1
|
Murat C, Kaya A, Kaya D, Erdoğan MA. Experimental study for in vitro prostate cancer treatment with microwave ablation and pulsed electromagnetic field. Electromagn Biol Med 2024:1-10. [PMID: 38708861 DOI: 10.1080/15368378.2024.2345606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/16/2024] [Indexed: 05/07/2024]
Abstract
This paper presents the findings of a comprehensive study exploring the synergistic effects arising from the combination of microwave ablation and pulsed electromagnetic field (PEMF) therapy on prostate cancer cells. The research encompassed five distinct experimental groups, with continuous electric field measurements conducted during the entire treatment process. Group 1 and Group 2, subjected to microwave power below 350 W, exhibited specific electric field values of 72,800 V/m and 56,600 V/m, respectively. In contrast, Group 3 and Group 4, exposed to 80 W microwave power, displayed electric field levels of approximately 1450 V/m, while remaining free from any observable electrical discharges. The migratory and invasive capacities of PC3 cells were assessed through a scratch test in all groups. Notably, cells in Group 3 and Group 4, subjected to the combined treatment of microwave ablation and PEMF, demonstrated significantly accelerated migration in comparison to those in Groups 1 and 2. Additionally, Group 5 cells, receiving PEMF treatment in isolation, exhibited decreased migratory ability. These results strongly suggest that the combined approach of microwave ablation and PEMF holds promise as a potential therapeutic intervention for prostate cancer, as it effectively reduced cell viability, induced apoptosis, and impeded migration ability in PC3 cells. Moreover, the isolated use of PEMF demonstrated potential in limiting migratory capacity, which could hold critical implications in the fight against cancer metastasis.
Collapse
Affiliation(s)
- Caner Murat
- Department of Electrical and Electronics Engineering, Recep Tayyip Erdogan University, Rıze, Turkey
| | - Adnan Kaya
- Department of Electrical and Electronics Engineering, Izmir Katip Celebi University, Izmir, Turkey
| | - Dilek Kaya
- Department of Biomedical Test Calibration Application and Research Center, Izmir Katip Celebi University, Izmir, Turkey
| | | |
Collapse
|
2
|
Mathy RM, Giannakis A, Franke M, Winiger A, Kauczor HU, Chang DH. Factors Impacting Microwave Ablation Zone Sizes: A Retrospective Analysis. Cancers (Basel) 2024; 16:1279. [PMID: 38610957 PMCID: PMC11011160 DOI: 10.3390/cancers16071279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/01/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
PURPOSE Evaluation of the influence of intrinsic and extrinsic conditions on ablation zone volumes (AZV) after microwave ablation (MWA). METHODS Retrospective analysis of 38 MWAs of therapy-naïve liver tumours performed with the NeuWave PR probe. Ablations were performed either in the 'standard mode' (65 W, 10 min) or in the 'surgical mode' (95 W, 1 min, then 65 W, 10 min). AZV measurements were obtained from contrast-enhanced computed tomography immediately post-ablation. RESULTS AZVs in the 'standard mode' were smaller than predicted by the manufacturer (length 3.6 ± 0.6 cm, 23% below 4.7 cm; width 2.7 ± 0.6, 23% below 3.5 cm). Ablation zone past the tip was limited to 6 mm in 28/32 ablations. Differences in AZV between the 'surgical mode' and 'standard mode' were not significant (15.6 ± 7.8 mL vs. 13.9 ± 8.8 mL, p = 0.6). AZVs were significantly larger in case of hepatocellular carcinomas (HCCs) (n = 19) compared to metastasis (n = 19; 17.8 ± 9.9 mL vs. 10.1 ± 5.1 mL, p = 0.01) and in non-perivascular tumour location (n = 14) compared to perivascular location (n = 24, 18.7 ± 10.4 mL vs. 11.7 ± 6.1 mL, p = 0.012), with both factors remaining significant in two-way analysis of variance (HCC vs. metastasis: p = 0.02; perivascular vs. non-perivascular tumour location: p = 0.044). CONCLUSION Larger AZVs can be expected in cases of HCCs compared with metastases and in non-perivascular locations. Using the 'surgical mode' does not increase AZV significantly.
Collapse
Affiliation(s)
- René Michael Mathy
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, 69120 Heidelberg, Germany; (A.G.)
| | - Athanasios Giannakis
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, 69120 Heidelberg, Germany; (A.G.)
- 2nd Department of Radiology, University General Hospital, “ATTIKON” Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Mareike Franke
- Department of Radiology, Cantonal Hospital of Lucerne, 6000 Lucerne, Switzerland
| | - Alain Winiger
- Department of Radiology, Cantonal Hospital of Lucerne, 6000 Lucerne, Switzerland
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, 69120 Heidelberg, Germany; (A.G.)
| | - De-Hua Chang
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, 69120 Heidelberg, Germany; (A.G.)
- Department of Radiology, Cantonal Hospital of Lucerne, 6000 Lucerne, Switzerland
| |
Collapse
|
3
|
Hui TCH, How GY, Chim MSM, Pua U. Comparative Study of Ablation Zone of EMPRINT HP Microwave Device with Contemporary 2.4 GHz Microwave Devices in an Ex Vivo Porcine Liver Model. Diagnostics (Basel) 2023; 13:2702. [PMID: 37627962 PMCID: PMC10453042 DOI: 10.3390/diagnostics13162702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: Percutaneous microwave ablation (MWA) is an accepted treatment of non-operative liver cancer. This study compares the ablation zones of four commercially available 2.45 GHz MWA systems (Emprint, Eco, Neuwave, and Solero) in an ex vivo porcine liver model. (2) Methods: Ex vivo porcine livers (n = 85) were obtained. Two ablation time setting protocols were evaluated, the manufacturer's recommended maximum time and a 3 min time, performed at the manufacturer-recommended maximum power setting. A total of 236 ablation samples were created with 32 (13.6%) samples rejected. A total of 204 samples were included in the statistical analysis. (3) Results: For single-probe protocols, Emprint achieved ablation zones with the largest SAD. Significant differences were found in all comparisons for the 3 min time setting and for all comparisons at the 10 min time setting except versus Neuwave LK15 and Eco. Emprint produced ablation zones that were also significantly more spherical (highest SI) than the single-probe ablations from all other manufacturers. No statistical differences were found for ablation shape or SAD between the single-probe protocols for Emprint and the three-probe protocols for Neuwave. (4) Conclusions: The new Emprint HP system achieved large and spherical ablation zones relative to other 2.45 GHz MWA systems.
Collapse
Affiliation(s)
- Terrence C. H. Hui
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Guo Yuan How
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Michelle S. M. Chim
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Uei Pua
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| |
Collapse
|
4
|
Effects of Pulsed Radiofrequency Source on Cardiac Ablation. Bioengineering (Basel) 2023; 10:bioengineering10020227. [PMID: 36829721 PMCID: PMC9952521 DOI: 10.3390/bioengineering10020227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Heart arrhythmia is caused by abnormal electrical conduction through the myocardium, which in some cases, can be treated with heat. One of the challenges is to reduce temperature peaks-by still guaranteeing an efficient treatment where desired-to avoid any healthy tissue damage or any electrical issues within the device employed. A solution might be employing pulsed heat, in which thermal dose is given to the tissue with a variation in time. In this work, pulsed heat is used to modulate induced temperature fields during radiofrequency cardiac ablation. A three-dimensional model of the myocardium, catheter and blood flow is developed. Porous media, heat conduction and Navier-Stokes equations are, respectively, employed for each of the investigated domains. For the electric field, solved via Laplace equation, it is assumed that the electrode is at a fixed voltage. Pulsed heating effects are considered with a cosine time-variable pulsed function for the fixed voltage by constraining the product between this variable and time. Different dimensionless frequencies are considered and applied for different blood flow velocity and sustained voltages. Results are presented for different pulsed conditions to establish if a reasonable ablation zone, known from the obtained temperature profiles, can be obtained without any undesired temperature peaks.
