Antenna Designs for Microwave Tissue Ablation

The Efficacy and Safety of a Microwave Ablation System with a Dipole Antenna Design Featuring Floating Sleeves and Anti-Phase Technology in Stereotactic Percutaneous Liver Tumor Ablation: Results from a Prospective Study

Purpose: To evaluate the efficacy and safety of the Surgnova Dophi™ M150E microwave ablation system in a prospective single-center observational study. Methods: A cohort of 50 patients with 77 primary or secondary liver tumors underwent CT-navigated stereotactic percutaneous microwave ablation with curative intention using the Surgnova Dophi™ M150E system. The endpoints were primary technique efficacy (PTE), number of complications, ablation defect dimensions, and sphericity index compared to previously reported findings. Results: The PTE was 97.4%, with complete ablation in 75 out of 77 tumors. Complications occurred in 10% of patients, with 4% classified as major. A comparison with previous in vivo data confirmed the reliability of the system in achieving reproducible and predictable ablation results. Conclusions: Stereotactic percutaneous microwave ablation with the Surgnova Dophi™ M150E system is safe and effective for liver tumor treatment.

Importance of the enhanced cooling system for more spherical ablation zones: Numerical simulation, ex vivo and in vivo validation

INTRODUCTION

This study aimed to investigate the efficacy of a small-gauge microwave ablation antenna (MWA) with an enhanced cooling system (ECS) for generating more spherical ablation zones.

METHODS

A comparison was made between two types of microwave ablation antennas, one with ECS and the other with a conventional cooling system (CCS). The finite element method was used to simulate in vivo ablation. Two types of antennas were used to create MWA zones for 5, 8, 10 min at 50, 60, and 80 W in ex vivo bovine livers (n = 6) and 5 min at 60 W in vivo porcine livers (n = 16). The overtreatment ratio, ablation aspect ratio, carbonization area, and other characteristcs of antennas were measured and compared using numerical simulation and gross pathologic examination.

RESULTS

In numerical simulation, the ECS antenna demonstrated a lower overtreatment ratio than the CCS antenna (1.38 vs 1.43 at 50 W 5 min, 1.19 vs 1.35 at 50 W 8 min, 1.13 vs 1.32 at 50 W 10 min, 1.28 vs 1.38 at 60 W 5 min, 1.14 vs 1.32 at 60 W 8 min, 1.10 vs 1.30 at 60 W 10 min). The experiments revealed that the ECS antenna generated ablation zones with a more significant aspect ratio (0.92 ± 0.03 vs 0.72 ± 0.01 at 50 W 5 min, 0.95 ± 0.02 vs 0.70 ± 0.01 at 50 W 8 min, 0.96 ± 0.01 vs 0.71 ± 0.04 at 50 W 10 min, 0.96 ± 0.01 vs 0.73 ± 0.02 at 60 W 5 min, 0.94 ± 0.03 vs 0.71 ± 0.03 at 60 W 8 min, 0.96 ± 0.02 vs 0.69 ± 0.04 at 60 W 10 min) and a smaller carbonization area (0.00 ± 0.00 cm2 vs 0.54 ± 0.06 cm2 at 50 W 5 min, 0.13 ± 0.03 cm2 vs 0.61 ± 0.09 cm2 at 50 W 8 min, 0.23 ± 0.05 cm2 vs 0.73 ± 0.05 m2 at 50 W 10 min, 0.00 ± 0.00 cm2 vs 1.59 ± 0.41 cm2 at 60 W 5 min, 0.23 ± 0.22 cm2 vs 2.11 ± 0.63 cm2 at 60 W 8 min, 0.57 ± 0.09 cm2 vs 2.55 ± 0.51 cm2 at 60 W 10 min). Intraoperative ultrasound images revealed a hypoechoic area instead of a hyperechoic area near the antenna. Hematoxylin-eosin staining of the dissected tissue revealed a correlation between the edge of the ablation zone and that of the hypoechoic area.

CONCLUSIONS

The ECS antenna can produce more spherical ablation zones with less charring and a clearer intraoperative ultrasound image of the ablation area than the CCS antenna.

