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Sebek J, Park WKC, Geimer S, Van Citters DW, Farah A, Dupuy DE, Meaney PM, Prakash P. Computational modeling of microwave ablation with thermal accelerants. Int J Hyperthermia 2023; 40:2255755. [PMID: 37710404 DOI: 10.1080/02656736.2023.2255755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023] Open
Abstract
PURPOSE To develop a computational model of microwave ablation (MWA) with a thermal accelerant gel and apply the model toward interpreting experimental observations in ex vivo bovine and in vivo porcine liver. METHODS A 3D coupled electromagnetic-heat transfer model was implemented to characterize thermal profiles within ex vivo bovine and in vivo porcine liver tissue during MWA with the HeatSYNC thermal accelerant. Measured temperature dependent dielectric and thermal properties of the HeatSYNC gel were applied within the model. Simulated extents of MWA zones and transient temperature profiles were compared against experimental measurements in ex vivo bovine liver. Model predictions of thermal profiles under in vivo conditions in porcine liver were used to analyze thermal ablations observed in prior experiments in porcine liver in vivo. RESULTS Measured electrical conductivity of the HeatSYNC gel was ∼83% higher compared to liver at room temperature, with positive linear temperature dependency, indicating increased microwave absorption within HeatSYNC gel compared to tissue. In ex vivo bovine liver, model predicted ablation zone extents of (31.5 × 36) mm with the HeatSYNC, compared to (32.9 ± 2.6 × 40.2 ± 2.3) mm in experiments (volume differences 4 ± 4.1 cm3). Computational models under in vivo conditions in porcine liver suggest approximating the HeatSYNC gel spreading within liver tissue during ablations as a plausible explanation for larger ablation zones observed in prior in vivo studies. CONCLUSION Computational models of MWA with thermal accelerants provide insight into the impact of accelerant on MWA, and with further development, could predict ablations with a variety of gel injection sites.
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Affiliation(s)
- Jan Sebek
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas, USA
| | | | - Shireen Geimer
- Expeditionary School at Black River, Ludlow, Vermont, USA
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA
| | | | | | | | - Paul M Meaney
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA
| | - Punit Prakash
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas, USA
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Yu J, Yu XL, Cheng ZG, Hu B, Han ZY, Liu FY, Hu ZQ, Wang H, Dong J, Pan J, Yang B, Sai X, Guo AT, Liang P. Percutaneous microwave ablation of renal cell carcinoma: practice guidelines of the ultrasound committee of Chinese medical association, interventional oncology committee of Chinese research hospital association. Int J Hyperthermia 2021; 37:827-835. [PMID: 32635839 DOI: 10.1080/02656736.2020.1779356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Imaging-guided percutaneous microwave ablation (MWA) with high thermal efficiency comprises rapid, successful management of small renal cell carcinomas (RCCs) in selected patients. Ultrasound Committee of Chinese Medical Association, Interventional Oncology Committee of Chinese Research Hospital Association developed evidence-based guidelines for MWA of RCCs after systematically reviewing the 1969-2019 literature. Systematic reviews, meta-analyses, randomized controlled trials, cohort, and case-control studies reporting MWA of RCCs were included and levels of evidence assessed. Altogether, 146 articles were identified, of which 35 reported percutaneous MWA for T1a RCCs and 5 articles for T1b RCCs. Guidelines were established based on indications, techniques, safety, and effectiveness of MWA for RCCs, with the goal of standardizing imaging-guided percutaneous MWA treatment of RCCs. Key points Microwave ablation is recommended for managing small renal cell carcinoma in selected patients. Imaging protocols are tailored based on the procedural plan, guidance, and evaluation. Patient's selection evaluation, updated technique information, clinical efficacy, and complications are recommended to standardize management. A joint task force (multidisciplinary team) summarized the key elements of the standardized report.