Collapse
|
5
|
Ortiz CB, Dang A, Derrick K, O'Donnell B, Bitar R, Parker M, Veraza R, Bunegin L, Borrego M, Yamaguchi S, Walker JA, Lopera J. Creation of an Ex Vivo Renal Perfusion Model to Investigate Microwave Ablation. J Vasc Interv Radiol 2023; 34:40-45.e2. [PMID: 36244634 DOI: 10.1016/j.jvir.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/20/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022] Open
Abstract
This study hypothesized that an ex vivo renal perfusion model can create smaller microwave ablation (MWA) measurements during perfused states compared with nonperfused states across multiple device settings. Nine bovine kidneys, a fluoroscopic compatible perfusion model, and a commercially-available clinical MWA system were used to perform 72 ablations (36 perfused and 36 nonperfused) at 9 different device settings. Comparing perfused and nonperfused ablations at each device setting, significant differences in volume existed for 6 of 9 settings (P < .05). Collapsed across time settings, the ablation volumes by power were the following (perfused and nonperfused, P value): 60 W, 2.3 cm3 ± 1.0 and 7.2 cm3 ± 2.7, P < .001; 100 W, 5.4 cm3 ± 2.1 and 11.5 cm3 ± 5.6, P < .01; and 140 W, 11.2 cm3 ± 3.7 and 18.7 cm3 ± 6.3, P < .01. Applied power correlated with ablation volume: perfused, 0.021 cm3/W and R = 0.462, P = .004, and nonperfused, 0.029 cm3/W and R = 0.565, P < .001. These results support that an ex vivo perfused organ system can evaluate MWA systems and demonstrate heat sink perfusion effects of decreased ablation size.
Collapse
Affiliation(s)
- Carlos B Ortiz
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Division of Interventional Radiology, Department of Radiology, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas.
| | - Annie Dang
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas
| | - Kade Derrick
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas
| | - Barrett O'Donnell
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Division of Interventional Radiology, Department of Radiology, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas
| | - Ryan Bitar
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas
| | - Matthew Parker
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Division of Interventional Radiology, Department of Radiology, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas
| | | | - Leonid Bunegin
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Vascular Perfusion Solutions, San Antonio, Texas
| | - Marina Borrego
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Division of Interventional Radiology, Department of Radiology, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas
| | - Seiji Yamaguchi
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Division of Transplant Surgery, Department of Surgery, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas
| | - John A Walker
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Division of Interventional Radiology, Department of Radiology, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas
| | - Jorge Lopera
- Long School of Medicine, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Division of Interventional Radiology, Department of Radiology, The University of Texas Health Sciences Center San Antonio, San Antonio, Texas
| |
Collapse
|
6
|
Hensen B, Hellms S, Werlein C, Jonigk D, Gronski PA, Bruesch I, Rumpel R, Wittauer EM, Vondran FWR, Parker DL, Wacker F, Gutberlet M. Correction of heat-induced susceptibility changes in respiratory-triggered 2D-PRF-based thermometry for monitoring of magnetic resonance-guided hepatic microwave ablation in a human-like in vivo porcine model. Int J Hyperthermia 2022; 39:1387-1396. [DOI: 10.1080/02656736.2022.2138987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Bennet Hensen
- Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- STIMULATE-Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
| | - Susanne Hellms
- Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | | | - Danny Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | | | - Inga Bruesch
- Institute for Laboratory Animal Science and Central Animal Facility, Hannover Medical School, Hannover, Germany
| | - Regina Rumpel
- Institute for Laboratory Animal Science and Central Animal Facility, Hannover Medical School, Hannover, Germany
| | - Eva-Maria Wittauer
- Institute for Laboratory Animal Science and Central Animal Facility, Hannover Medical School, Hannover, Germany
| | - Florian W. R. Vondran
- Clinic for General, Abdominal and Transplant Surgery, Hannover Medical School, Hannover, Germany
| | - Dennis L. Parker
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, USA
| | - Frank Wacker
- Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- STIMULATE-Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
| | - Marcel Gutberlet
- Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- STIMULATE-Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
| |
Collapse
|
7
|
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: 0.5] [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.
Collapse
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
| |
Collapse
|
8
|
Zanus G, Tagliente G, Rossi S, Bonis A, Zambon M, Scopelliti M, Brizzolari M, Grossi U, Romano M, Finotti M. Pulsed Microwave Liver Ablation: An Additional Tool to Treat Hepatocellular Carcinoma. Cancers (Basel) 2022; 14:cancers14030748. [PMID: 35159014 PMCID: PMC8833939 DOI: 10.3390/cancers14030748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Hepatocellular carcinoma (HCC) is the seventh most frequent neoplasm and the second most common oncologic cause of death, mostly in patients with end-stage liver disease. HCC treatment is complex and different solutions are available, ranging from liver transplants to local therapies. In this study, we analyze the role of pulsed microwave liver ablation as an additional treatment option. Abstract This study aimed to analyze the outcomes of HCC patients treated with a novel technique—pulsed microwave ablation (MWA)—in terms of safety, local tumor progression (LTP), intrahepatic recurrence (IHR), and overall survival (OS). A total of 126 pulsed microwave procedures have been performed in our center. We included patients with mono- or multifocal HCC (BCLC 0 to D). The LTP at 12 months was 9.9%, with an IHR rate of 27.8% at one year. Survival was 92.0% at 12 months with 29.4% experiencing post-operative complications (28.6% Clavien–Dindo 1–2, 0.8% Clavien–Dindo 3–4). Stratifying patients by BCLC, we achieved BCLC 0, A, B, C, and D survival rates of 100%, 93.2%, 93.3%, 50%, and 100%, respectively, at one year, which was generally superior to or in line with the expected survival rates among patients who are started on standard treatment. The pulsed MWA technique is safe and effective. The technique can be proposed not only in patients with BCLC A staging but also in the highly selected cases of BCLC B, C, and D, confirming the importance of the concept of stage migration. This procedure, especially if performed with a minimally invasive technique (laparoscopic or percutaneous), is repeatable with a short postoperative hospital stay.
Collapse
Affiliation(s)
- Giacomo Zanus
- 4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy; (G.Z.); (G.T.); (S.R.); (A.B.); (M.Z.); (M.S.); (M.B.); (U.G.); (M.R.)
| | - Giovanni Tagliente
- 4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy; (G.Z.); (G.T.); (S.R.); (A.B.); (M.Z.); (M.S.); (M.B.); (U.G.); (M.R.)
| | - Serena Rossi
- 4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy; (G.Z.); (G.T.); (S.R.); (A.B.); (M.Z.); (M.S.); (M.B.); (U.G.); (M.R.)
| | - Alessandro Bonis
- 4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy; (G.Z.); (G.T.); (S.R.); (A.B.); (M.Z.); (M.S.); (M.B.); (U.G.); (M.R.)
| | - Mattia Zambon
- 4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy; (G.Z.); (G.T.); (S.R.); (A.B.); (M.Z.); (M.S.); (M.B.); (U.G.); (M.R.)
| | - Michele Scopelliti
- 4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy; (G.Z.); (G.T.); (S.R.); (A.B.); (M.Z.); (M.S.); (M.B.); (U.G.); (M.R.)
| | - Marco Brizzolari
- 4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy; (G.Z.); (G.T.); (S.R.); (A.B.); (M.Z.); (M.S.); (M.B.); (U.G.); (M.R.)
| | - Ugo Grossi
- 4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy; (G.Z.); (G.T.); (S.R.); (A.B.); (M.Z.); (M.S.); (M.B.); (U.G.); (M.R.)
| | - Maurizio Romano
- 4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy; (G.Z.); (G.T.); (S.R.); (A.B.); (M.Z.); (M.S.); (M.B.); (U.G.); (M.R.)
| | - Michele Finotti
- 4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy; (G.Z.); (G.T.); (S.R.); (A.B.); (M.Z.); (M.S.); (M.B.); (U.G.); (M.R.)