Safety and Effectiveness of Triple-Antenna Hepatic Microwave Ablation

Microwave ablation is becoming a standard procedure for treating tumors based on heat generation, causing an elevation in the tissue temperature level from 50 to 60 °C, causing tissue death. Microwave ablation is associated with uniform cell killing within ablation zones, multiple-antenna capability, low complication rates, and long-term survival. Several reports have demonstrated that multiple-antenna microwave ablation is a promising strategy for safely, rapidly, and effectively treating large tumors. The key advantage of multi-antenna tumor microwave ablation is the creation of a large, well-defined ablation zone without excessively long treatment times or high power that can damage healthy tissue. The strategic positioning of multiple probes provides a fully ablated volume, even in regions where individual probe damage is incomplete. Accurate modeling of the complex thermal and electromagnetic behaviors of tissue is critical for optimizing microwave ablation because material parameters and tissue responses can change significantly during the procedure. In the case of multi-antenna microwave ablation, the calculation complexity increases significantly, requiring significant computational resources and time. This study aimed to evaluate the efficacy and safety of liver percutaneous microwave ablation using the simultaneous activation of three antennas for the treatment of lesions larger than 3 cm. Based on the known results from a single-probe setup, researchers can estimate and evaluate various spatial configurations of the three-probe array to identify the optimal arrangement. Due to the synergistic effects of the combined radiation from the three antennas, the resulting ablation zone can be significantly larger, leading to better outcomes in terms of treatment time and effectiveness. The obtained results revealed that volumetric damage and the amount of damaged healthy tissue are smaller for a three-antenna configuration than for microwave ablation using a single-antenna and two-antenna configurations.

Assessment of thermochromic phantoms for characterizing microwave ablation devices

BACKGROUND AND PURPOSE

Thermochromic gel phantoms provide a controlled medium for visual assessment of thermal ablation device performance. However, there are limited studies reporting on the comparative assessment of ablation profiles assessed in thermochromic gel phantoms against those in ex vivo tissue. The objective of this study was to compare microwave ablation zones in a thermochromic tissue-mimicking gel phantom and ex vivo bovine liver and to report on measurements of the temperature-dependent dielectric and thermal properties of the phantom.

METHODS

Thermochromic polyacrylamide phantoms were fabricated following a previously reported protocol. Phantom samples were heated to temperatures in the range of 20°C-90°C in a temperature-controlled water bath, and colorimetric analysis of images of the phantom taken after heating was used to develop a calibration between color changes and the temperature to which the phantom was heated. Using a custom, 2.45 GHz water-cooled microwave ablation antenna, ablations were performed in fresh ex vivo liver and phantoms using 65 W applied for 5 min or 10 min (n = 3 samples in each medium for each power/time combination). Broadband (500 MHz-6 GHz) temperature-dependent dielectric and thermal properties of the phantom were measured over the temperature range of 22°C-100°C.

RESULTS

Colorimetric analysis showed that the sharp change in gel phantom color commences at a temperature of 57°C. Short and long axes of the ablation zone in the phantom (as assessed by the 57°C isotherm) for 65 W, 5 min ablations were aligned with the extents of the ablation zone observed in ex vivo bovine liver. However, for the 65 W, 10 min setting, ablations in the phantom were on average 23.7% smaller in the short axis and 7.4 % smaller in the long axis than those observed in ex vivo liver. Measurements of the temperature-dependent relative permittivity, thermal conductivity, and volumetric heat capacity of the phantom largely followed similar trends to published values for ex vivo liver tissue.

CONCLUSION

Thermochromic tissue-mimicking phantoms provides a controlled, and reproducible medium for comparative assessment of microwave ablation devices and energy delivery settings. However, ablation zone size and shapes in the thermochromic phantom do not accurately represent ablation sizes and shapes observed in ex vivo liver tissue for high energy delivery treatments (65 W, 10 min). One cause for this limitation is the difference in temperature-dependent thermal and dielectric properties of the thermochromic phantom compared to ex vivo bovine liver tissue, as reported in the present study.