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Affiliation(s)
- Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
| | - Bing Hu
- Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China.,Department of Ultrasound in Med, 6th People's Hospital of Shanghai Jiaotong, University, Shanghai, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
| | - Zhi-Quan Hu
- Department of Ultrasound, Medical Imaging Union Hospital of Tongji Medical College of HUST Wuhan, China
| | - Hui Wang
- Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China.,Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Jun Dong
- Department of Urology, Chinese PLA General Hospital, Beijing, China
| | - Jie Pan
- Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China.,Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Bo Yang
- Department of Oncology, Chinese PLA General Hospital, Beijing, China
| | - Xiaoyong Sai
- Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Geriatric Diseases, Institute of Geriatrics, Beijing, China
| | - Ai-Tao Guo
- Department of Pathology, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
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Huang H, Zhang L, Moser MAJ, Zhang W, Zhang B. A review of antenna designs for percutaneous microwave ablation. Phys Med 2021; 84:254-264. [PMID: 33773908 DOI: 10.1016/j.ejmp.2021.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/03/2021] [Accepted: 03/06/2021] [Indexed: 12/15/2022] Open
Abstract
Microwave (MW) antenna is a key element in microwave ablation (MWA) treatments as the means that energy is delivered in a focused manner to the tumor and its surrounding area. The energy delivered results in a rise in temperature to a lethal level, resulting in cell death in the ablation zone. The delivery of energy and hence the success of MWA is closely dependent on the structure of the antennas. Therefore, three design criteria, such as expected ablation zone pattern, efficiency of energy delivery, and minimization of the diameter of the antennas have been the focus along the evolution of the MW antenna. To further improve the performance of MWA in the treatment of various tumors through inventing novel antennas, this article reviews the state-of-the-art and summarizes the development of MW antenna designs regarding the three design criteria.
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Affiliation(s)
- Hangming Huang
- Energy-based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China
| | - Lifeng Zhang
- Department of General Surgery, the First Affiliated Hospital of Soochow University,Soochow University, Jiangsu, China
| | - Michael A J Moser
- Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Wenjun Zhang
- Division of Biomedical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, Canada
| | - Bing Zhang
- Energy-based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China.
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Guo RQ, Li XG. Computed tomography (CT)-guided percutaneous coaxial biopsy combined with microwave ablation for the treatment of renal masses. MINIM INVASIV THER 2020; 31:191-196. [PMID: 32720829 DOI: 10.1080/13645706.2020.1797816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE This study aimed to investigate the feasibility, safety, and efficacy of computed tomography (CT)-guided percutaneous coaxial biopsy combined with microwave ablation (MWA) for the treatment of renal masses. MATERIAL AND METHODS The clinical data of ten patients (14 tumors) treated with CT-guided percutaneous coaxial biopsy combined with MWA from January 2017 to November 2019 were retrospectively analyzed. The patients were followed up for 2-33 months. The outcomes were evaluated with plain and contrast spiral CT scans. Renal function was assessed using the estimated glomerular filtration rate. RESULTS No severe MWA-related complication was observed. All the tumors were successfully ablated. There was no imaging evidence of local residual tumor, local tumor recurrence, or disease progression during the follow-up period. CONCLUSIONS CT-guided percutaneous coaxial biopsy combined with MWA might be an effective option for the diagnosis and treatment of renal masses in selected patients.