- Baylor Scott & White Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX 75204, USA
- Correspondence:
| |
Collapse
|
9
|
A New Thermal Damage-Controlled Protocol for Thermal Ablation Modeled with Modified Porous Media-Based Bioheat Equation with Variable Porosity. Processes (Basel) 2022. [DOI: 10.3390/pr10020236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Thermal ablation of tumors is a minimally invasive technique more and more employed in cancer treatments. The main shortcomings of this technique are, on the one hand, the risk of an incomplete ablation, and on the other hand, the destruction of the surrounding healthy tissue. In this work, thermal ablation of a spherical hepatocellular carcinoma tumor (HCC) surrounded by healthy tissue is modeled. A modified porous media-based bioheat model is employed, including porosity variability from tumor core to healthy tissue, following experimental in vivo measures. Moreover, three different protocols are investigated: a constant heating protocol, a pulsating protocol, and a new developed damage-controlled protocol. The proposed damage-controlled protocol changes the heating source from constant to pulsating according to the thermal damage probability on the tumor rim. The equations are numerically solved by means of the commercial software COMSOL Multiphysics, and the outcomes show that the new proposed protocol is able to achieve the complete ablation in less time than the completely pulsating protocol, and to reach tissue temperature on the tumor rim 10 °C smaller than the constant protocol. These results are relevant to develop and improve different patient-based and automated protocols which can be embedded in medical devices’ software or in mobile applications, supporting medical staff with innovative technical solutions.
Collapse
|
10
|
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: 2.0] [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.
Collapse
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
| |
Collapse
|
11
|
Prud'homme C, Teriitehau C, Adam J, Kyaw Tun J, Roux C, Hakime A, Delpla A, Deschamps F, de Baere T, Tselikas L. Lung microwave ablation - an in vivo swine tumor model experiment to evaluate ablation zones. Int J Hyperthermia 2021; 37:879-886. [PMID: 32689829 DOI: 10.1080/02656736.2020.1787530] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To evaluate microwave ablation (MWA) algorithms, comparing pulsed and continuous mode in an in vivo lung tumor mimic model. MATERIALS AND METHODS A total of 43 lung tumor-mimic models of 1, 2 or 3 cm were created in 11 pigs through an intra-pulmonary injection of contrast-enriched minced muscle. Tumors were ablated under fluoroscopic and 3D-CBCT-guidance using a single microwave antenna. Continuous (CM) and pulsed mode (PM) were used. According to tumor size, 3 different algorithms for both continuous and pulsed mode were used. The ablation zones were measured using post-procedural 3D-CBCT and on pathologic specimens. RESULTS Two radiologists measured the ablation zones on CBCT and they significantly correlated with macroscopic and microscopic pathological findings: r = 0.75 and 0.74 respectively (p < 0.0001) (inter-observer correlation r = 0.9). For 1, 2 and 3 cm tumors mimics lesions (TMLs), mean maximal and transverse ablation diameters were 3.6 [Formula: see text] 0.3 × 2.2 [Formula: see text] 0.3 cm; 4.1 [Formula: see text] 0.5 × 2.6 [Formula: see text] 0.3 cm and 4.8 [Formula: see text] 0.3 × 3.2 [Formula: see text] 0.3 cm respectively using CM; And, 3.0 [Formula: see text] 0.2 × 2.1 [Formula: see text] 0.2 cm; 4.0 [Formula: see text] 0.4 × 2.7 [Formula: see text] 0.4 cm and 4.6 [Formula: see text] 0.4 × 3.2 [Formula: see text] 0.4 cm respectively for PM, without any significant difference except for 1 cm TMLs treated by PM ablation which were significantly smaller (p = 0.009) The sphericity index was 1.6, 1.6, 1.5 and 1.4, 1.5, 1.4 at 1, 2 and 3 cm for CM and PM respectively, p = 0.07, 0.14 and 0.13 for 1, 2 and 3 cm tumors mimics. CONCLUSION Microwave ablation for 1-3 cm lung tumors were successfully realized but with a moderate reproducibility rate, using either CM or PM. Immediate post ablation CBCT can accurately evaluate ablation zones.
Collapse
Affiliation(s)
- Clara Prud'homme
- Département d' Anesthésie, Chirurgie et Interventionel, Gustave Roussy, Villejuif, France
| | - Christophe Teriitehau
- Département d' Anesthésie, Chirurgie et Interventionel, Gustave Roussy, Villejuif, France
| | - Julien Adam
- Department of Pathology, Gustave Roussy, Villejuif, France
| | - Jimmy Kyaw Tun
- Interventional Radiology Department, Barts Health NHS Trust, London, UK
| | - Charles Roux
- Département d' Anesthésie, Chirurgie et Interventionel, Gustave Roussy, Villejuif, France
| | - Antoine Hakime
- Département d' Anesthésie, Chirurgie et Interventionel, Gustave Roussy, Villejuif, France
| | - Alexandre Delpla
- Département d' Anesthésie, Chirurgie et Interventionel, Gustave Roussy, Villejuif, France
| | - Fréderic Deschamps
- Département d' Anesthésie, Chirurgie et Interventionel, Gustave Roussy, Villejuif, France
| | - Thierry de Baere
- Département d' Anesthésie, Chirurgie et Interventionel, Gustave Roussy, Villejuif, France.,Université Paris-Saclay, Saint-Aubin, France
| | - Lambros Tselikas
- Département d' Anesthésie, Chirurgie et Interventionel, Gustave Roussy, Villejuif, France
| |
Collapse
|
12
|
OuYang Z, Lou Z, Lou Z, Jin K, Sun J, Chen Z. Microwave ablation for the removal of pharyngeal benign lesions: A prospective pilot case series. Am J Otolaryngol 2021; 42:102916. [PMID: 33485048 DOI: 10.1016/j.amjoto.2021.102916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We evaluated microwave ablation (MWA) for treatment of isolated pharyngeal benign lesions, in terms of technical feasibility, efficacy, and safety. METHODS The patients with pharyngeal benign lesions were treated with endoscopic MWA with a 2450-MHz single cooled-shaft microwave antenna and sent for histological examination. Postoperative pain intensity was measured via visual analogue scale (VAS) on the 12th hour and the third postoperative days. RESULTS Of the 137 patients with pharyngeal benign lesions who met the inclusion criteria. The most commonly involved site was the uvula (n = 66, 48.2%), followed by the lateral pharyngeal wall (n = 37, 27.0%), the nasopharyngeal posterior wall (n = 23, 16.8%) and the soft palate (n = 11, 8.0%). All of the procedures were completed using local anesthesia and were well-tolerated by the patients. The ablation time was 5-10 min, with an average duration of 6.3 ± 1.8 min. The most common pathology was papilloma (n = 96, 70.1%), followed by nasopharyngeal cysts (n = 21, 15.3%), polyp (n = 10, 7.3%), epidermoid cysts (n = 8, 5.8%) and Thornwaldt cysts (n = 2, 1.5%). The mean VAS pain score was 2.36 ± 1.08 on postoperative 12th hour and 1.21 ± 0.54 on postoperative third day. At the 6-month follow-up examination, there were no severe complications, such as recurrence, bleeding, or synechiae of the nasal cavity, eustachian tube injury, in any of the patients. CONCLUSIONS The MWA for the treatment of isolated pharyngeal benign lesion is feasible and alternative to conventional surgical methods, it allows excision of the lesion while providing hemostasis, involves only a short ablation time and has a very low risk of complications. Most of our patients well-tolerate the procedure, which may be performed under local anesthesia in the outpatient setting.