Temperature Simulation of an Ablation Needle for the Prediction of Tissue Necrosis during Liver Ablation

Background/Objectives: Microwave ablation (MWA) is the leading therapy method for treating patients with liver cancer. MWA simulation is used to further improve the therapy and to help develop new devices. Methods: A water-cooled ablation needle was reconstructed. MWA simulations of a polyacrylamide phantom were carried out and compared with a representative clinical example (tumor diameter: 8.75 mm). The Arrhenius damage model and a critical temperature approach of 60 °C were applied to assess the necrosis zones. Finally, the simulation results were compared to the corresponding MR measurements. Results: Most of the heating in the simulation took place at a distance of 5 mm along the transverse axis and 20 mm along the longitudinal axis above the needle tip. The calculated Dice scores for the Arrhenius model were 0.77/0.53 for the phantom/clinical case. For the critical temperature approach, Dice scores of 0.60/0.66 for the phantom/clinical case were achieved. Conclusions: The comparison between simulated and measured temperature increases showed an excellent agreement. However, differences in the predicted necrosis volume might be caused by omitting consideration of the heat sink effect, especially in the clinical case. Nevertheless, this workflow enables short MWA simulation times (approximately 3 min) and demonstrates a step towards possible integration into daily clinical use.

Using Patient-Specific 3D Modeling and Simulations to Optimize Microwave Ablation Therapy for Liver Cancer

Microwave ablation (MWA) of liver tumors presents challenges like under- and over-ablation, potentially leading to inadequate tumor destruction and damage to healthy tissue. This study aims to develop personalized three-dimensional (3D) models to simulate MWA for liver tumors, incorporating patient-specific characteristics. The primary objective is to validate the predicted ablation zones compared to clinical outcomes, offering insights into MWA before therapy to facilitate accurate treatment planning. Contrast-enhanced CT images from three patients were used to create 3D models. The simulations used coupled electromagnetic wave propagation and bioheat transfer to estimate the temperature distribution, predicting tumor destruction and ablation margins. The findings indicate that prolonged ablation does not significantly improve tumor destruction once an adequate margin is achieved, although it increases tissue damage. There was a substantial overlap between the clinical ablation zones and the predicted ablation zones. For patient 1, the Dice score was 0.73, indicating high accuracy, with a sensitivity of 0.72 and a specificity of 0.76. For patient 2, the Dice score was 0.86, with a sensitivity of 0.79 and a specificity of 0.96. For patient 3, the Dice score was 0.8, with a sensitivity of 0.85 and a specificity of 0.74. Patient-specific 3D models demonstrate potential in accurately predicting ablation zones and optimizing MWA treatment strategies.

Transmission Coefficient-Based Monitoring of Microwave Ablation: Development and Experimental Evaluation in Ex Vivo Tissue

OBJECTIVES

To assess the feasibility of monitoring transient evolution of thermal ablation zones with a microwave transmission coefficient-based technique.

METHODS

Microwave ablation was performed in ex vivo bovine liver with two 2.45 GHz directional antennas. A custom apparatus was developed to enable periodic switching between "heating mode" when power from the generator was coupled to the antennas, and "monitoring mode", when antennas were coupled to a network analyzer for broadband transmission coefficient ( s21) measurements. Experiments were performed with applied powers ranging between 30-50 W per antenna for 53-1219 s. Transient s21 spectra over the course of ablations were analyzed to determine feasibility of predicting extent of ablation zones and compared against ground truth assessment from images of sectioned tissue. A linear regression-based mapping between the two datasets was derived to predict ablation extent.

RESULTS

Normalized average transmission coefficient initially rapidly decreased and then increased before asymptotically approaching steady state, with the transition time ranging between 53 s (45 W) and 109 s (30 W). Analysis of ground truth ablation zone images indicated time to complete ablation of 230-350 s. The relative prediction error for time to complete ablation derived from the s21 data was in the range of 1.6%-2.3% compared to ground truth.

CONCLUSION

We have demonstrated the feasibility of monitoring transient evolution of thermal ablation zones using microwave transmission coefficient measurements in ex vivo tissue.

SIGNIFICANCE

The presented technique has potential to contribute towards addressing the clinical need for a method of monitoring evolution of thermal ablation zones.

