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Semin intervent Radiol 2013; 30(01): 056-066
DOI: 10.1055/s-0033-1333654
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Microwave Ablation of Hepatic Malignancy

Meghan G. Lubner
1   Department of Radiology
,
Christopher L. Brace
1   Department of Radiology
2   Department of Biomedical Engineering
3   Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin
,
Tim J. Ziemlewicz
1   Department of Radiology
,
J. Louis Hinshaw
1   Department of Radiology
,
Fred T. Lee Jr.
1   Department of Radiology
› Author Affiliations
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Publication History

Publication Date:
27 February 2013 (online)

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Abstract

Microwave ablation is an extremely promising heat-based thermal ablation modality that has particular applicability in treating hepatic malignancies. Microwaves can generate very high temperatures in very short time periods, potentially leading to improved treatment efficiency and larger ablation zones. As the available technology continues to improve, microwave ablation is emerging as a valuable alternative to radiofrequency ablation in the treatment of hepatic malignancies. This article reviews the current state of microwave ablation including technical and clinical considerations.

Keywords

interventional radiology - microwave - ablation - liver tumors
 

  • References

  • 1 Brace CL. Microwave ablation technology: what every user should know. Curr Probl Diagn Radiol 2009; 38 (2) 61-67
    CrossrefPubMedGoogle Scholar
  • 2 Duck F. Physical Properties of Tissue: A Comprehensive Reference Book. London, United Kingdom: Academic Press; 1990
    Google Scholar
  • 3 Brace CL. Radiofrequency and microwave ablation of the liver, lung, kidney, and bone: what are the differences?. Curr Probl Diagn Radiol 2009; 38 (3) 135-143
    CrossrefPubMedGoogle Scholar
  • 4 Simon J, Dupuy DE, Mayo-Smith WW. Microwave ablation: principles and applications. Radiographics 2005; 25 (Suppl. 01) S69-S83
    CrossrefPubMedGoogle Scholar
  • 5 Brace CL, Laeseke PF, Sampson LA, Frey TM, van der Weide DW, Lee Jr FT. Microwave ablation with a single small-gauge triaxial antenna: in vivo porcine liver model. Radiology 2007; 242 (2) 435-440
    CrossrefPubMedGoogle Scholar
  • 6 Hines-Peralta AU, Pirani N, Clegg P , et al. Microwave ablation: results with a 2.45-GHz applicator in ex vivo bovine and in vivo porcine liver. Radiology 2006; 239 (1) 94-102
    CrossrefPubMedGoogle Scholar
  • 7 Shock SA, Meredith K, Warner TF , et al. Microwave ablation with loop antenna: in vivo porcine liver model. Radiology 2004; 231 (1) 143-149
    CrossrefPubMedGoogle Scholar
  • 8 Lu MD, Xu HX, Xie XY , et al. Percutaneous microwave and radiofrequency ablation for hepatocellular carcinoma: a retrospective comparative study. J Gastroenterol 2005; 40 (11) 1054-1060
    CrossrefPubMedGoogle Scholar
  • 9 Schramm W, Yang D, Haemmerich D. Contribution of direct heating, thermal conduction and perfusion during radiofrequency and microwave ablation. Conf Proc IEEE Eng Med Biol Soc 2006; 1: 5013-5016
    PubMedGoogle Scholar
  • 10 Yang D, Converse MC, Mahvi DM, Webster JG. Measurement and analysis of tissue temperature during microwave liver ablation. IEEE Trans Biomed Eng 2007; 54 (1) 150-155
    CrossrefPubMedGoogle Scholar
  • 11 Skinner MG, Iizuka MN, Kolios MC, Sherar MD. A theoretical comparison of energy sources—microwave, ultrasound and laser—for interstitial thermal therapy. Phys Med Biol 1998; 43 (12) 3535-3547
    CrossrefPubMedGoogle Scholar
  • 12 Brace CL, Laeseke PF, Sampson LA, Frey TM, van der Weide DW, Lee Jr FT. Microwave ablation with multiple simultaneously powered small-gauge triaxial antennas: results from an in vivo swine liver model. Radiology 2007; 244 (1) 151-156
    CrossrefPubMedGoogle Scholar
  • 13 Wright AS, Lee Jr FT, Mahvi DM. Hepatic microwave ablation with multiple antennae results in synergistically larger zones of coagulation necrosis. Ann Surg Oncol 2003; 10 (3) 275-283
    CrossrefPubMedGoogle Scholar
  • 14 Haemmerich D, Lee Jr FT. Multiple applicator approaches for radiofrequency and microwave ablation. Int J Hyperthermia 2005; 21 (2) 93-106
    CrossrefPubMedGoogle Scholar
  • 15 Oshima F, Yamakado K, Nakatsuka A, Takaki H, Makita M, Takeda K. Simultaneous microwave ablation using multiple antennas in explanted bovine livers: relationship between ablative zone and antenna. Radiat Med 2008; 26 (7) 408-414
    CrossrefPubMedGoogle Scholar
  • 16 Durick NA, Laeseke PF, Broderick LS , et al. Microwave ablation with triaxial antennas tuned for lung: results in an in vivo porcine model. Radiology 2008; 247 (1) 80-87
    CrossrefPubMedGoogle Scholar
  • 17 Trembly BS, Douple EB, Ryan TP, Hoopes PJ. Effect of phase modulation on the temperature distribution of a microwave hyperthermia antenna array in vivo. Int J Hyperthermia 1994; 10 (5) 691-705
    CrossrefPubMedGoogle Scholar
  • 18 Magin RL, Peterson AF. Noninvasive microwave phased arrays for local hyperthermia: a review. Int J Hyperthermia 1989; 5 (4) 429-450
    CrossrefPubMedGoogle Scholar
  • 19 Clibbon KL, McCowen A, Hand JW. SAR distributions in interstitial microwave antenna arrays with a single dipole displacement. IEEE Trans Biomed Eng 1993; 40 (9) 925-932
    CrossrefPubMedGoogle Scholar
  • 20 Camart JC, Dubois L, Fabre JJ, Vanloot D, Chive M. 915 MHz microwave interstitial hyperthermia. Part II: Array of phase-monitored antennas. Int J Hyperthermia 1993; 9 (3) 445-454
    CrossrefPubMedGoogle Scholar
  • 21 Bhardwaj N, Strickland AD, Ahmad F, Atanesyan L, West K, Lloyd DM. A comparative histological evaluation of the ablations produced by microwave, cryotherapy and radiofrequency in the liver. Pathology 2009; 41 (2) 168-172
    CrossrefPubMedGoogle Scholar
  • 22 Yu NC, Raman SS, Kim YJ, Lassman C, Chang X, Lu DS. Microwave liver ablation: influence of hepatic vein size on heat-sink effect in a porcine model. J Vasc Interv Radiol 2008; 19 (7) 1087-1092
    CrossrefPubMedGoogle Scholar
  • 23 Awad MM, Devgan L, Kamel IR, Torbensen M, Choti MA. Microwave ablation in a hepatic porcine model: correlation of CT and histopathologic findings. HPB (Oxford) 2007; 9 (5) 357-362
    CrossrefPubMedGoogle Scholar
  • 24 Lu DS, Raman SS, Limanond P , et al. Influence of large peritumoral vessels on outcome of radiofrequency ablation of liver tumors. J Vasc Interv Radiol 2003; 14 (10) 1267-1274
    CrossrefPubMedGoogle Scholar
  • 25 Fan W, Li X, Zhang L, Jiang H, Zhang J. Comparison of microwave ablation and multipolar radiofrequency ablation in vivo using two internally cooled probes. AJR Am J Roentgenol 2012; 198 (1) W46-50
    PubMedGoogle Scholar
  • 26 Bhardwaj N, Dormer J, Ahmad F , et al. Microwave ablation of the liver: a description of lesion evolution over time and an investigation of the heat sink effect. Pathology 2011; 43 (7) 725-731
    CrossrefPubMedGoogle Scholar
  • 27 Boutros C, Somasundar P, Garrean S, Saied A, Espat NJ. Microwave coagulation therapy for hepatic tumors: review of the literature and critical analysis. Surg Oncol 2010; 19 (1) e22-e32
    CrossrefPubMedGoogle Scholar
  • 28 Shibata T, Iimuro Y, Yamamoto Y , et al. Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy. Radiology 2002; 223 (2) 331-337
    CrossrefPubMedGoogle Scholar
  • 29 Dong B, Liang P, Yu X , et al. Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma: results in 234 patients. AJR Am J Roentgenol 2003; 180 (6) 1547-1555
    CrossrefPubMedGoogle Scholar
  • 30 Shiomi H, Naka S, Sato K , et al. Thoracoscopy-assisted magnetic resonance guided microwave coagulation therapy for hepatic tumors. Am J Surg 2008; 195 (6) 854-860
    CrossrefPubMedGoogle Scholar
  • 31 Iannitti DA, Martin RC, Simon CJ , et al. Hepatic tumor ablation with clustered microwave antennae: the US phase II trial. HPB (Oxford) 2007; 9 (2) 120-124
    CrossrefPubMedGoogle Scholar
  • 32 Seki S, Sakaguchi H, Iwai S , et al. Five-year survival of patients with hepatocellular carcinoma treated with laparoscopic microwave coagulation therapy. Endoscopy 2005; 37 (12) 1220-1225
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Liang P, Dong B, Yu X , et al. Prognostic factors for survival in patients with hepatocellular carcinoma after percutaneous microwave ablation. Radiology 2005; 235 (1) 299-307
    CrossrefPubMedGoogle Scholar
  • 34 Xu HX, Lu MD, Xie XY , et al. Prognostic factors for long-term outcome after percutaneous thermal ablation for hepatocellular carcinoma: a survival analysis of 137 consecutive patients. Clin Radiol 2005; 60 (9) 1018-1025
