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Shi J, Jiang Y, Li J, Chen H, Cong N. Impact of microwave ablation on survival rates and recurrence in hepatic malignant tumors. Clin Transl Oncol 2025; 27:1131-1141. [PMID: 39136926 DOI: 10.1007/s12094-024-03626-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 07/19/2024] [Indexed: 03/18/2025]
Abstract
PURPOSE This study aimed to evaluate the efficacy of percutaneous microwave ablation (MWA) for treating hepatic malignant tumors and to identify factors influencing tumor recurrence post-treatment. METHODS A total of 249 patients with hepatic malignant tumors treated at the Shandong Cancer Hospital and Institute were included, and 101 patients were analyzed. Disease-free and overall survival rates were assessed at 1, 2, and 3 years post-MWA. Correlations between tumor recurrence and factors such as Child-Pugh B classification and lesion count were examined, and a meta-analysis was conducted to identify independent risk factors for recurrence. RESULTS The study found disease-free survival rates of 80.2%, 72.3%, and 70.3% at 1, 2, and 3 years post-MWA, with overall survival rates at 99%, 97%, and 96%. Significant correlations were observed between tumor recurrence, Child-Pugh B classification, and the number of lesions. Meta-analysis confirmed lesion count and Child-Pugh B classification as independent risk factors for recurrence following MWA treatment. CONCLUSION The study underscores the importance of considering Child-Pugh B classification and lesion count in predicting tumor recurrence after MWA for hepatic malignant tumors. These findings offer valuable insights for clinicians in decision-making and post-treatment monitoring.
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Affiliation(s)
- Jutian Shi
- Intervention Ward One, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No. 440, Jiyan Road, Huaiyin District, Jinan, 250000, Shandong Province, China
| | - Yutian Jiang
- Department of Interventional, Yan Tai Yu Huangding Hospital, Yan Tai, 264000, China
| | - Jinpeng Li
- Intervention Ward One, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No. 440, Jiyan Road, Huaiyin District, Jinan, 250000, Shandong Province, China
| | - Hua Chen
- Intervention Ward One, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No. 440, Jiyan Road, Huaiyin District, Jinan, 250000, Shandong Province, China
| | - Ning Cong
- Intervention Ward One, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No. 440, Jiyan Road, Huaiyin District, Jinan, 250000, Shandong Province, China.
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Jin X, Jiang M, Qian L, Tao L, Yang Y, Xing L, Qian Z, Li W. Effect of 433 MHz double-slot microwave antennas for double-zone ablation in ex vivo swine liver experiment. PLoS One 2025; 20:e0315678. [PMID: 39933011 PMCID: PMC11813083 DOI: 10.1371/journal.pone.0315678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 11/29/2024] [Indexed: 02/13/2025] Open
Abstract
PURPOSE To evaluate the effects of axial length and slot-to-slot distance of double-slot microwave antenna (DSMA) with frequency of 433 MHz on the size and shape of ablation zones created under different input microwave powers. MATERIALS AND METHODS The design of double slot microwave antennas (DSMAs) with axial lengths (70 mm, 30 mm) and slot-to-slot distance (49 mm, 10 mm) were optimized by numerical simulation and ex vivo liver experiments. Finite-element method simulations and forty ablations of swine liver were employed to obtain the temperature distributions within liver tissue using DSMAs at the 433 MHz operating frequency in a range of heating powers (20, 30, 40 and 50W) for 600 s. The dependence of the effectiveness of MWA on the axial length and slot-to-slot distance of antenna as well as the input power was further evaluated by analyzing morphologic characteristics of ablated zone. RESULTS Two-zone ablation was achieved by two types of double-slot antennas in our study with frequency of 433 MHz, and the observed shapes of ex vivo experimental ablation zones were in good agreement with patterns predicted by simulation models. The ablation zone exhibited a 'gourd' shape after the treatment using the antenna with longer axial length and slot-to-slot distance, while the short antenna caused a guitar-shape ablation in liver tissue after MWA. CONCLUSION The dedicated design of our DSMAs with a frequency of 433 MHz could enable new ablation shapes with controllable dimensions, which can be applied to the clinical treatment of MWA for gourd-shaped liver tumors and other long-shaped tumors. Furthermore, research can be conducted on how to design the antenna as flexible and use it for the treatment of pulmonary nodules or varicose veins.
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Affiliation(s)
- Xiaofei Jin
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Key Laboratory of Multi-modal Brain-Computer Precision Drive, Industry and Information Technology Ministry, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Mengwei Jiang
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Lu Qian
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Ling Tao
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Key Laboratory of Brain-Machine Intelligence Technology, Ministry of Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Yamin Yang
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Key Laboratory of Multi-modal Brain-Computer Precision Drive, Industry and Information Technology Ministry, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Lidong Xing
- Key Laboratory of Multi-modal Brain-Computer Precision Drive, Industry and Information Technology Ministry, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Zhiyu Qian
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Key Laboratory of Multi-modal Brain-Computer Precision Drive, Industry and Information Technology Ministry, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Weitao Li
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Key Laboratory of Multi-modal Brain-Computer Precision Drive, Industry and Information Technology Ministry, Nanjing University of Aeronautics and Astronautics, Nanjing, China
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Alemaryeen A, Noghanian S. A Survey of the Thermal Analysis of Implanted Antennas for Wireless Biomedical Devices. MICROMACHINES 2023; 14:1894. [PMID: 37893331 PMCID: PMC10609145 DOI: 10.3390/mi14101894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Wireless implantable biomedical devices (IBDs) are emerging technologies used to enhance patient treatment and monitoring. The performance of wireless IBDs mainly relies on their antennas. Concerns have emerged regarding the potential of wireless IBDs to unintentionally cause tissue heating, leading to potential harm to surrounding tissue. The previous literature examined temperature estimations and specific absorption rates (SAR) related to IBDs, mainly within the context of thermal therapy applications. Often, these studies consider system parameters such as frequency, input power, and treatment duration without isolating their individual impacts. This paper provides an extensive literature review, focusing on key antenna design parameters affecting heat distribution in IBDs. These parameters encompass antenna design, treatment settings, testing conditions, and thermal modeling. The research highlights that input power has the most significant impact on localized temperature, with operating frequency ranked as the second most influential factor. While emphasizing the importance of understanding tissue heating and optimizing antennas for improved power transfer, these studies also illuminate existing knowledge gaps. Excessive tissue heat can lead to harmful effects such as vaporization, carbonization, and irreversible tissue changes. To ensure patient safety and reduce expenses linked to clinical trials, employing simulation-driven approaches for IBD antenna design and optimization is essential.
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Affiliation(s)
- Ala Alemaryeen
- Department of Computer Engineering and Communication, Tafila Technical University, Tafila 66110, Jordan
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Jin X, Liu W, Li Y, Qian L, Zhu Q, Li W, Qian Z. Evaluation method of ex vivo porcine liver reduced scattering coefficient during microwave ablation based on temperature. BIOMED ENG-BIOMED TE 2022; 67:491-501. [DOI: 10.1515/bmt-2022-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022]
Abstract
Abstract
The principle of microwave ablation (MWA) is to cause irreversible damage (protein coagulation, necrosis, etc.) to tumor cells at a certain temperature by heating, thereby destroying the tumor. We have long used functional near-infrared spectroscopy (fNIRs) to monitor clinical thermal ablation efficacy. After a lot of experimental verification, it can be found that there is a clear correlation between the reduced scattering coefficient and the degree of tissue damage. During the MWA process, the reduced scattering coefficient has a stable change. Therefore, both temperature (T) and reduced scattering coefficient (
μ
s
′
${\mu }_{s}^{\prime }$
) are related to the thermal damage of the tissue. This paper mainly studies the changing law of T and
μ
s
′
${\mu }_{s}^{\prime }$
during MWA and establishes a relationship model. The two-parameter simultaneous acquisition system was designed and used to obtain the T and
μ
s
′
${\mu }_{s}^{\prime }$
of the ex vivo porcine liver during MWA. The correlation model between T and
μ
s
′
${\mu }_{s}^{\prime }$
is established, enabling the quantitative estimation of
μ
s
′
${\mu }_{s}^{\prime }$
of porcine liver based on T. The maximum and the minimum relative errors of
μ
s
′
${\mu }_{s}^{\prime }$
are 79.01 and 0.39%, respectively. Through the electromagnetic simulation of the temperature field during MWA, 2D and 3D fields of reduced scattering coefficient can also be obtained using this correlation model. This study contributes to realize the preoperative simulation of the optical parameter field of microwave ablation and provide 2D/3D therapeutic effect for clinic.
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Affiliation(s)
- Xiaofei Jin
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Wenwen Liu
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Yiran Li
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Lu Qian
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Qiaoqiao Zhu
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Weitao Li
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Zhiyu Qian
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
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Jin X, Feng Y, Zhu R, Qian L, Yang Y, Yu Q, Zou Z, Li W, Liu Y, Qian Z. Temperature control and intermittent time-set protocol optimization for minimizing tissue carbonization in microwave ablation. Int J Hyperthermia 2022; 39:868-879. [PMID: 35858640 DOI: 10.1080/02656736.2022.2075041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE The charring tissue formation in the ablated lesion during the microwave ablation (MWA) of tumors would induce various unwanted inflammatory responses. This paper aimed to deliver appropriate thermal dose for effective ablations while preventing tissue carbonization by optimizing the treatment protocol during MWA with the set combinations of temperature control and pulsed microwave energy delivery. MATERIAL AND METHODS The thermal phase transition of ex vivo porcine liver tissues were recorded by differential scanning calorimetry (DSC) to determine the temperature threshold during microwave output control. MWA was performed by an in-house built system with the ease of microwave output parameter adjustment and real-time temperature monitoring. The effects of continuous and pulsed microwave deliveries as well as various intermittent time-set of MWA were evaluated by measuring the dimensions of the coagulation zone and the carbonization zone. RESULTS The DSC scans demonstrated that the ex vivo porcine liver tissues have been in a state of endothermic heat during the heating process, where the maximum absorbed heat occurred at the temperature of 105 °C ± 5 °C. The temperature control during MWA resulted in effective coagulative necrosis while preventing tissue carbonization, after setting 100 °C as the upper threshold temperature and 60 °C as the lower threshold. Both the numerical simulation and ex vivo experiments have shown that, upon the optimization of the time-set parameters in the periodic intermittent pulsed microwave output, the tissue carbonization was significantly diminished. CONCLUSION This study developed a straight-forward anti-carbonization strategy in MWA by modulating the pulsing mode and intermittent time. The programmed protocols of intermittent pulsing MWA have demonstrated its potentials toward future expansion of MWA technology in clinical application.
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Affiliation(s)
- Xiaofei Jin
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Yu Feng
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Roujun Zhu
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Lu Qian
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Yamin Yang
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Qindong Yu
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Zhihan Zou
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Weitao Li
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Yangyang Liu
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Zhiyu Qian
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
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Radosevic A, Prieto D, Burdío F, Berjano E, Prakash P, Trujillo M. Short pulsed microwave ablation: computer modeling and ex vivo experiments. Int J Hyperthermia 2021; 38:409-420. [PMID: 33719808 DOI: 10.1080/02656736.2021.1894358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE To study the differences between continuous and short-pulse mode microwave ablation (MWA). METHODS We built a computational model for MWA including a 200 mm long and 14 G antenna from Amica-Gen and solved an electromagnetic-thermal coupled problem using COMSOL Multiphysics. We compared the coagulation zone (CZ) sizes created with pulsed and continuous modes under ex vivo and in vivo conditions. The model was used to compare long vs. short pulses, and 1000 W high-powered short pulses. Ex vivo experiments were conducted to validate the model. RESULTS The computational models predicted the axial diameter of the CZ with an error of 2-3% and overestimated the transverse diameter by 9-11%. For short pulses, the ex vivo computer modeling results showed a trend toward larger CZ when duty cycles decreases. In general, short pulsed mode yielded higher CZ diameters and volumes than continuous mode, but the differences were not significant (<5%), as in terms of CZ sphericity. The same trends were observed in the simulations mimicking in vivo conditions. Both CZ diameter and sphericity were similar with short and long pulses. Short 1000 W pulses produced smaller sphericity and similar CZ sizes under in vivo and ex vivo conditions. CONCLUSIONS The characteristics of the CZ created by continuous and pulsed MWA show no significant differences from ex vivo experiments and computer simulations. The proposed idea of enlarging coagulation zones and improving their sphericity in pulsed mode was not evident in this study.
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Affiliation(s)
- Aleksandar Radosevic
- Department of Radiology, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Diego Prieto
- BioMIT, Department of Applied Mathematics, Universitat Politècnica de València, Valencia, Spain
| | | | - Enrique Berjano
- BioMIT, Department of Electronic Engineering, Universitat Politècnica de València, Valencia, Spain
| | - Punit Prakash
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, KS, USA
| | - Macarena Trujillo
- BioMIT, Department of Applied Mathematics, Universitat Politècnica de València, Valencia, Spain
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Zhang M, Cheng Y, Liu H, Nan Q. Study on the effect of different blood flow velocities of pulmonary vein on endocardial microwave ablation of atrial fibrillation. Technol Health Care 2021; 30:29-41. [PMID: 33998563 DOI: 10.3233/thc-202421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To cure atrial fibrillation, the maximum ablation depth (⩾ 50∘C) should exceed the myocardial thickness to achieve the effect of transmural ablation. The blood flow of pulmonary vein in the endocardium can cause the change in the myocardial temperature distribution. Therefore, the study investigated the effect of different pulmonary vein blood flow velocities on the endocardial microwave ablation. METHODS The finite element model of the endocardial microwave ablation of pulmonary vein was simulated by electromagnetic thermal flow coupling. The ablation power was 30 W and the ablation time was within 30 s. The blood flow in the coupling of fluid mechanics equation and heat transfer equation results in the heat damage. Furthermore, the cause of the different lesion dimensions is the blood flow velocity. The flow velocities were set as 0, 0.02, 0.05, 0.07, 0.12, 0.16, 0.20, 0.25 and 0.30 m/s. RESULTS When the flow velocities were 0, 0.02, 0.05, 0.07, 0.12, 0.16, 0.20, 0.25 and 0.30 m/s, the maximum ablation depth were 6.0, 5.56, 5.16, 5.12, 5.04, 5.01, 4.98, 4.96 and 4.94 mm, respectively; the maximum ablation width were 12.52, 9.63, 9.23, 9.16, 9.07, 9.05, 8.94, 8.91, 8.90 mm, respectively; the maximum ablation length were 12.00, 11.61, 8.98, 8.59, 8.37, 8.23, 8.16, 8.06 and 8.04 mm respectively. To achieve transmural ablation, the time was 3, 3, 3, 3, 3, 4, 4, 4, 4 s, respectively when the myocardial thickness was 2 mm; the time was 7, 8, 8, 8, 9, 9, 9, 9, 9 s, respectively when 3 mm; the time was 15, 16, 18, 19, 19, 20, 20, 20, 20 s, respectively when 4 mm. CONCLUSIONS When the velocity increases from 0 m/s to 3 m/s, the microwave lesion depth decreases by 1.06 mm. To achieve transmural ablation, when the myocardial thickness is 2 mm, 3 and 4 s should be taken when the velocity is 0-0.12 and 0.120.30 m/s, respectively; when the myocardial thickness is 3 mm, 7, 8 and 9 s should be taken when 0, 0-0.07 and 0.07-0.30 m/s respectively; when the myocardial thickness is 4 mm, 15, 16, 18, 19, 20 s should be taken when 0, 0-0.02, 0.02-0.05, 0.05-0.12, 0.12 m/s-0.30 m/s.
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Huang H, Zhang L, Moser MAJ, Zhang W, Zhang B. A review of antenna designs for percutaneous microwave ablation. Phys Med 2021; 84:254-264. [PMID: 33773908 DOI: 10.1016/j.ejmp.2021.03.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/03/2021] [Accepted: 03/06/2021] [Indexed: 12/15/2022] Open
Abstract
Microwave (MW) antenna is a key element in microwave ablation (MWA) treatments as the means that energy is delivered in a focused manner to the tumor and its surrounding area. The energy delivered results in a rise in temperature to a lethal level, resulting in cell death in the ablation zone. The delivery of energy and hence the success of MWA is closely dependent on the structure of the antennas. Therefore, three design criteria, such as expected ablation zone pattern, efficiency of energy delivery, and minimization of the diameter of the antennas have been the focus along the evolution of the MW antenna. To further improve the performance of MWA in the treatment of various tumors through inventing novel antennas, this article reviews the state-of-the-art and summarizes the development of MW antenna designs regarding the three design criteria.
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Affiliation(s)
- Hangming Huang
- Energy-based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China
| | - Lifeng Zhang
- Department of General Surgery, the First Affiliated Hospital of Soochow University,Soochow University, Jiangsu, China
| | - Michael A J Moser
- Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Wenjun Zhang
- Division of Biomedical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, Canada
| | - Bing Zhang
- Energy-based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China.
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Numerical Analysis of Human Cancer Therapy Using Microwave Ablation. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app10010211] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Microwave ablation is one type of hyperthermia treatment of cancer that involves heating tumor cells. This technique uses electromagnetic wave effects to kill cancer cells. A micro-coaxial antenna is introduced into the biological tissue. The radiation emitted by the antenna is absorbed by the tissue and leads to the heating of cancer cells. The diffuse increase in temperature should reach a certain value to achieve the treatment of cancer cells but it should be less than a certain other value to avoid damaging normal cells. This is why hyperthermia treatment should be carefully monitored. A numerical simulation is useful and may provide valuable information. The bio-heat equation and Maxwell’s equations are solved using the finite element method. Electro-thermal effects, temperature distribution profile, specific absorption rate (SAR), and fraction of necrotic tissue within cancer cells are analyzed. The results show that SAR and temperature distribution are strongly affected by input microwave power. High microwave power causes a high SAR value and raises the temperature above 50 °C, which may destroy healthy cells. It is revealed that with a power of 10 W, the tumor cells will be killed without damaging the surrounding tissue.
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