Optimizing Sensor Placement for Temperature Mapping during Ablation Procedures

Accurately mapping the temperature during ablation is crucial for improving clinical outcomes. While various sensor configurations have been suggested in the literature, depending on the sensors' type, number, and size, a comprehensive understanding of optimizing these parameters for precise temperature reconstruction is still lacking. This study addresses this gap by introducing a tool based on a theoretical model to optimize the placement of fiber Bragg grating sensors (FBG) within the organ undergoing ablation. The theoretical model serves as a general framework, allowing for adaptation to various situations. In practical application, the model provides a foundational structure, with the flexibility to tailor specific optimal solutions by adjusting problem-specific data. We propose a nonlinear and nonconvex (and, thus, only solvable in an approximated manner) optimization formulation to determine the optimal distribution and three-dimensional placement of FBG arrays. The optimization aims to find a trade-off among two objectives: maximizing the variance of the expected temperatures measured by the sensors, which can be obtained from a predictive simulation that considers both the type of applicator used and the specific organ involved, and maximizing the squared sum of the distances between the sensor pairs. The proposed approach provides a trade-off between collecting diverse temperatures and not having all the sensors concentrated in a single area. We address the optimization problem through the utilization of approximation schemes in programming. We then substantiate the efficacy of this approach through simulations. This study tackles optimizing the FBGs' sensor placement for precise temperature monitoring during tumor ablation. Optimizing the FBG placement enhances temperature mapping, aiding in tumor cell eradication while minimizing damage to surrounding tissues.

Safety and Efficacy of Percutaneous Liver Microwave Ablation Using a Fully Water-Cooled Choke Ring Antenna: First Multicenter Clinical Report

INTRODUCTION

The safety and efficacy of a microwave ablation (MWA) system for the liver with novel technologies in field control, antenna cooling through the inner part of the choke ring, and dual temperature monitoring were evaluated in this multicenter retrospective study.

MATERIAL AND METHODS

Ablation characteristics and efficacy were assessed on follow-up imaging (computed tomography or magnetic resonance imaging). Safety was evaluated according to CTCAE classification.

RESULTS

Eighty-seven liver tumors (65 metastases and 22 hepatocellular carcinomas) measuring 17.8 ± 7.9 mm were treated in 68 patients. Ablation zones measured 35.6 ± 11 mm in longest diameter. The coefficients of variation of the longest and shortest ablation diameters were 30.1% and 26.4%, respectively. The mean sphericity index of the ablation zone was 0.78 ± 0.14. Seventy-one ablations (82%) had a sphericity index above 0.66. At 1 month, all tumors demonstrated complete ablation with margins of 0-5 mm, 5-10 mm, and greater than 10 mm achieved in 22%, 46%, and 31% of tumors, respectively. After a median follow-up of 10 months, local tumor control was achieved in 84.7% of treated tumors after a single ablation and in 86% after one patient received a second ablation. One grade 3 complication (stress ulcer) occurred, but was unrelated to the procedure. Ablation zone size and geometry in this clinical study were in accordance with previously reported in vivo preclinical findings.

CONCLUSION

Promising results were reported for this MWA device. The high spherical index, reproducibility, and predictability of the resulting treatment zones translated to a high percentage of adequate safety margins, providing good local control rate.

Novel tumor localization model and prediction of ablation zone using an intertwined helical antenna for the treatment of hepatocellular carcinoma

Hepatocellular carcinoma has been the leading cause of death in recent centuries and with the advent of newer technologies, several thermal and cryo-ablation techniques have been introduced in the recent past. In this regard, microwave ablation has developed into a promising method for thermal ablation technique. However, due to clinical obligations, in-vivo analysis is not feasible and ex-vivo analysis is inaccurate due to changes in the electrical and thermal properties of the tissue. Therefore, in this study, temperature-dependent permittivity, electrical conductivity, and thermal conductivity along with phase change effect due to temperature reaching above 100°C are incorporated using finite element method model. Further, using an intertwined normal mode helical antenna ablation probe, a change in resonant frequency (Δf) and reflection coefficient (ΔS₁₁ ) from the actual value (antenna parameter in the air at 5 GHz) is modeled using second-order polynomial curve fitting to predict the surrounding permittivity in the range of 30-70. A maximum deviation of 0.8 value in permittivity from the actual value is observed. However, to obtain a generalized methodology, XG Boost and CAT Boost algorithms are used. Further, since ablation diameter plays a crucial role in achieving optimal tumor ablation, an artificial neural network (ANN) algorithm with three different optimizers is incorporated to predict ablation diameter using five critical parameters. Such an ANN algorithm which can predict the transversal and axial ablation zone may provide optimal ablation outcomes.

Multi-criterion optimization of invasive antenna applicators for Au@Fe3O4, Au@-Fe2O3 and Au@-Fe2O3 mediated microwave ablation treatment

Magnetic nanoparticle (MNP) mediated microwave ablation has the great potential at present to address challenges associated with treatment planning such as maximum heat generation in the vicinity of targeted tissues in lesser penetration time. Further, the antenna applicators injected in human phantom must be rigid and thin. The derivative-free optimization algorithms are carried out for optimum design of monopole, slot, dipole, and tapered slot antenna applicators for ablation of tumour tissues invasively. It is found that in terms of input impedance matching, the used multi-criterion Nelder-Mead optimization performs efficiently for tapered slot applicator achieving S₁₁ value of -40 dB with much reduced antenna dimensions. In order to further escalate the performance of tapered slot antenna, gold (Au)-coated iron-based MNPs are suggested for tumor infusion. Spherical gold-coated shell material is preferrable for more sphericity of ablation zone, biocompatibility and due to high conductivity, heat generated in MNPs can be transferred to biological tissues more rapidly. The size, type, and shape of MNPs also influence the heat generation in tumor tissues. Thus, three different types of MNPs having high magnetization properties, Au@Fe₃O₄, Au@α-Fe₂O₃ and Au@γ-Fe₂O₃ have been employed to study the performance in terms of maximum rise in temperature, specific absorption rate (SAR), and area of ablation zone by varying core size radius of MNPs. Results demonstrate that increase in radius of MNP core helps in increasing the temperature distribution and reduction in ablation zone. The optimized lesion is achieved for 20 nm core radius of Au@Fe₃O4.

Broadband Dielectric Spectroscopy with a Microwave Ablation Antenna

Microwave ablation is a technique used to treat tumorous tissue. Its clinical use has been greatly expanding in the last few years. Because the design of the ablation antenna and the success of the treatment greatly depend on the accurate knowledge of the dielectric properties of the tissue being treated, it is highly valuable to have a microwave ablation antenna that is also able to perform in-situ dielectric spectroscopy. In this work, an open-ended coaxial slot ablation antenna design operating at 5.8 GHz is adopted from previous work, and its sensing abilities and limitations are investigated in respect of the dimensions of the material under test. Numerical simulations were performed to investigate the functionality of the floating sleeve of the antenna and to find the optimal de-embedding model and calibration option for obtaining accurate dielectric properties of the area of interest. Results show that, as in the case of the open-ended coaxial probe, the accuracy of the measurement greatly depends on the likeness between the calibration standards' dielectric properties and the material under test. Finally, the results of this paper clarify to which extent the antenna can be used to measure dielectric properties and paves the way to future improvements and the introduction of this functionality into microwave thermal ablation treatments.

Survival benefit of thermal ablation therapy for patients with stage II-III non-small cell lung cancer: A propensity-matched analysis

BACKGROUND

Thermal ablation (TA) is considered a safe alternative to surgical resection for the treatment of non-small cell lung cancer (NSCLC). While previous studies have shown that TA is beneficial for stage I NSCLC patients, however, few have reported on TA efficacy in patients with stage II-III NSCLC. The current study investigated the impact of TA on the overall survival (OS) and cancer-specific survival (CSS) of patients with stage II-III NSCLC.

METHODS

Data on patients with stage II-III NSCLC who did not undergo surgical resection between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM), Kaplan-Meier survival curves, and Cox regression were used for statistical analyses.

RESULTS

A total of 57,959 stage II-III NSCLC patients who did not undergo surgical resection were included in this study, 261 of whom received TA. Overall, TA was associated with a longer OS (p = 0.035) and CSS (p = 0.005) than non-ablation. After 1:3 PSM, 252 patients receiving TA and 732 patients not receiving ablation were enrolled in the matched cohort. The OS (p = 0.047) and CSS (p = 0.029) remained higher in the TA group than in the non-ablation group after PSM. Cox regression analysis showed that age, sex, primary tumor site, pathological type, tumor size, radiotherapy, chemotherapy, and thermal ablation were independently associated with OS and CSS (p <0.05). Subgroup analysis found that the advantages of TA were more pronounced among individuals ≥70 years of age, with tumor size ≤3.0 cm, or who did not receive radiotherapy.

CONCLUSION

TA could be an effective alternative treatment for stage II-III NSCLC patients unsuitable for surgical resection, particularly those ≥70 years of age, with tumor size ≤3.0 cm, or who have not received radiotherapy.

Direction of Tissue Contraction after Microwave Ablation: A Comparative Experimental Study in Ex Vivo Bovine Liver

Objective

This study aimed to investigate the direction of tissue contraction after microwave ablation in ex vivo bovine liver models.