    CrossrefPubMedGoogle Scholar
  • 35 Qian GJ, Wang N, Shen Q , et al. Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma: experimental and clinical studies. Eur Radiol 2012; 22 (9) 1983-1990
    CrossrefPubMedGoogle Scholar
  • 36 Takami Y, Ryu T, Wada Y, Saitsu H. Evaluation of intraoperative microwave coagulo-necrotic therapy (MCN) for hepatocellular carcinoma: a single center experience of 719 consecutive cases. J Hepatobiliary Pancreat Sci 2012; (Epub ahead of print)
    PubMedGoogle Scholar
  • 37 Jiao DC, Zhou Q, Han XW , et al. Microwave ablation treatment of liver cancer with a 2,450-MHz cooled-shaft antenna: pilot study on safety and efficacy. Asian Pac J Cancer Prev 2012; 13 (2) 737-742
    CrossrefPubMedGoogle Scholar
  • 38 Strickland AD, Clegg PJ, Cronin NJ , et al. Experimental study of large-volume microwave ablation in the liver. Br J Surg 2002; 89 (8) 1003-1007
    CrossrefPubMedGoogle Scholar
  • 39 Yu NC, Lu DS, Raman SS , et al. Hepatocellular carcinoma: microwave ablation with multiple straight and loop antenna clusters—pilot comparison with pathologic findings. Radiology 2006; 239 (1) 269-275
    CrossrefPubMedGoogle Scholar
  • 40 Ng KK, Poon RT, Lo CM, Yuen J, Tso WK, Fan ST. Analysis of recurrence pattern and its influence on survival outcome after radiofrequency ablation of hepatocellular carcinoma. J Gastrointest Surg 2008; 12 (1) 183-191
    CrossrefPubMedGoogle Scholar
  • 41 Chung IK, Park MJ, Kwon KT , et al. The factors related to the prognosis of solitary hepatocellular carcinoma after radiofrequency ablation [in Korean]. Korean J Hepatol 2005; 11 (4) 371-380
    PubMedGoogle Scholar
  • 42 Kim YS, Rhim H, Cho OK, Koh BH, Kim Y. Intrahepatic recurrence after percutaneous radiofrequency ablation of hepatocellular carcinoma: analysis of the pattern and risk factors. Eur J Radiol 2006; 59 (3) 432-441
    CrossrefPubMedGoogle Scholar
  • 43 Yu Z, Liu W, Fan L, Shao J, Huang Y, Si X. The efficacy and safety of percutaneous microwave coagulation by a new microwave delivery system in large hepatocellular carcinomas: four case studies. Int J Hyperthermia 2009; 25 (5) 392-398
    CrossrefPubMedGoogle Scholar
  • 44 Gravante G, Ong SL, Metcalfe MS, Strickland A, Dennison AR, Lloyd DM. Hepatic microwave ablation: a review of the histological changes following thermal damage. Liver Int 2008; 28 (7) 911-921
    CrossrefPubMedGoogle Scholar
  • 45 Simon CJ, Dupuy DE, Iannitti DA , et al. Intraoperative triple antenna hepatic microwave ablation. AJR Am J Roentgenol 2006; 187 (4) W333-W340
    CrossrefPubMedGoogle Scholar
  • 46 Yin XY, Xie XY, Lu MD , et al. Percutaneous thermal ablation of medium and large hepatocellular carcinoma: long-term outcome and prognostic factors. Cancer 2009; 115 (9) 1914-1923
    CrossrefPubMedGoogle Scholar
  • 47 Veltri A, Gazzera C, Rotondella C, Camerano F, Busso M, Gandini G. Image-guided microwave ablation of hepatic tumours: preliminary experience. Radiol Med (Torino) 2012; 117 (3) 378-392
    CrossrefPubMedGoogle Scholar
  • 48 Liu C, Liang P, Liu F , et al. MWA combined with TACE as a combined therapy for unresectable large-sized hepatocellular carcinoma. Int J Hyperthermia 2011; 27 (7) 654-662
    CrossrefPubMedGoogle Scholar
  • 49 Seki T, Wakabayashi M, Nakagawa T , et al. Percutaneous microwave coagulation therapy for solitary metastatic liver tumors from colorectal cancer: a pilot clinical study. Am J Gastroenterol 1999; 94 (2) 322-327
    CrossrefPubMedGoogle Scholar
  • 50 Shibata T, Niinobu T, Ogata N, Takami M. Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma. Cancer 2000; 89 (2) 276-284
    CrossrefPubMedGoogle Scholar
  • 51 Ogata Y, Uchida S, Hisaka T , et al. Intraoperative thermal ablation therapy for small colorectal metastases to the liver. Hepatogastroenterology 2008; 55 (82–83) 550-556
    PubMedGoogle Scholar
  • 52 Liang P, Wang Y, Yu X, Dong B. Malignant liver tumors: treatment with percutaneous microwave ablation—complications among cohort of 1136 patients. Radiology 2009; 251 (3) 933-940
    CrossrefPubMedGoogle Scholar
  • 53 Bertot LC, Sato M, Tateishi R, Yoshida H, Koike K. Mortality and complication rates of percutaneous ablative techniques for the treatment of liver tumors: a systematic review. Eur Radiol 2011; 21 (12) 2584-2596
    CrossrefPubMedGoogle Scholar