Collapse
Affiliation(s)
- ZhiGuo OuYang
- Department of Otorhinolaryngology, Yiwu Hospital of Wenzhou Medical University (Yiwu Central Hospital), Yiwu City 322000, Zhejiang Province, China
| | - Zihan Lou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Zhengcai Lou
- Department of Otorhinolaryngology, Yiwu Hospital of Wenzhou Medical University (Yiwu Central Hospital), Yiwu City 322000, Zhejiang Province, China.
| | - Kangfen Jin
- Department of Otorhinolaryngology, Yiwu Hospital of Wenzhou Medical University (Yiwu Central Hospital), Yiwu City 322000, Zhejiang Province, China
| | - Junzhi Sun
- Department of Otorhinolaryngology, Yiwu Hospital of Wenzhou Medical University (Yiwu Central Hospital), Yiwu City 322000, Zhejiang Province, China
| | - Zhengnong Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China.
| |
Collapse
|
13
|
Andreozzi A, Brunese L, Iasiello M, Tucci C, Vanoli GP. Numerical analysis of the pulsating heat source effects in a tumor tissue. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 200:105887. [PMID: 33280933 DOI: 10.1016/j.cmpb.2020.105887] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Hyperthermia treatment is nowadays recognized as the fourth additional cancer therapy technique following surgery, chemotherapy, and radiation; it is a minimally or non-invasive technique which involves fewer complications, a shorter hospital stay, and fewer costs. In this paper, pulsating heat effects on heat transfer in a tumor tissue under hyperthermia are analyzed. The objective of the paper is to find and quantify the advantages of pulsatile heat protocols under different periodical heating schemes and for different tissue morphologies. METHODS The tumor tissue is modeled as a porous sphere made up of a solid phase (tissue, interstitial space, etc.) and a fluid phase (blood). A Local Thermal Non-Equilibrium (LTNE) model is employed to consider the local temperature difference between the two phases. Governing equations with the appropriate boundary conditions are solved with the finite-element code COMSOL Multiphysics®. The pulsating effect is modeled with references to a cosine function with different frequencies, and such different heating protocols are compared at equal delivered energy, i. e. different heating times at equal maximum power. RESULTS Different tissue properties in terms of blood vessels sizes and blood volume fraction in tissue (porosity) are investigated. The results are shown in terms of tissue temperature and percentage of necrotic tissue obtained. The most powerful result achieved using a pulsating heat source instead of a constant one is the decreasing of maximum temperature in any considered case, even reaching about 30% lower maximum temperatures. Furthermore, the evaluation of tissue damage at the end of treatment shows that pulsating heat allows to necrotize the same tumoral tissue area of the non-pulsating heat source. CONCLUSIONS Modeling pulsating heat protocols in thermal ablation under different periodical heating schemes and considering different tissues morphologies in a tumor tissue highlights how the application of pulsating heat sources allows to avoid high temperature peaks, and simultaneously to ablate the same tumoral area obtained with a non-pulsating heat source. This is a powerful result to improve medical protocols and devices in thermal ablation of tumors.
Collapse
Affiliation(s)
- Assunta Andreozzi
- Dipartimento di Ingegneria Industriale, Università degli studi di Napoli Federico II, P.le Tecchio 80, 80125, Napoli, Italy
| | - Luca Brunese
- Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università del Molise, Via Francesco De Sanctis 1, 86100, Campobasso, ITALY
| | - Marcello Iasiello
- Dipartimento di Ingegneria Industriale, Università degli studi di Napoli Federico II, P.le Tecchio 80, 80125, Napoli, Italy
| | - Claudio Tucci
- Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università del Molise, Via Francesco De Sanctis 1, 86100, Campobasso, ITALY.
| | - Giuseppe Peter Vanoli
- Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università del Molise, Via Francesco De Sanctis 1, 86100, Campobasso, ITALY
| |
Collapse
|
14
|
Performance of the Emprint and Amica Microwave Ablation Systems in ex vivo Porcine Livers: Sphericity and Reproducibility Versus Size. Cardiovasc Intervent Radiol 2021; 44:952-958. [PMID: 33462682 PMCID: PMC8172387 DOI: 10.1007/s00270-020-02742-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/04/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE To investigate the performance of two microwave ablation (MWA) systems regarding ablation volume, ablation shape and variability. MATERIALS AND METHODS In this ex vivo study, the Emprint and Amica MWA systems were used to ablate porcine livers at 4 different settings of time and power (3 and 5 minutes at 60 and 80 Watt). In total, 48 ablations were analysed for ablation size and shape using Vitrea Advanced Visualization software after acquisition of a 7T MRI scan. RESULTS Emprint ablations were smaller (11,1 vs. 21,1 mL p < 0.001), more spherical (sphericity index of 0.89 vs. 0.59 p < 0.001) and showed less variability than Amica ablations. In both systems, longer ablation time and higher power resulted in significantly larger ablation volumes. CONCLUSION Emprint ablations were more spherical, and the results showed a lower variability than those of Amica ablations. This comes at the price of smaller ablation volumes.
Collapse
|
15
|
Filippiadis D, Mazioti A, Velonakis G, Tsochantzis A, Tosoratti N, Kelekis A, Kelekis N. Continuous versus pulsed microwave ablation in the liver: any difference in intraoperative pain scores? Ann Gastroenterol 2021; 34:80-84. [PMID: 33414626 PMCID: PMC7774668 DOI: 10.20524/aog.2020.0557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 12/31/2022] Open
Abstract
Background This study prospectively compared intraoperative pain scores during percutaneous microwave ablation of the liver in patients randomized between continuous and pulsed energy delivery algorithms. Methods During a 12-month period, 20 patients who underwent microwave liver ablation were prospectively randomized between 2 different energy delivery modes: “continuous mode” (CM, n=10) and “pulsed mode” (PM, n=10). All ablation sessions were performed using the same microwave ablation platform under computed tomographic guidance and intravenous analgesia. Within 30 min post ablation, all patients completed a questionnaire assigning a numeric pain intensity score from 0 (no pain) to 10. Results Mean pain scores were 8.17±1.850 in the CM group and 4.50±1.567 in the PM group, with a statistically significant difference of 3.667±2.807 pain units (P=0.001). The mean procedure time was 53.5±20.90 min in the PM group vs. 58.5±17.44 min in the CM group (P=0.279). The mean size of the lesions was 2.81±0.95 cm in the PM group and 2.81±0.85 cm in the CM group (P=0.984). On a per-lesion basis, technical success was achieved in all evaluable tumors in both groups. No difference was noted in the local tumor control on the 6-month imaging evaluation. No complications were observed in the CM arm, while small perihepatic hemorrhagic fluid collections were reported in the PM group. Conclusions Both algorithms for microwave energy delivery have comparable treatment effects in terms of 6-month local tumor control for liver lesions <3 cm in diameter. PM treatments compared to CM appear to induce significantly less pain in patients undergoing percutaneous liver ablation under intravenous analgesia.