Materials and Methods

Ablation procedures were conducted in a total of 90 sites in ex vivo bovine liver models, including the surface (n = 60) and parenchyma (n = 30), to examine the direction of contraction of the tissue in the peripheral and central regions from the microwave antenna. Three commercially available 2.45-GHz microwave systems (Emprint, Neuwave, and Surblate) were used. For surface ablation, the lengths of two overlapped square markers were measured after 2.5- and 5-minutes ablations (n = 10 ablations for each system for each ablation time). For parenchyma ablation, seven predetermined distances between the markers were measured on the cutting plane after 5- and 10-minutes ablations (n = 5 ablations for each system for each ablation time). The contraction in the radial and longitudinal directions and the sphericity index (SI) of the ablation zones were compared between the three systems using analysis of variance.

Results

In the surface ablation experiment, the mean longitudinal contraction ratio and SI from a 5-minutes ablation using the Emprint, Neuwave, and Surblate systems were 28.92% and 1.04, 20.10% and 0.53, and 24.90% and 0.45, respectively (p < 0.001). A positive correlation between longitudinal contraction and SI was noted, and a similar radial contraction was observed. In the parenchyma ablation experiment, the mean longitudinal contraction ratio and SI from a 10-minutes ablation using the three pieces of equipment were 38.60% and 1.06, 32.45% and 0.61, and 28.50% and 0.50, respectively (p < 0.001). There was a significant difference in the longitudinal contraction properties, whereas there was no significant difference in the radial contraction properties.

Conclusion

The degree of longitudinal contraction showed significant differences depending on the microwave ablation equipment, which may affect the SI of the ablation zone.

On Efficacy of Microwave Ablation in the Thermal Treatment of an Early-Stage Hepatocellular Carcinoma

Microwave ablation at 2.45 GHz is gaining popularity as an alternative therapy to hepatic resection with a higher overall survival rate than external beam radiation therapy and proton beam therapy. It also offers better long-term recurrence-free overall survival when compared with radiofrequency ablation. To improve the design and optimization of microwave ablation procedures, numerical models can provide crucial information. A three-dimensional model of the antenna and targeted tissue without homogeneity assumptions are the most realistic representation of the physical problem. Due to complexity and computational resources consumption, most of the existing numerical studies are based on using two-dimensional axisymmetric models to emulate actual three-dimensional cancers and surrounding tissue, which is often far from reality. The main goal of this study is to develop a fully three-dimensional model of a multislot microwave antenna immersed into liver tissue affected by early-stage hepatocellular carcinoma. The geometry of the tumor is taken from the 3D-IRCADb-01 liver tumors database. Simulations were performed involving the temperature dependence of the blood perfusion, dielectric and thermal properties of both healthy and tumoral liver tissues. The water content changes during the ablation process are also included. The optimal values of the input power and the ablation time are determined to ensure complete treatment of the tumor with minimal damage to the healthy tissue. It was found that a multislot antenna is designed to create predictable, large, spherical zones of the ablation that are not influenced by varying tissue environments. The obtained results may be useful for determining optimal conditions necessary for microwave ablation to be as effective as possible for treating early-stage hepatocellular carcinoma, with minimized invasiveness and collateral damages.

Numerical Optimization of an Open-Ended Coaxial Slot Applicator for the Detection and Microwave Ablation of Tumors

Simple Summary

In this work, a parametric analysis of a dual-mode applicator for microwave ablation treatments is proposed to optimize the geometric parameters of the structure. The dual-mode concept means that the applicator comprises an additional sensing mode to determine the dielectric properties of the surrounding tissue before and during the ablation procedure. Based on numerical electromagnetic-thermal coupled simulations the most optimal design in terms of applicator efficiency as well as ablation zone volume and shape is determined that further fulfills the sensitivity requirements of the sensing mode. The multiobjective optimization problem is solved graphically with the so-called Pareto-optimization method. The resulting Pareto-optimal dual-mode applicator designs are characterized by electromagnetic and thermal simulations and discussed.

