Microwave Ablation: Comparison of Simultaneous and Sequential Activation of Multiple Antennas in Liver Model Systems.

PURPOSE To compare microwave ablation zones created by using sequential or simultaneous power delivery in ex vivo and in vivo liver tissue. MATERIALS AND METHODS All procedures were approved by the institutional animal care and use committee. Microwave ablations were performed in both ex vivo and in vivo liver models with a 2.45-GHz system capable of powering up to three antennas simultaneously. Two- and three-antenna arrays were evaluated in each model. Sequential and simultaneous ablations were created by delivering power (50 W ex vivo, 65 W in vivo) for 5 minutes per antenna (10 and 15 minutes total ablation time for sequential ablations, 5 minutes for simultaneous ablations). Thirty-two ablations were performed in ex vivo bovine livers (eight per group) and 28 in the livers of eight swine in vivo (seven per group). Ablation zone size and circularity metrics were determined from ablations excised postmortem. Mixed effects modeling was used to evaluate the influence of power delivery, number of antennas, and tissue type. RESULTS On average, ablations created by using the simultaneous power delivery technique were larger than those with the sequential technique (P < .05). Simultaneous ablations were also more circular than sequential ablations (P = .0001). Larger and more circular ablations were achieved with three antennas compared with two antennas (P < .05). Ablations were generally smaller in vivo compared with ex vivo. CONCLUSION The use of multiple antennas and simultaneous power delivery creates larger, more confluent ablations with greater temperatures than those created with sequential power delivery.

[1]  M. G. Mack,et al.  MR-guided laser-induced thermotherapy (LITT) of liver tumours: experimental and clinical data , 2004, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[2]  P. Liang,et al.  Percutaneous microwave ablation for hepatocellular carcinoma adjacent to large vessels: a long-term follow-up. , 2014, European journal of radiology.

[3]  Guy Marchal,et al.  Local Recurrence After Hepatic Radiofrequency Coagulation: Multivariate Meta-Analysis and Review of Contributing Factors , 2005, Annals of surgery.

[4]  W. Lau,et al.  Percutaneous thermal ablation of medium and large hepatocellular carcinoma , 2009, Cancer.

[5]  Guy Marchal,et al.  Radiofrequency Ablation versus Resection for Resectable Colorectal Liver Metastases: Time for a Randomized Trial? , 2009, Digestive Surgery.

[6]  Xiao-Yan Xie,et al.  Percutaneous thermal ablation of medium and large hepatocellular carcinoma: Long-term outcome and prognostic factors , 2008 .

[7]  T. Vogl,et al.  Image-guided tumor ablation: standardization of terminology and reporting criteria--a 10-year update. , 2014, Radiology.

[8]  L. Solbiati,et al.  Complications of Microwave Ablation for Liver Tumors: Results of a Multicenter Study , 2012, CardioVascular and Interventional Radiology.

[9]  A D Strickland,et al.  A comparative histological evaluation of the ablations produced by microwave, cryotherapy and radiofrequency in the liver , 2009, Pathology.

[10]  P. F. Turner Interstitial Equal-Phased Arrays for EM Hyperthermia , 1986 .

[11]  Francis A. Duck,et al.  Physical properties of tissue : a comprehensive reference book , 1990 .

[12]  J. Hinshaw,et al.  Radiofrequency ablation: simultaneous application of multiple electrodes via switching creates larger, more confluent ablations than sequential application in a large animal model. , 2009, Journal of Vascular and Interventional Radiology.

[13]  S. Goldberg,et al.  Minimally Invasive Image-Guided Therapies for Hepatocellular Carcinoma , 2002, Journal of clinical gastroenterology.

[14]  Anthony E. Samir,et al.  Radiofrequency ablation of hepatic tumours: effect of post-ablation margin on local tumour progression , 2010, European Radiology.

[15]  T. Winter,et al.  Multiple-electrode radiofrequency ablation: comparison with a conventional cluster electrode in an in vivo porcine kidney model. , 2007, Journal of vascular and interventional radiology : JVIR.

[16]  J. Hinshaw,et al.  Creation of short microwave ablation zones: in vivo characterization of single and paired modified triaxial antennas. , 2014, Journal of vascular and interventional radiology : JVIR.

[17]  D. Haemmerich,et al.  Multiple applicator approaches for radiofrequency and microwave ablation , 2005, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[18]  L. Ellis,et al.  Radiofrequency Ablation of Unresectable Primary and Metastatic Hepatic Malignancies: Results in 123 Patients , 1999 .

[19]  D. W. van der Weide,et al.  Multiple-Antenna Microwave Ablation: Spatially Distributing Power Improves Thermal Profiles and Reduces Invasiveness. , 2009, Journal of interventional oncology.

[20]  Katsunori Saigenji,et al.  Radiofrequency ablation of hepatocellular carcinoma: correlation between local tumor progression after ablation and ablative margin. , 2007, AJR. American journal of roentgenology.

[21]  H. Ueno,et al.  Satellite lesions in patients with small hepatocellular carcinoma with reference to clinicopathologic features , 2002, Cancer.

[22]  G. Gazelle,et al.  Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions. , 2000, Radiology.

[23]  Christopher L Brace,et al.  Microwave ablation with multiple simultaneously powered small-gauge triaxial antennas: results from an in vivo swine liver model. , 2007, Radiology.

[24]  Joon Koo Han,et al.  Multiple-Electrode Radiofrequency Ablation of In Vivo Porcine Liver: Comparative Studies of Consecutive Monopolar, Switching Monopolar Versus Multipolar Modes , 2007, Investigative radiology.

[25]  Sandro Sironi,et al.  Percutaneous microwave ablation of hepatic tumors: prospective evaluation of postablation syndrome and postprocedural pain. , 2014, Journal of vascular and interventional radiology : JVIR.

[26]  David M. Mahvi,et al.  Hepatic Microwave Ablation With Multiple Antennae Results in Synergistically Larger Zones of Coagulation Necrosis , 2003, Annals of Surgical Oncology.

[27]  T. Winter,et al.  Multiple-electrode radiofrequency ablation of hepatic malignancies: initial clinical experience. , 2007, AJR. American journal of roentgenology.

[28]  Masashi Makita,et al.  Simultaneous microwave ablation using multiple antennas in explanted bovine livers: relationship between ablative zone and antenna , 2008, Radiation Medicine.

[29]  Christopher L Brace,et al.  Microwave ablation technology: what every user should know. , 2009, Current problems in diagnostic radiology.

[30]  Takashi Shibata,et al.  Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma , 2000, Cancer.

[31]  J. Webster,et al.  Large-volume radiofrequency ablation of ex vivo bovine liver with multiple cooled cluster electrodes. , 2005, Radiology.