Collapse
Affiliation(s)
- Dimitrios Filippiadis
- 2 Department of Radiology, "Attikon" University General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Dimitrios Filippiadis, Argyro Mazioti, George Velonakis, Athanasios Tsochantzis, Alexis Kelekis, Nikolaos Kelekis)
| | - Argyro Mazioti
- 2 Department of Radiology, "Attikon" University General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Dimitrios Filippiadis, Argyro Mazioti, George Velonakis, Athanasios Tsochantzis, Alexis Kelekis, Nikolaos Kelekis)
| | - George Velonakis
- 2 Department of Radiology, "Attikon" University General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Dimitrios Filippiadis, Argyro Mazioti, George Velonakis, Athanasios Tsochantzis, Alexis Kelekis, Nikolaos Kelekis)
| | - Athanasios Tsochantzis
- 2 Department of Radiology, "Attikon" University General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Dimitrios Filippiadis, Argyro Mazioti, George Velonakis, Athanasios Tsochantzis, Alexis Kelekis, Nikolaos Kelekis)
| | - Nevio Tosoratti
- R&D Manager, HS Hospital Service SpA, Aprilia (LT), Italy (Nevio Tosoratti)
| | - Alexis Kelekis
- 2 Department of Radiology, "Attikon" University General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Dimitrios Filippiadis, Argyro Mazioti, George Velonakis, Athanasios Tsochantzis, Alexis Kelekis, Nikolaos Kelekis)
| | - Nikolaos Kelekis
- 2 Department of Radiology, "Attikon" University General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Dimitrios Filippiadis, Argyro Mazioti, George Velonakis, Athanasios Tsochantzis, Alexis Kelekis, Nikolaos Kelekis)
| |
Collapse
|
16
|
Mohtashami Y, Behdad N, Hagness SC. Ex Vivo Performance of a Flexible Microwave Ablation Antenna. IEEE Trans Biomed Eng 2020; 68:1680-1689. [PMID: 33125323 DOI: 10.1109/tbme.2020.3033986] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE In this study, we investigate the performance of a flexible microwave ablation antenna for generating localized ablation zones. METHODS We designed a helical dipole antenna to operate at 1.9 GHz in egg white and liver. Semi-rigid prototypes of the antenna were fabricated and used to perform ablation experiments in egg white and perfused liver. Pulsed and continuous-wave power deliveries at different power levels were used. Flexible prototypes of the antenna were fabricated and used to perform ex vivo ablation experiments in perfused liver. RESULTS Pulsing was effective in reducing the shaft heating of semi-rigid cables. The antenna was capable of producing substantial ablation zones in perfused liver. Typical diameters (perpendicular to the antenna axis) of generated ablation zones with semi-rigid antennas in egg white and perfused liver were 30 mm and 20 mm, respectively. The flexible antenna had a good impedance match while bent. Average diameter of generated ablation zones by the flexible antenna with 10-W continuous-wave experiments in perfused liver was 26 mm. No significant difference was observed between the performances of semi-rigid and flexible prototypes. CONCLUSION The flexible helical dipole antenna is capable of maintaining its good impedance match while bent and can generate substantial ablation zones in presence of perfusion. SIGNIFICANCE The proposed flexible antenna is promising for minimally invasive treatment of tumors that are otherwise inaccessible by rigid antennas. One example is lung where a catheter-based deployment of the flexible antenna into the tumor via airways may substantially reduce risks associated with using rigid antennas.
Collapse
|
17
|
Trujillo M, Prakash P, Faridi P, Radosevic A, Curto S, Burdio F, Berjano E. How large is the periablational zone after radiofrequency and microwave ablation? Computer-based comparative study of two currently used clinical devices. Int J Hyperthermia 2020; 37:1131-1138. [PMID: 32996794 PMCID: PMC7714001 DOI: 10.1080/02656736.2020.1823022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Purpose: To compare the size of the coagulation (CZ) and periablational (PZ) zones created with two commercially available devices in clinical use for radiofrequency (RFA) and microwave ablation (MWA), respectively. Methods: Computer models were used to simulate RFA with a 3-cm Cool-tip applicator and MWA with an Amica-Gen applicator. The Arrhenius model was used to compute the damage index (Ω). CZ was considered when Ω> 4.6 (>99% of damaged cells). Regions with 0.6<Ω< 2.1 were considered as the PZ (tissue that has undergone moderate sub-ablative hyperthermia). The ratio of PZ volume to CZ volume (PZ/CZ) was regarded as a measure of performance, since a low value implies achieving a large CZ while keeping the PZ small. Results: Ten-min RFA (51 W) created smaller periablational zones than 10-min MWA (11.3 cm3 vs. 17.2 22.9 cm3, for 60 100 W MWA, respectively). Prolonging duration from 5 to 10 min increased the PZ in MWA more than in RFA (2.7 cm3 for RFA vs. 8.3–11.9 cm3 for 60–100 W MWA, respectively). PZ/CZ for RFA were relatively high (65–69%), regardless of ablation time, while those for MWA were highly dependent on the duration (increase of up to 25% between 5 and 10 min) and on the applied power (smaller values as power was raised, 102% for 60 W vs. 81% for 100 W, both for 10 min). The lowest PZ/CZ across all settings was 56%, obtained with 100 W-5 min MWA. Conclusions: Although RFA creates smaller periablational zones than MWA, 100 W-5 min MWA provides the lowest PZ/CZ.
Collapse
Affiliation(s)
- Macarena Trujillo
- BioMIT, Department of Applied Mathematics, Universitat Politècnica de València, Valencia, Spain
| | - Punit Prakash
- Mike Wiegers Department of Electrical and Computer Engineering, Kansas State University, Manhattan, KS, USA
| | - Pegah Faridi
- Mike Wiegers Department of Electrical and Computer Engineering, Kansas State University, Manhattan, KS, USA
| | | | - Sergio Curto
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | | | - Enrique Berjano
- BioMIT, Department of Electronic Engineering, Universitat Politècnica de València, Valencia, Spain
| |
Collapse
|
18
|
Andreozzi A, Iasiello M, Netti PA. Effects of pulsating heat source on interstitial fluid transport in tumour tissues. J R Soc Interface 2020; 17:20200612. [PMID: 32993430 DOI: 10.1098/rsif.2020.0612] [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: 11/12/2022] Open
Abstract
Macromolecules and drug delivery to solid tumours is strongly influenced by fluid flow through interstitium, and pressure-induced tissue deformations can have a role in this. Recently, it has been shown that temperature-induced tissue deformation can influence interstitial fluid velocity and pressure fields, too. In this paper, the effect of modulating-heat strategies to influence interstitial fluid transport in tissues is analysed. The whole tumour tissue is modelled as a deformable porous material, where the solid phase is made up of the extracellular matrix and cells, while the fluid phase is the interstitial fluid that moves through the solid matrix driven by the fluid pressure gradient and vascular capillaries that are modelled as a uniformly interspersed fluid point-source. Pulsating-heat generation is modelled with a time-variable cosine function starting from a direct current approach to solve the voltage equation, for different pulsations. From the steady-state solution, a step-variation of vascular pressure included in the model equation as a mass source term via the Starling equation is simulated. Dimensionless 1D radial equations are numerically solved with a finite-element scheme. Results are presented in terms of temperature, volumetric strain, pressure and velocity profiles under different conditions. It is shown that a modulating-heat procedure influences velocity fields, that might have a consequence in terms of mass transport for macromolecules or drug delivery.
Collapse
Affiliation(s)
- A Andreozzi
- Dipartimento di Ingegneria Industriale (DII), Università degli Studi di Napoli Federico II, Piazzale Tecchio, 80, 80125 Napoli, Italy
| | - M Iasiello
- Dipartimento di Ingegneria Industriale (DII), Università degli Studi di Napoli Federico II, Piazzale Tecchio, 80, 80125 Napoli, Italy
| | - P A Netti
- Dipartimento di Ingegneria Chimica, dei Materiali e della Produzione Industriale (DICMAPI), Università degli Studi di Napoli Federico II, Piazzale Tecchio, 80, 80125 Napoli, Italy
| |
Collapse
|
19
|
Winkelmann MT, Gohla G, Kübler J, Weiß J, Clasen S, Nikolaou K, Hoffmann R. MR-Guided High-Power Microwave Ablation in Hepatic Malignancies: Initial Results in Clinical Routine. Cardiovasc Intervent Radiol 2020; 43:1631-1638. [PMID: 32699978 PMCID: PMC7591402 DOI: 10.1007/s00270-020-02584-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/26/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Evaluation of technique effectiveness, patient safety and ablation parameters of MR-guided microwave ablation in hepatic malignancies using an MR-conditional high-power microwave ablation system. MATERIALS AND METHODS Institutional review board approval and informed patient consent were obtained. Patients who underwent MR-guided microwave ablation of hepatic malignancies in a 1.5T wide-bore scanner using a perfusion-cooled high-power microwave ablation system with a maximum generator power of 150 W were included. Ablation parameters comprising procedure durations, net ablation duration, applicator positions and ablation zone dimensions were recorded. Adverse events were classified according to the CIRSE classification system. Technique effectiveness was assessed after 1 month. Follow-up was conducted with contrast-enhanced MRI and ranged from 1 to 20 months (mean: 6.1 ± 5.4 months). RESULTS Twenty-one consecutive patients (age: 63.4 ± 10.5 years; 5 female) underwent 22 procedures for 28 tumours (9 hepatocellular carcinomas, 19 metastases) with a mean tumour diameter of 14.6 ± 5.4 mm (range: 6-24 mm). Technique effectiveness was achieved in all lesions. Tumours were treated using 1.7 ± 0.7 applicator positions (range: 1-3). Mean energy and ablation duration per tumour were 75.3 ± 35.4 kJ and 13.3 ± 6.2 min, respectively. Coagulation zone short- and long-axis diameters were 29.1 ± 6.4 mm and 39.9 ± 7.4 mm, respectively. Average procedure duration was 146.4 ± 26.2 min (range: 98-187 min). One minor complication was reported. Five patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed during initial follow-up. CONCLUSION MR-guided high-power microwave ablation provides safe and effective treatment of hepatic malignancies with short ablation times and within acceptable procedure durations.
Collapse
Affiliation(s)
- Moritz T Winkelmann
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Georg Gohla
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Jens Kübler
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Jakob Weiß
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Stephan Clasen
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Rüdiger Hoffmann
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
| |
Collapse
|
20
|
Hui TCH, Brace CL, Hinshaw JL, Quek LHH, Huang IKH, Kwan J, Lim GHT, Lee FT, Pua U. Microwave ablation of the liver in a live porcine model: the impact of power, time and total energy on ablation zone size and shape. Int J Hyperthermia 2020; 37:668-676. [DOI: 10.1080/02656736.2020.1774083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
| | - Christopher Lee Brace
- Department of Radiology and Biomedical Engineering, University of Wisconsin, Madison, WI, USA
| | - J. Louis Hinshaw
- Department of Radiology and Urology, University of Wisconsin, Madison, WI, USA
| | | | | | - Justin Kwan
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Gavin Hock Tai Lim
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Fred T. Lee
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore
- Department of Radiology and Urology, University of Wisconsin, Madison, WI, USA
| | - Uei Pua
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore
| |
Collapse
|
21
|
Andreozzi A, Iasiello M, Tucci C. An overview of mathematical models and modulated-heating protocols for thermal ablation. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/bs.aiht.2020.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
22
|
Millimeter-wave pulsed heating in vitro: cell mortality and heat shock response. Sci Rep 2019; 9:15249. [PMID: 31649300 PMCID: PMC6813304 DOI: 10.1038/s41598-019-51731-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 09/28/2019] [Indexed: 02/07/2023] Open
Abstract
Millimeter wave (MMW)-induced heating represents a promising alternative for non-invasive hyperthermia of superficial skin cancer, such as melanoma. Pulsed MMW-induced heating of tumors allows for reaching high peak temperatures without overheating surrounding tissues. Herein, for the first time, we evaluate apoptotic and heat shock responses of melanoma cells exposed in vitro to continuous (CW) or pulsed-wave (PW) amplitude-modulated MMW at 58.4 GHz with the same average temperature rise. Using an ad hoc exposure system, we generated 90 min pulse train with 1.5 s pulse duration, period of 20 s, amplitude of 10 °C, and steady-state temperature at the level of cells of 49.2 °C. The activation of Caspase-3 and phosphorylation of HSP27 were investigated using fluorescence microscopy to monitor the spatial variation of cellular response. Our results demonstrate that, under the considered exposure conditions, Caspase-3 activation was almost 5 times greater following PW exposure compared to CW. The relationship between the PW-induced cellular response and SAR-dependent temperature rise was non-linear. Phosphorylation of HSP27 was 58% stronger for PW compared to CW. It exhibits a plateau for the peak temperature ranging from 47.7 to 49.2 °C. Our results provide an insight into understanding of the cellular response to MMW-induced pulsed heating.
Collapse
|
23
|
Lou ZC. Rapid hemostasis: a novel and effective outpatient procedure using microwave ablation to control epistaxis of isolated mucosal bulge lesions. Braz J Otorhinolaryngol 2019; 87:269-273. [PMID: 31722853 PMCID: PMC9422522 DOI: 10.1016/j.bjorl.2019.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/21/2019] [Accepted: 09/02/2019] [Indexed: 01/20/2023] Open
Abstract
Introduction Recurrent epistaxis is commonly encountered in the rhinology outpatient clinic. Under endoscopic guidance, both bipolar cautery and monopolar forceps (combined with suction) have been employed to control the bleeding. However, the use of monopolar forceps requires the placement of grounding pads. Most procedures are currently performed in operating rooms. Objective We investigated outcomes after the use of Microwave Ablation (MWA) to control epistaxis in adults with isolated mucosal bulge lesions. All procedures were performed with patients under local anesthesia in our outpatient clinic. Methods This is a retrospective cohort study. We included 83 adults with epistaxis of isolated mucosal bulge lesions. Microwave ablation was performed in the outpatient clinic to control bleeding, after induction of local anesthesia. The primary outcome was successful hemostasis. The secondary outcomes were the rebleeding rates at weeks 1 and 4 and month 6, and complications (crust or synechiae formation, septal perforation, and/or orbit or brain complications). Results All bleeding points were successfully ablated; hemostasis was achieved within 1–2 min. The mean pain score was 1.83 intra-operatively and 0.95 1 h postoperatively. No patient re-bled, and no severe MWA-related complication (septal perforation, synechiae formation, or orbit or brain complication) was recorded to 6 months of follow-up. Conclusions Endoscopic microwave ablation with patients under local anesthesia is a novel, safe, effective, rapid, well-tolerated, outpatient treatment for adults with epistaxis of isolated mucosal bulge lesions, especially those for whom general anesthesia might be risky, those with electrical implants, and those exhibiting contraindications for arterial embolization.
Collapse
Affiliation(s)
- Zheng Cai Lou
- Yiwu Central Hospital, Department of Otorhinolaryngology, Yiwu, China.
| |
Collapse
|
24
|
Orlacchio R, Zhadobov M, Alekseev SI, Nikolayev D, Sauleau R, Le Page Y, Le Dréan Y. Millimeter-Wave Heating in In Vitro Studies: Effect of Convection in Continuous and Pulse-Modulated Regimes. Bioelectromagnetics 2019; 40:553-568. [PMID: 31579965 DOI: 10.1002/bem.22223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 09/12/2019] [Indexed: 11/09/2022]
Abstract
Shallow penetration of millimeter waves (MMW) and non-uniform illumination in in vitro experiments result in a non-uniform distribution of the specific absorption rate (SAR). These SAR gradients trigger convective currents in liquids affecting transient and steady-state temperature distributions. We analyzed the effect of convection on temperature dynamics during MMW exposure in continuous-wave (CW) and pulsed-wave (PW) amplitude-modulated regimes using micro-thermocouples. Temperature rise kinetics are characterized by the occurrence of a temperature peak that shifts to shorter times as the SAR of the MMW exposure increases and precedes initiation of convection in bulk. Furthermore, we demonstrate that the liquid volume impacts convection. Increasing the volume results in earlier triggering of convection and in a greater cooling rate after the end of the exposure. In PW regimes, convection strongly depends on the pulse duration that affects the heat pulse amplitude and cooling rate. The latter results in a change of the average temperature in PW regime. Bioelectromagnetics. 2019;40:553-568. © 2019 Bioelectromagnetics Society.
Collapse
Affiliation(s)
- Rosa Orlacchio
- CNRS, IETR (Institut d'Electronique et de Télécommunication de Rennes)-UMR 6164, University of Rennes, Rennes, France.,CNRS, XLIM, UMR 7252, University of Limoges, Limoges, France
| | - Maxim Zhadobov
- CNRS, IETR (Institut d'Electronique et de Télécommunication de Rennes)-UMR 6164, University of Rennes, Rennes, France
| | - Stanislav I Alekseev
- Institute of Cell Biophysics of Russian Academy of Sciences, Pushchino, Moscow, Russia
| | - Denys Nikolayev
- Microwaves and Antennas Group (MAG), EPFL, Lausanne, Switzerland
| | - Ronan Sauleau
- CNRS, IETR (Institut d'Electronique et de Télécommunication de Rennes)-UMR 6164, University of Rennes, Rennes, France
| | - Yann Le Page
- Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) UMR_S 1085, University of Rennes, Rennes, France
| | - Yves Le Dréan
- Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) UMR_S 1085, University of Rennes, Rennes, France
| |
Collapse
|
25
|
Lou ZC. Microwave Ablation for the Removal of Benign Lesion of Nasal Cavity: "How I Do It". Am J Rhinol Allergy 2019; 34:74-79. [PMID: 31483686 DOI: 10.1177/1945892419873990] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Isolated benign lesions of the nasal cavity are commonly seen in the rhinology clinic; their treatment using various therapies has been explored in several studies. Methods In this retrospective study, isolated lesions of the nasal cavity were removed from 47 patients using microwave ablation (MWA) with a 2450-MHz cooled MWA antenna and sent for histological examination. Results The most commonly involved site was the nasal septum (n = 21, 44.7%), followed by the inferior turbinate (n = 12, 25.5%), bulla ethmoidalis (n = 9, 19.1%), and uncinate process (n = 5, 10.6%). The most common pathology was hemangioma (n = 36, 76.6%), followed by nasal polyp (n = 9, 19.1%) and squamous papilloma (n = 2, 4.3%). All lesions were removed endoscopically using MWA in patients administered local anesthesia. The total duration of ablation was 5 to 10 minutes, with an average duration of 7.3 ± 2.6 minutes. Follow-up at 6 months revealed no severe complications, including no cases of recurrent epistaxis, septal perforation, or synechiae of the nasal cavity. Conclusions The advantages of MWA are its short ablation time and minimal complications. This was demonstrated in our study in which a single session of MWA was sufficient to excise the isolated lesion while providing hemostasis. Most of the patients well tolerated the procedure, which could be performed using local anesthesia in the outpatient setting.
Collapse
Affiliation(s)
- Zheng-Cai Lou
- Department of Otorhinolaryngology, The Affiliated Yiwu Hospital of Wenzhou Medical University, Zhejiang, China
| |
Collapse
|
26
|
Ruiter SJS, Heerink WJ, de Jong KP. Liver microwave ablation: a systematic review of various FDA-approved systems. Eur Radiol 2019; 29:4026-4035. [PMID: 30506218 PMCID: PMC6611060 DOI: 10.1007/s00330-018-5842-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/18/2018] [Accepted: 10/19/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of the present study is to analyze preclinical and clinical data on the performance of the currently US Food and Drug Administration (FDA)-approved microwave ablation (MWA) systems. METHODS A review of the literature, published between January 1, 2005, and December 31, 2016, on seven FDA-approved MWA systems, was conducted. Ratio of ablation zone volume to applied energy R(AZ:E) and sphericity indices were calculated for ex vivo and in vivo experiments. RESULTS Thirty-four studies with ex vivo, in vivo, and clinical data were summarized. In total, 14 studies reporting data on ablation zone volume and applied energy were included for comparison R(AZ:E). A significant correlation between volume and energy was found for the ex vivo experiments (r = 0.85, p < 0.001) in contrast to the in vivo experiments (r = 0.54, p = 0.27). CONCLUSION Manufacturers' algorithms on microwave ablation zone sizes are based on preclinical animal experiments with normal liver parenchyma. Clinical data reporting on ablation zone volume in relation to applied energy and sphericity index during MWA are scarce and require more adequate reporting of MWA data. KEY POINTS • Clinical data reporting on the ablation zone volume in relation to applied energy during microwave ablation are scarce. • Manufacturers' algorithms on microwave ablation zone sizes are based on preclinical animal experiments with normal liver parenchyma. • Preclinical data do not predict actual clinical ablation zone volumes in patients with liver tumors.
Collapse
Affiliation(s)
- Simeon J S Ruiter
- Department of HPB Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
| | - Wouter J Heerink
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Center for Medical Imaging, University of Groningen, Groningen, Netherlands
| | - Koert P de Jong
- Department of HPB Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Center for Medical Imaging, University of Groningen, Groningen, Netherlands
| |
Collapse
|
27
|
Kim C. Understanding the nuances of microwave ablation for more accurate post-treatment assessment. Future Oncol 2018; 14:1755-1764. [DOI: 10.2217/fon-2017-0736] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Microwave ablation (MWA) is a relatively new thermal modality for minimally invasive procedures compared with radiofrequency ablation. Although MWA and radiofrequency ablation are thermal modalities, their underlying physics and principles greatly differ. Consequently, it is imperative that clinicians be aware of how these differences impact realized ablation volumes to consistently ensure technical success and better patient outcomes. This paper will review the nuances specific to MWA technology (i.e., tissue properties, perfusion/heat sink effect, ablation assessment, imaging accuracy and tissue contraction) that are often overlooked based on familiarity with conventional thermal modalities to guide more accurate assessment of post-treatment MWA volumes.