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Affiliation(s)
- Run-Qi Guo
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Xiao-Guang Li
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
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Radiofrequency Ablation, Cryoablation, and Microwave Ablation for T1a Renal Cell Carcinoma: A Comparative Evaluation of Therapeutic and Renal Function Outcomes. J Vasc Interv Radiol 2019; 30:1035-1042. [DOI: 10.1016/j.jvir.2018.12.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 12/09/2018] [Accepted: 12/11/2018] [Indexed: 02/08/2023] Open
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Peña K, Ishahak M, Arechavala S, Leveillee RJ, Salas N. Comparison of temperature change and resulting ablation size induced by a 902–928 MHz and a 2450 MHz microwave ablation system in in-vivo porcine kidneys. Int J Hyperthermia 2019; 36:313-321. [DOI: 10.1080/02656736.2019.1565788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Karli Peña
- Joint Bioengineering and Endourology Developmental Surgical Laboratory, Division of Endourology, Laparoscopy, and Minimally-Invasive Surgery, Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Matthew Ishahak
- Joint Bioengineering and Endourology Developmental Surgical Laboratory, Division of Endourology, Laparoscopy, and Minimally-Invasive Surgery, Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Stacie Arechavala
- Joint Bioengineering and Endourology Developmental Surgical Laboratory, Division of Endourology, Laparoscopy, and Minimally-Invasive Surgery, Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Raymond J. Leveillee
- Joint Bioengineering and Endourology Developmental Surgical Laboratory, Division of Endourology, Laparoscopy, and Minimally-Invasive Surgery, Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
- Division of Urology, Department of Surgery, Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Nelson Salas
- Joint Bioengineering and Endourology Developmental Surgical Laboratory, Division of Endourology, Laparoscopy, and Minimally-Invasive Surgery, Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
- Department of Vascular and Interventional Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
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Introduction of Microwave Ablation Into a Renal Ablation Practice: Valuable Lessons Learned. AJR Am J Roentgenol 2018; 211:1381-1389. [PMID: 30247980 DOI: 10.2214/ajr.18.19775] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the early outcomes of percutaneous microwave ablation (MWA) for clinical stage T1 (cT1) renal masses when performed within a high-volume ablation practice with critical emphasis on procedural safety. MATERIALS AND METHODS A retrospective review of a percutaneous renal ablation registry identified 26 patients with a total of 27 cT1 renal masses treated with MWA between 2011 and 2017. Mean patient age was 63.8 years and 16 (61.5%) patients were male. Mean renal mass size ± SD was 2.3 ± 0.8 cm (range, 1.1-4.7 cm). The main outcome parameters investigated were technical success, local tumor progression, survival rates, and complications. Complications were categorized using the Clavien-Dindo classification system. Rates of local progression-free and cancer-specific survival (PFS and CSS, respectively) were estimated using the Kaplan-Meier method. RESULTS Technical success was 100% on contrast-enhanced CT or MRI performed immediately after renal MWA. Twenty-four patients (92%) with 25 tumors had follow-up imaging for 3 months or longer (mean, 20.6 ± 11.6 months), with no local tumor recurrences identified. Estimated 3-year local PFS and CSS were 96% and 94%, respectively. The overall complication rate was 19.2%; two patients (7.7%) experienced minor complications (grade I or II) and three patients (11.5%) experienced major bleeding or urinary-related complications (grade III or higher), including one death. CONCLUSION This study suggests that percutaneous MWA is a promising minimally invasive treatment option for cT1 renal masses. Nonetheless, major bleeding and urinary-related complications can occur, and further studies are needed to determine optimal patient and tumor selection for renal MWA.
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Choi SH, Kim JW, Kim JH, Kim KW. Efficacy and Safety of Microwave Ablation for Malignant Renal Tumors: An Updated Systematic Review and Meta-Analysis of the Literature Since 2012. Korean J Radiol 2018; 19:938-949. [PMID: 30174484 PMCID: PMC6082757 DOI: 10.3348/kjr.2018.19.5.938] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/10/2018] [Indexed: 02/06/2023] Open
Abstract
Objective To systematically determine the treatment outcomes of percutaneous microwave ablation (MWA) in patients with malignant renal tumor. Materials and Methods Original studies that reported the clinical outcomes of MWA in patients with malignant renal tumors were identified in MEDLINE and EMBASE from 2012 to June 30, 2017. Inverse variance and random-effects models were used to evaluate and acquire meta-analytic summary estimates of various clinical outcomes, including technical outcomes (technical success rate [TSR] and technical efficacy rate [TER]), oncologic outcomes (local tumor recurrence rate [LRR], cancer-specific survival rate [CSSR], and overall survival rate [OSR]), and complications. Results Among the 145 articles screened, 13 articles including 567 patients carrying 616 malignant renal tumors were included in the meta-analysis. The meta-analytic pooled TSR and TER were 97.3% (95% confidence interval, 94.3-99.4%; I2 = 0.0%) and 97.6% (95.0-99.4%, I2 = 48.5%), respectively. The meta-analytic pooled LRR was 2.1% (0.3-4.7%, I2 = 54.1%). At 1-, 2-, 3-, and 5-year follow-up time points, the meta-analytic pooled CSSRs were 99.1% (97.2-100.0%; I2 = 0.0%), 98.4% (95.1-100.0%; I2 = 31.2%), 97.6% (93.4-99.9%; I2 = 52.3%), and 96.9% (93.3-99.2%; I2 = 0.0%) respectively, while the OSRs were 98.3% (96.1-99.8%; I2 = 0.0%), 94.9% (91.7-97.5%; I2 = 0.0%), 86.8% (81.9-91.1%; I2 = 22.1%), and 81.9% (75.4-87.6%; I2 = 0.0%). In terms of major complications, a 1.8% (0.6-3.3%; I2 = 0.0%) rate of meta-analytic pooled incidence was found. Conclusion Microwave ablation showed favorable technical and oncologic outcomes with a low incidence of major complications. Hence, image-guided percutaneous MWA can be considered as a safe and effective treatment for malignant renal tumors.
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Affiliation(s)
- Sang Hyun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Jong Woo Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Jin Hyoung Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
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9
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Sartori S, Mauri G, Tombesi P, Di Vece F, Bianchi L, Pacella CM. Ultrasound-guided percutaneous laser ablation is safe and effective in the treatment of small renal tumors in patients at increased bleeding risk. Int J Hyperthermia 2018; 35:19-25. [PMID: 29749271 DOI: 10.1080/02656736.2018.1468038] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE The aim of this retrospective study was to assess the safety and effectiveness of laser ablation (LA) in patients with small renal cell carcinomas (RCC) and increased risk of bleeding. MATERIAL AND METHODS From 2013 to 2017, nine patients (six males, three females, aged 68.5 ± 12.2 years) at high risk of bleeding underwent ultrasonography-guided LA for an RCC. Patients were considered at increased risk of bleeding because of impairment of coagulation parameters, concomitant antiplatelet therapy, or at-risk location of the tumor (one, five, and three patients, respectively). RCC diameter ranged from 11 to 23 mm. According to tumor size, two or three laser fibers were introduced through 21-gauge needles and 1800 J per fiber were delivered in 6 min with a fixed power of 5 W. Major and minor complications, technical success, and primary and secondary technical effectiveness and tumor recurrence were recorded. RESULTS Just one Grade 1 complication was observed: a small asymptomatic hematoma that spontaneously resolved. Technical success was 100%, 1 month technical efficacy was 88.9% (8/9 patients). One patient with residual tumor was successfully retreated 1 month later, and secondary efficacy rate was 100%. No local tumor recurrence occurred during a median follow-up of 26 months (range 11-49 months). CONCLUSIONS LA is safe and effective in the treatment of small RCC and might represent a valid option in patients with increased risk of bleeding.
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Affiliation(s)
- Sergio Sartori
- a Section of Interventional Ultrasound, Department of Internal Medicine , St. Anna Hospital , Ferrara , Italy
| | - Giovanni Mauri
- b Department of Interventional Radiology , European Institute of Oncology , Milan , Italy
| | - Paola Tombesi
- a Section of Interventional Ultrasound, Department of Internal Medicine , St. Anna Hospital , Ferrara , Italy
| | - Francesca Di Vece
- a Section of Interventional Ultrasound, Department of Internal Medicine , St. Anna Hospital , Ferrara , Italy
| | - Lara Bianchi
- a Section of Interventional Ultrasound, Department of Internal Medicine , St. Anna Hospital , Ferrara , Italy
| | - Claudio Maurizio Pacella
- c Department of Diagnostic Imaging and Interventional Radiology , Regina Apostolorum Hospital , Albano Laziale, Rome , Italy
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Thermal Ablation of T1c Renal Cell Carcinoma: A Comparative Assessment of Technical Performance, Procedural Outcome, and Safety of Microwave Ablation, Radiofrequency Ablation, and Cryoablation. J Vasc Interv Radiol 2018; 29:943-951. [PMID: 29628298 DOI: 10.1016/j.jvir.2017.12.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/01/2017] [Accepted: 12/19/2017] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To evaluate perioperative outcomes of thermal ablation with microwave (MW), radiofrequency (RF), and cryoablation for stage T1c renal cell carcinoma (RCC). MATERIALS AND METHODS A retrospective analysis of 384 patients (mean age, 71 y; range, 22-88 y) was performed between October 2006 and October 2016. Mean radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines; preoperative aspects and dimensions used for anatomic classification; and centrality index scores were 6.3, 7.9, and 2.7, respectively. Assessment of pre- and postablation serum blood urea nitrogen, creatinine, and estimated glomerular filtration rate was performed to assess functional outcomes. Linear regression analyses were performed to compare sedation medication dosages among the three treatment cohorts. Univariable and multivariable logistic regression analyses were performed to compare rates of residual disease and complications among treatment modalities. RESULTS A total of 437 clinical stage T1N0M0 biopsy-proven RCCs measuring 1.2-6.9 cm were treated with computed tomography (CT)-guided MW ablation (n = 44; 10%), RF ablation (n = 347; 79%), or cryoablation (n = 46; 11%). There were no significant differences in patient demographic or tumor characteristics among cohorts. Complication rates and immediate renal function changes were similar among the three ablation modalities (P = .46 and P = .08, respectively). MW ablation was associated with significantly decreased ablation time (P < .05), procedural time (P < .05), and dosage of sedative medication (P < .05) compared with RF ablation and cryoablation. CONCLUSIONS CT-guided percutaneous MW ablation is comparable to RF ablation or cryoablation for the treatment of stage T1N0M0 RCC with regard to treatment response and is associated with shorter treatment times and less sedation than RF ablation or cryoablation. In addition, the safety profile of CT-guided MW ablation is noninferior to those of RF ablation or cryoablation.
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11
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Deshazer G, Hagmann M, Merck D, Sebek J, Moore KB, Prakash P. Computational modeling of 915 MHz microwave ablation: Comparative assessment of temperature-dependent tissue dielectric models. Med Phys 2017; 44:4859-4868. [DOI: 10.1002/mp.12359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 04/20/2017] [Accepted: 04/20/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Garron Deshazer
- Department of Radiation Oncology; Siteman Cancer Center; Barnes-Jewish Hospital & Washington University School of Medicine; 4921 Parkview Pl St. Louis MO 63110 USA
- Department of Diagnostic Imaging; Rhode Island Hospital; 593 Eddy Street Providence RI 02903 USA
| | - Mark Hagmann
- Perseon Medical; 2188 W 2200 S Salt Lake City UT 84119 USA
| | - Derek Merck
- Department of Diagnostic Imaging; Rhode Island Hospital; 593 Eddy Street Providence RI 02903 USA
| | - Jan Sebek
- Department of Electrical and Computer Engineering; Kansas State University; Manhattan KS 66506 USA
| | - Kent B. Moore
- Perseon Medical; 2188 W 2200 S Salt Lake City UT 84119 USA
| | - Punit Prakash
- Department of Electrical and Computer Engineering; Kansas State University; Manhattan KS 66506 USA
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12
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Krokidis ME, Orsi F, Katsanos K, Helmberger T, Adam A. CIRSE Guidelines on Percutaneous Ablation of Small Renal Cell Carcinoma. Cardiovasc Intervent Radiol 2016; 40:177-191. [DOI: 10.1007/s00270-016-1531-y] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 12/01/2016] [Indexed: 01/09/2023]
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13
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Mansilla AV, Bivins EE, Contreras F, Hernandez MA, Kohler N, Pepe JW. CT-Guided Microwave Ablation of 45 Renal Tumors: Analysis of Procedure Complexity Utilizing a Percutaneous Renal Ablation Complexity Scoring System. J Vasc Interv Radiol 2016; 28:222-229. [PMID: 27988263 DOI: 10.1016/j.jvir.2016.10.