Abstract

A multiobjective optimization method for a dual-mode microwave applicator is proposed. Dual-modality means that microwaves are used apart from the treatment, and also for the monitoring of the microwave ablation intervention. (1) The use of computational models to develop and improve microwave ablation applicator geometries is essential for further advances in this field. (2) Numerical electromagnetic–thermal coupled simulation models are used to analyze the performance of the dual-mode applicator in liver tissue; the sensitivity evaluation of the dual-mode applicator’s sensing mode constrains the set of optimal solutions. (3) Three Pareto-optimal design parameter sets are derived that are optimal in terms of applicator efficiency as well as volume and sphericity of the ablation zone. The resulting designs of the dual-mode applicator provide a suitable sensitivity to distinguish between healthy and tumorous liver tissue. (4) The optimized designs are presented and numerically characterized. An improvement on the performance of previously proposed dual-mode applicator designs is achieved. The multiphysical simulation model of electromagnetic and thermal properties of the applicator is applicable for future comprehensive design procedures.

Heating technology for malignant tumors: a review

The therapeutic application of heat is very effective in cancer treatment. Both hyperthermia, i.e., heating to 39-45 °C to induce sensitization to radiotherapy and chemotherapy, and thermal ablation, where temperatures beyond 50 °C destroy tumor cells directly are frequently applied in the clinic. Achievement of an effective treatment requires high quality heating equipment, precise thermal dosimetry, and adequate quality assurance. Several types of devices, antennas and heating or power delivery systems have been proposed and developed in recent decades. These vary considerably in technique, heating depth, ability to focus, and in the size of the heating focus. Clinically used heating techniques involve electromagnetic and ultrasonic heating, hyperthermic perfusion and conductive heating. Depending on clinical objectives and available technology, thermal therapies can be subdivided into three broad categories: local, locoregional, or whole body heating. Clinically used local heating techniques include interstitial hyperthermia and ablation, high intensity focused ultrasound (HIFU), scanned focused ultrasound (SFUS), electroporation, nanoparticle heating, intraluminal heating and superficial heating. Locoregional heating techniques include phased array systems, capacitive systems and isolated perfusion. Whole body techniques focus on prevention of heat loss supplemented with energy deposition in the body, e.g., by infrared radiation. This review presents an overview of clinical hyperthermia and ablation devices used for local, locoregional, and whole body therapy. Proven and experimental clinical applications of thermal ablation and hyperthermia are listed. Methods for temperature measurement and the role of treatment planning to control treatments are discussed briefly, as well as future perspectives for heating technology for the treatment of tumors.

Thermal ablation in adrenal disorders: a discussion of the technology, the clinical evidence and the future

PURPOSE OF REVIEW

To summarise the emerging role of thermal ablation as a therapeutic modality in the management of functioning adrenal tumours and metastases to the adrenal gland.

RECENT FINDINGS

Observational evidence has demonstrated the benefit of thermal ablation in (i) resolving adrenal endocrinopathy arising from benign adenomas, (ii) treating solitary metastases to the adrenal and (iii) controlling metastatic adrenocortical carcinoma and phaeochromocytoma/paraganglioma.

SUMMARY

Microwave thermal ablation offers a promising, minimally invasive therapeutic modality for the management of functioning adrenocortical adenomas and adrenal metastases. Appropriate technological design, treatment planning and choice of imaging modality are necessary to overcome technical challenges associated with this emerging therapeutic approach.

A review of antenna designs for percutaneous microwave ablation

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.

Evaluation of the performance of designed coaxial antennas for hyperthermia using simulation and experimental methods

Introduction: Antenna geometries and tissue properties affect microwave energy distributions during microwave ablation procedures. There is paucity information on the potential of antenna fabricated from a thick semi-rigid coaxial cable in the field of microwave thermal therapy. This study aimed at comparing the performance of two dual-slot antennas designed from different semi-rigid coaxial cables for the ablation of a liver tumour using numerical simulation and experimental validation methods.

Materials and Methods: COMSOL Multiphysics software was used for designing dual-slot antennas and as well as to evaluate microwave energy deposition and heat distribution in the liver tissue. Experimental validations were conducted on the ex-vivo bovine livers to validate the simulation results.

Results: Thick antenna developed in this study produced a higher sphericity index, larger ablation diameter and reduced backward heating along the antenna shaft than the existing one. The experimental validation results also indicate significant differences between the two antennas in terms of ablation diameters (p = 0.04), ablation lengths (p = 0.02) and aspect ratios (p = 0.02).

Conclusion: Based on the findings in this study, antenna fabricated from a thick coaxial cable has a higher potential of localizing microwave energy in the liver than conventional antennas.

Design and Characterization of a Minimally Invasive Bipolar Electrode for Electroporation

OBJECTIVE

To test a new bipolar electrode for electroporation consisting of a single minimally invasive needle.

METHODS

A theoretical study was performed by using Comsol Multiphysics^® software. The prototypes of electrode have been tested on potatoes and pigs, adopting an irreversible electroporation protocol. Different applied voltages and different geometries of bipolar electrode prototype have been evaluated.

RESULTS

Simulations and pre-clinical tests have shown that the volume of ablated area is mainly influenced by applied voltage, while the diameter of the electrode had a lesser impact, making the goal of minimal-invasiveness possible. The conductive pole's length determined an increase of electroporated volume, while the insulated pole length inversely affects the electroporated volume size and shape; when the insulated pole length decreases, a more regular shape of the electric field is obtained. Moreover, the geometry of the electrode determined a different shape of the electroporated volume. A parenchymal damage in the liver of pigs due to irreversible electroporation protocol was observed.

CONCLUSION

The minimally invasive bipolar electrode is able to treat an electroporated volume of about 10 mm in diameter by using a single-needle electrode. Moreover, the geometry and the electric characteristics can be selected to produce ellipsoidal ablation volumes.

Directional Microwave Ablation: Experimental Evaluation of a 2.45-GHz Applicator in Ex Vivo and In Vivo Liver

PURPOSE

To experimentally characterize a microwave (MW) ablation applicator designed to produce directional ablation zones.

MATERIALS AND METHODS

Using a 14-gauge, 2.45-GHz side-firing MW ablation applicator, 36 ex vivo bovine liver ablations were performed. Ablations were performed at 60 W, 80 W, and 100 W for 3, 5, and 10 minutes (n = 4 per combination). Ablation zone forward and backward depth and width were measured and directivity was calculated as the ratio of forward to backward depth. Thirteen in vivo ablations were performed in 2 domestic swine with the applicator either inserted into the liver (80 W, 5 min, n = 3; 100 W, 5 min, n = 3; 100 W, 10 min, n = 2) or placed on the surface of the liver with a nontarget tissue placed on the back side of the applicator (80 W, 5 min, n = 5). The animals were immediately euthanized after the procedure; the livers were harvested and sectioned perpendicular to the axis of the applicator. In vivo ablation zones were measured following viability staining and assessed on histopathology.

RESULTS

Mean ex vivo ablation forward depth was 8.3-15.5 mm. No backward heating was observed at 60 W, 3-5 minutes; directivity was 4.7-11.0 for the other power and time combinations. In vivo ablation forward depth was 10.3-11.5 mm, and directivity was 11.5-16.1. No visible or microscopic thermal damage to nontarget tissues in direct contact with the back side of the applicator was observed.

CONCLUSIONS

The side-firing MW ablation applicator can create directional ablation zones in ex vivo and in vivo tissues.

Millimeter-wave pulsed heating in vitro: cell mortality and heat shock response

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.

Broadband lung dielectric properties over the ablative temperature range: Experimental measurements and parametric models

PURPOSE

Computational models of microwave tissue ablation are widely used to guide the development of ablation devices, and are increasingly being used for the development of treatment planning and monitoring platforms. Knowledge of temperature-dependent dielectric properties of lung tissue is essential for accurate modeling of microwave ablation (MWA) of the lung.

METHODS

We employed the open-ended coaxial probe method, coupled with a custom tissue heating apparatus, to measure dielectric properties of ex vivo porcine and bovine lung tissue at temperatures ranging between 31 and 150 ∘ C, over the frequency range 500 MHz to 6 GHz. Furthermore, we employed numerical optimization techniques to provide parametric models for characterizing the broadband temperature-dependent dielectric properties of tissue, and their variability across tissue samples, suitable for use in computational models of microwave tissue ablation.

RESULTS

Rapid decreases in both relative permittivity and effective conductivity were observed in the temperature range from 94 to 108 ∘ C. Over the measured frequency range, both relative permittivity and effective conductivity were suitably modeled by piecewise linear functions [root mean square error (RMSE) = 1.0952 for permittivity and 0.0650 S/m for conductivity]. Detailed characterization of the variability in lung tissue properties was provided to enable uncertainty quantification of models of MWA.

CONCLUSIONS

The reported dielectric properties of lung tissue, and parametric models which also capture their distribution, will aid the development of computational models of microwave lung ablation.