Microwave ablation of the lung: Comparison of 19G with 14G and 16G microwave antennas in ex vivo porcine lung

Background: Percutaneous image-guided thermal ablation has an increasing role in the treatment of primary and metastatic lung tumors. Although microwave ablation (MWA) has emerged advantageous as a new ablation technology, more research is needed to improve it. This study aims to investigate the ablation zone of three microwave antennas in ex vivo porcine lung. Materials and Methods: In the ex vivo standard model and porcine lung model, MWA was performed in three power output settings (50 W, 60 W, and 70 W) for 3, 6, 9, and 12 min using three microwave antennas, with outer diameter of 1.03 mm (19G), 1.6 mm (16G), and 2.0 mm (14G). A total of 108 and 216 sessions were performed (3 or 6 sessions per time setting with the 14G, 16G, and 19G microwave antennas). After the MWA was complete, we evaluated the shape and extent of the coagulation zone and measured the maximum long-axis (along the needle axis; length [L]) and maximum short-axis (perpendicular to the needle; diameter [D]) of the ablation zones using a ruler; subsequently, the sphericity index (L/D) was calculated. The sphericity index can be simplified as long-axis/short-axis. Results: In the ex vivo standard model study, the long- and short-axis diameters and sphericity indices were not statistically different between the 14G, 16G, and 19G groups. In the ex vivo porcine lung study, the long- and short-axis diameters did not differ statistically between the 14G, 16G, and 19G groups (P < 0.05 each). The sphericity index for the 19G microwave antenna was higher than the sphericity indices for the 14G and 16G microwave antennas (P < 0.05); however, the index for the 14G microwave antenna was not statistically different than that for the 16G microwave antenna (P > 0.05). Conclusions: The ablation zone of the 19G antenna was the same as those of the 14G and 16G antennas in vitro. Thus, the 19G antenna may reduce the incidence of complications in lung tumor ablation.

[1]  Zhongmin Wang,et al.  Expert consensus on thermal ablation therapy of pulmonary subsolid nodules (2021 Edition) , 2021, Journal of cancer research and therapeutics.

[2]  B. Radjenovic,et al.  Finite Element Analysis of the Microwave Ablation Method for Enhanced Lung Cancer Treatment , 2021, Cancers.

[3]  X. Ye,et al.  Multicentre study of microwave ablation for pulmonary oligorecurrence after radical resection of non-small-cell lung cancer , 2021, British Journal of Cancer.

[4]  F. Abtin,et al.  Society of Interventional Radiology Quality Improvement Standards on Percutaneous Ablation of Non-Small Cell Lung Cancer and Metastatic Disease to the Lungs. , 2021, Journal of vascular and interventional radiology : JVIR.

[5]  Bing Zhang,et al.  A review of antenna designs for percutaneous microwave ablation. , 2021, Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics.

[6]  A. Jemal,et al.  Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries , 2021, CA: a cancer journal for clinicians.

[7]  T. Zander,et al.  Microwave ablation enhances tumor-specific immune response in patients with hepatocellular carcinoma , 2020, Cancer Immunology, Immunotherapy.

[8]  Zheng-Yu Lin,et al.  Evaluation of the correlation between infrared thermal imaging-magnetic resonance imaging-pathology of microwave ablation of lesions in rabbit lung tumors , 2020, Journal of cancer research and therapeutics.

[9]  Yang Bo,et al.  The application of magnetic resonance imaging-guided microwave ablation for lung cancer , 2020, Journal of cancer research and therapeutics.

[10]  K. Steinke,et al.  Long‐term outcome following microwave ablation of early‐stage non‐small cell lung cancer , 2020, Journal of medical imaging and radiation oncology.

[11]  Jing-Wang Bi,et al.  Microwave ablation plus chemotherapy versus chemotherapy in advanced non-small cell lung cancer: a multicenter, randomized, controlled, phase III clinical trial , 2020, European Radiology.

[12]  A. Chi,et al.  Comparison of Long-term Survival of Patients With Early-Stage Non–Small Cell Lung Cancer After Surgery vs Stereotactic Body Radiotherapy , 2019, JAMA network open.

[13]  Q. Nan,et al.  Experimental and numerical study of microwave ablation on ex-vivo porcine lung , 2019, Electromagnetic biology and medicine.

[14]  M. Sydnor,et al.  Current State of Tumor Ablation Therapies , 2019, Digestive Diseases and Sciences.

[15]  Yang Wang,et al.  A Meta-Analysis of Clinical Outcomes After Radiofrequency Ablation and Microwave Ablation for Lung Cancer and Pulmonary Metastases. , 2019, Journal of the American College of Radiology : JACR.

[16]  Xia Yang,et al.  Percutaneous microwave ablation of stage I medically inoperable non‐small cell lung cancer: Clinical evaluation of 47 cases , 2014, Journal of surgical oncology.

[17]  Muneeb Ahmed,et al.  Image-guided tumor ablation: standardization of terminology and reporting criteria--a 10-year update: supplement to the consensus document. , 2014, Journal of vascular and interventional radiology : JVIR.

[18]  K. Fei,et al.  Risk Factors for Major Adverse Events of Video-Assisted Thoracic Surgery Lobectomy for Lung Cancer , 2014, International journal of medical sciences.

[19]  C. Brace,et al.  Tumor ablation: common modalities and general practices. , 2013, Techniques in vascular and interventional radiology.

[20]  D. de Ruysscher,et al.  Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. , 2013, Annals of oncology : official journal of the European Society for Medical Oncology.

[21]  S. Kanazawa,et al.  Lung Cancer Ablation: Complications , 2013, Seminars in Interventional Radiology.

[22]  Hu Bing,et al.  A polyacrylamide gel phantom for radiofrequency ablation , 2008, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[23]  E. Madsen,et al.  Tissue-mimicking phantom materials for narrowband and ultrawideband microwave applications , 2005, Physics in medicine and biology.

[24]  Daniel Y Sze,et al.  CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. , 2003, Radiology.

[25]  M J Bronskill,et al.  Magnetic resonance imaging of thermal coagulation effects in a phantom for calibrating thermal therapy devices. , 2000, Medical physics.

[26]  Punit Prakash,et al.  Antenna Designs for Microwave Tissue Ablation. , 2018, Critical reviews in biomedical engineering.

[27]  Robert E Lenkinski,et al.  Radiofrequency ablation: modeling the enhanced temperature response to adjuvant NaCl pretreatment. , 2004, Radiology.

[28]  K Sugimachi,et al.  Excised human neoplastic tissues are more sensitive to heat than the adjacent normal tissues. , 1988, European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes.