Author(s):  
Jan Schaible ◽  
Benedikt Pregler ◽  
Niklas Verloh ◽  
Ingo Einspieler ◽  
Wolf Bäumler ◽  
...  
Keyword(s):  
Tumor Size ◽  
Microwave Ablation ◽  
Liver Tumors ◽  
Multiple Logistic Regression Analysis ◽  
Percutaneous Ablation ◽  
Primary Efficacy ◽  
Robotic Navigation ◽  
Liver Malignancies ◽  
Small Tumor ◽  
Small Tumor Size

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.

scholarly journals Efficacy and safety of percutaneous microwave ablation for hepatocellular carcinomas <4 cm in difficult location

2020 ◽  
Vol 93 (1116) ◽  
pp. 20191025
Author(s):  
Amar Mukund ◽  
Ravindran Ramalingam ◽  
Karan Manoj Anandpara ◽  
Yashwant Patidar ◽  
Rajan Vijayaraghavan ◽  
...  
Keyword(s):  
Microwave Ablation ◽  
Percutaneous Ablation ◽  
Control Group ◽  
Efficacy Rate ◽  
Complication Rates ◽  
Hepatocellular Carcinomas ◽  
Proper Patient Selection ◽  
Significant Difference ◽  
Technical Efficacy ◽  
Percutaneous Microwave Ablation

Objective: Tumor location is a critical factor for determining technical success and local recurrence following percutaneous ablation of hepatocellular carcinomas (HCC). The purpose of this retrospective study was to evaluate the safety and outcome measures of percutaneous microwave ablation (pMWA) for HCCs <4 cm in difficult locations. Methods: Retrospective review included 81 patients who underwent pMWA for HCCs <4 cm. Fourty-three patients (30 males and 13 females; mean age, 61 years) with 53 HCCs located near the diaphragm, heart, gallbladder, kidney, gastrointestinal tract, large vessel and exophytic location were included under difficult location group. Thirty-eight patients (29 males and nine females; mean age, 60 years) with 48 HCCs in other locations were included under control group. Baseline demographics were recorded. Technical efficacy, local tumor progression (LTP), and complication rates were evaluated. Results: Mean follow-up period was 3.4 months (range 1–7). There was no major complication in both the groups; two patients had a mild perihepatic hemorrhage in the difficult location group which was managed conservatively. There was no difference between the groups in the overall technical efficacy rate (84.9% vs 91.7%, p = 0.294), LTP rate (4.4% vs 2.2%. p = 0.57) or complication rate (4.6% vs 0%, p = 0.177). Conclusion: Our data suggest that there is no significant difference in technical efficacy, LTP or complication rates for MWA in both difficult and normal locations. Advances in knowledge: With proper patient selection, pre-procedural planning and appropriate technique, pMWA is feasible, safe, and effective for small HCCs in difficult location with an acceptable range of complications.

Three-dimensional echo decorrelation imaging of percutaneous microwave ablation in liver tumors

2021 ◽  
Vol 150 (4) ◽  
pp. A32-A32
Author(s):  
Elmira Ghahramani Z. ◽  
Peter D. Grimm ◽  
Bahar Saremi ◽  
Kyuran A. Choe ◽  
Seetharam Chadalavada ◽  
...  
Keyword(s):  
Microwave Ablation ◽  
Liver Tumors ◽  
Three Dimensional ◽  
Percutaneous Microwave Ablation

scholarly journals Microwave ablation of 105 T1 renal tumors: technique efficacy with a mean follow-up of two years

2020 ◽  
pp. 028418512095628
Author(s):  
Vanessa Acosta Ruiz ◽  
Pär Dahlman ◽  
Einar Brekkan ◽  
Maria Lönnemark ◽  
Anders Magnusson
Keyword(s):  
Microwave Ablation ◽  
Small Sample ◽  
Renal Tumors ◽  
Efficacy Rate ◽  
Primary Efficacy ◽  
Curative Intent ◽  
Renal Masses ◽  
Contrast Enhanced Ct ◽  
Potential Benefits

Background Thermal ablation (TA) with radiofrequency (RFA) or cryoablation (CA) are established treatments for small renal masses (≤4 cm). Microwave ablation (MWA) has several potential benefits (decreased ablation time, less susceptibility to heat-sink, higher lesion temperatures than RFA) but is still considered experimental considering the available small-sample studies with short follow-up. Purpose To evaluate technique efficacy and complications of our initial experience of renal tumors treated using percutaneous MWA with a curative intent. Material and Methods A total of 105 renal tumors (in 93 patients) were treated between April 2014 and August 2017. MWA was performed percutaneously with computed tomography (CT) guidance under conscious sedation (n=82) or full anesthesia. Patients were followed with contrast-enhanced CT scans at six months and yearly thereafter for a minimum of five years. The mean follow-up time was 2.1 years. The percentage of tumors completely ablated in a single session (primary efficacy rate) and those successfully treated after repeat ablation (secondary efficacy rate) were recorded. Patient and tumor characteristics as well as complications were collected retrospectively. Results The median patient age was 70 years and median tumor size was 25 mm. Primary efficacy rate was 96.2% (101/105 tumors). After including two residual tumors for a second ablation session, secondary efficacy was 97.1% (102/105). Periprocedural complications were found in 5.2% (5/95) sessions: four Clavien-Dindo I and one Clavien-Dindo IIIa. One postprocedural Clavien-Dindo II complication was found. Conclusion MWA has high efficacy rates and few complications compared to other TA methods at a mean follow-up of two years.

scholarly journals Histological Correlation for Radiofrequency and Microwave Ablation in the Local Control of Hepatocellular Carcinoma (HCC) before Liver Transplantation: A Comprehensive Review

Cancers ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 104
Author(s):  
Peiman Habibollahi ◽  
Rahul A. Sheth ◽  
Erik N. K. Cressman
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Microwave Ablation ◽  
Liver Tumors ◽  
High Specificity ◽  
Lesion Size ◽  
Ablation Techniques ◽  
High Rate ◽  
Pathological Findings ◽  
Comprehensive Review

Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most widely studied and applied ablation techniques for treating primary and secondary liver tumors. These techniques are considered curative for small hepatic tumors, with post-ablation outcomes most commonly assessed by an imaging follow up. However, there is increasing evidence of a discrepancy between radiological and pathological findings when ablated lesions are evaluated following liver resection or liver transplantation. A comprehensive review of the available literature reporting the complete pathological response (cPR) following RFA and MWA was performed to estimate the success rate and identify the factors associated with treatment failure. Following RFA, cPR is reported in 26–96% of tumors compared to 57–95% with MWA. Larger tumor size and vessels larger than 3 mm adjacent to the treated tumor are the most important factors identified by previous studies associated with viable residual tumors after RFA. Correlating post-ablation radiological studies with pathological findings shows that computed tomography (CT) and magnetic resonance imaging (MRI) have low sensitivity but high specificity for detecting residual viable or recurrent hepatocellular carcinoma (HCC) tumors. There are promising recent reports combining multiprobe ablation techniques with three-dimensional treatment planning software and stereotactic-aiming instrumentation to achieve more than 90% cPR in both small and large HCC tumors. In conclusion, the reported success for achieving cPR in HCC following RFA and MWA is highly variable in different studies and decreases with increasing lesion size and unfavorable tumor characteristics. Very few studies have reported a high rate of cPR. As these studies are single-center and retrospective, they need to be further validated and reproduced in other clinical settings.

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