Collapse
Affiliation(s)
- Christy Kim
- Angio Dynamics, Inc., 1850 Mt Diablo Blvd, Ste 660, Walnut Creek, CA 94596, USA
| |
Collapse
|
28
|
The use of porcine corrosion casts for teaching human anatomy. Ann Anat 2017; 213:69-77. [PMID: 28578926 DOI: 10.1016/j.aanat.2017.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/14/2017] [Accepted: 05/04/2017] [Indexed: 02/08/2023]
Abstract
In teaching and learning human anatomy, anatomical autopsy and prosected specimens have always been indispensable. However, alternative methods must often be used to demonstrate particularly delicate structures. Corrosion casting of porcine organs with Biodur E20® Plus is valuable for teaching and learning both gross anatomy and, uniquely, the micromorphology of cardiovascular, respiratory, digestive, and urogenital systems. Assessments of casts with a stereomicroscope and/or scanning electron microscope as well as highlighting cast structures using color coding help students to better understand how the structures that they have observed as two-dimensional images actually exist in three dimensions, and students found using the casts to be highly effective in their learning. Reconstructions of cast hollow structures from (micro-)computed tomography scans and videos facilitate detailed analyses of branching patterns and spatial arrangements in cast structures, aid in the understanding of clinically relevant structures and provide innovative visual aids. The casting protocol and teaching manual we offer can be adjusted to different technical capabilities and might also be found useful for veterinary or other biological science classes.
Collapse
|
29
|
Kinner S, Schubert TB, Nocerino EA, Hynes S, Colgan TJ, Loeffler AG, Brace C, Reeder SB, Winslow E. MR visible localization device for radiographic-pathologic correlation of surgical specimens. Magn Reson Imaging 2016; 37:159-163. [PMID: 27899330 DOI: 10.1016/j.mri.2016.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 11/25/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE The detection of small parenchymal hepatic lesions identified by preoperative imaging remains a challenge for traditional pathologic methods in large specimens. We developed a magnetic resonance imaging (MRI) compatible localization device for imaging of surgical specimens aimed to improve identification and localization of hepatic lesions ex vivo. MATERIALS AND METHODS The device consists of two stationary and one removable MR-visible grids lined with silicone gel, creating an orthogonal 3D matrix for lesion localization. To test the device, five specimens of swine liver with a random number of lesions created by microwave ablation were imaged on a 3T MR scanner. Two readers independently evaluated lesion coordinates and size, which were then correlated with sectioning guided by MR imaging. RESULTS All lesions (n=38) were detected at/very close to the expected localization. Inter-reader agreement of lesion localization was almost perfect (0.92). The lesion size estimated by MRI matched macroscopic lesion size in cut specimen (±2mm) in 34 and 35, respectively, out of 38 lesions. CONCLUSION Use of this MR compatible device for ex vivo imaging proved feasible for detection and three-dimensional localization of liver lesions, and has potential to play an important role in the ex vivo examination of surgical specimens in which pathologic correlation is clinically important.
Collapse
Affiliation(s)
- Sonja Kinner
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany.
| | - Tilman B Schubert
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA; Clinic of Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland
| | | | - Shannon Hynes
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Timothy J Colgan
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - Agnes G Loeffler
- Pathology Clinic, University of Wisconsin-Madison, Madison, WI, USA
| | - Christopher Brace
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA; Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Emily Winslow
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA
| |
Collapse
|
30
|
Ryan TP, Brace CL. Interstitial microwave treatment for cancer: historical basis and current techniques in antenna design and performance. Int J Hyperthermia 2016; 33:3-14. [DOI: 10.1080/02656736.2016.1214884] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
| | - Christopher L. Brace
- Departments of Radiology and Biomedical Engineering, University of Wisconsin, Madison, WI, USA
| |
Collapse
|
31
|
Lopresto V, Pinto R, Farina L, Cavagnaro M. Treatment planning in microwave thermal ablation: clinical gaps and recent research advances. Int J Hyperthermia 2016; 33:83-100. [PMID: 27431328 DOI: 10.1080/02656736.2016.1214883] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Microwave thermal ablation (MTA) is a minimally invasive therapeutic technique aimed at destroying pathologic tissues through a very high temperature increase induced by the absorption of an electromagnetic field at microwave (MW) frequencies. Open problems, which are delaying MTA applications in clinical practice, are mainly linked to the extremely high temperatures, up to 120 °C, reached by the tissue close to the antenna applicator, as well as to the ability of foreseeing and controlling the shape and dimension of the thermally ablated area. Recent research was devoted to the characterisation of dielectric, thermal and physical properties of tissue looking at their changes with the increasing temperature, looking for possible developments of reliable, automatic and personalised treatment planning. In this paper, a review of the recently obtained results as well as new unpublished data will be presented and discussed.
Collapse
Affiliation(s)
- V Lopresto
- a Division of Health Protection Technologies , Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA) , Rome , Italy
| | - R Pinto
- a Division of Health Protection Technologies , Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA) , Rome , Italy
| | - L Farina
- b Department of Information Engineering, Electronics and Telecommunications , Sapienza University of Rome , Rome , Italy
| | - M Cavagnaro
- b Department of Information Engineering, Electronics and Telecommunications , Sapienza University of Rome , Rome , Italy
| |
Collapse
|
32
|
Meloni MF, Chiang J, Laeseke PF, Dietrich CF, Sannino A, Solbiati M, Nocerino E, Brace CL, Lee FT. Microwave ablation in primary and secondary liver tumours: technical and clinical approaches. Int J Hyperthermia 2016; 33:15-24. [PMID: 27416729 DOI: 10.1080/02656736.2016.1209694] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Thermal ablation is increasingly being utilised in the treatment of primary and metastatic liver tumours, both as curative therapy and as a bridge to transplantation. Recent advances in high-powered microwave ablation systems have allowed physicians to realise the theoretical heating advantages of microwave energy compared to other ablation modalities. As a result there is a growing body of literature detailing the effects of microwave energy on tissue heating, as well as its effect on clinical outcomes. This article will discuss the relevant physics, review current clinical outcomes and then describe the current techniques used to optimise patient care when using microwave ablation systems.
Collapse
Affiliation(s)
- Maria Franca Meloni
- a Department of Radiology , Interventional Ultrasound, Institute of Care IGEA , Milan , Italy
| | - Jason Chiang
- b Department of Radiology , University of Wisconsin , Madison , Wisconsin , USA
| | - Paul F Laeseke
- b Department of Radiology , University of Wisconsin , Madison , Wisconsin , USA
| | - Christoph F Dietrich
- c Department of Internal Medicine , Caritas Krankenhas Bad Mergentheim , Bad Mergentheim , Germany
| | - Angela Sannino
- d Department of Clinical Medicine and Surgery , University of Naples Federico II , Naples , Italy
| | - Marco Solbiati
- e Department of Electronics, Information and Bioengineering , Politecnico Milano , Milan , Italy
| | - Elisabetta Nocerino
- f Department of Radiology , San Paolo Hospital, University of Milan , Milan , Italy
| | - Christopher L Brace
- b Department of Radiology , University of Wisconsin , Madison , Wisconsin , USA
| | - Fred T Lee
- b Department of Radiology , University of Wisconsin , Madison , Wisconsin , USA
| |
Collapse
|