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 10/11/2016] [Accepted: 10/16/2016] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To develop a scoring system that stratifies complexity of percutaneous ablation of renal tumors. MATERIALS AND METHODS Analysis was performed of 36 consecutive patients (mean age, 64 y; range, 30-89 y) who underwent CT-guided microwave (MW) ablation of 45 renal tumors (mean tumor diameter, 2.4 cm; range, 1.2-4.0 cm). Technical success and effectiveness were determined based on intraprocedural and follow-up imaging studies. The RENAL score and the proposed percutaneous renal ablation complexity (P-RAC) score were calculated for each tumor. RESULTS Technical success was 93.3% (n = 42). Biopsy of 38 of 45 renal tumors revealed 23 renal cell carcinomas. Median follow-up period was 9.7 months (range, 2.9-46.8 months). There were no tumor recurrences. One major complication, ureteropelvic junction stricture, occurred (2.6%). The P-RAC score was found to differ statistically from the RENAL score (t = 3.754, df = 44, P = .001). A positive correlation was found between the P-RAC score and number of antenna insertions (r = .378, n = 45, P = .011) and procedure duration (r = .328, n = 45, P = .028). No correlation was found between the RENAL score and number of MW antenna insertions (r = .110, n = 45, P = .472) or procedure duration (r = .263, n = 45, P = .081). Hydrodissection was significantly more common in the P-RAC high-complexity category than in low-complexity category (χ2 = 12.073, df = 2, P = .002). CONCLUSIONS The P-RAC score may be useful in stratifying percutaneous renal ablation complexity. Further studies with larger sample sizes are necessary to validate the P-RAC score and to determine if it can predict risk of complications.
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Affiliation(s)
- Alberto V Mansilla
- Radiology Specialists of Florida, Florida Hospital, 601 East Rollins Street, Orlando, FL 32803.
| | - Eugene E Bivins
- Volunteer Research Program, Florida Hospital, 601 East Rollins Street, Orlando, FL 32803
| | - Francisco Contreras
- Radiology Specialists of Florida, Florida Hospital, 601 East Rollins Street, Orlando, FL 32803
| | - Manuel A Hernandez
- Radiology Specialists of Florida, Florida Hospital, 601 East Rollins Street, Orlando, FL 32803
| | - Nathan Kohler
- Department of Radiology, Florida Hospital, 601 East Rollins Street, Orlando, FL 32803
| | - Julie W Pepe
- Office of Research Administration, Florida Hospital, 601 East Rollins Street, Orlando, FL 32803
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Gonzalez-Aguirre AJ, Durack JC. Managing Complications Following Nephron-Sparing Procedures for Renal Masses. Tech Vasc Interv Radiol 2016; 19:194-202. [PMID: 27641453 DOI: 10.1053/j.tvir.2016.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Small renal malignancies are commonly treated with nephron-sparing procedures including partial nephrectomy and percutaneous ablation. Although these procedures offer faster patient recovery and preserve renal function, a variety of complications can occur. Here, we review vascular and nonvascular complications associated with nephron-sparing renal mass treatments and discuss options for minimally invasive image-guided management.
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Affiliation(s)
- Adrian J Gonzalez-Aguirre
- Department of Radiology, Interventional Radiology Section, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jeremy C Durack
- Department of Radiology, Interventional Radiology Section, Memorial Sloan Kettering Cancer Center, New York, NY.
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Amabile C, Ahmed M, Solbiati L, Meloni MF, Solbiati M, Cassarino S, Tosoratti N, Nissenbaum Y, Ierace T, Goldberg SN. Microwave ablation of primary and secondary liver tumours: ex vivo, in vivo, and clinical characterisation. Int J Hyperthermia 2016; 33:34-42. [PMID: 27443519 DOI: 10.1080/02656736.2016.1196830] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
| | - Muneeb Ahmed
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Luigi Solbiati
- Department of Interventional Oncologic Radiology, General Hospital of Busto Arsizio, Busto Arsizio, Italy
| | | | - Marco Solbiati
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | | | | | - Yitzhak Nissenbaum
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Tiziana Ierace
- Department of Interventional Oncologic Radiology, General Hospital of Busto Arsizio, Busto Arsizio, Italy
| | - S. Nahum Goldberg
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Radiology, Hadassah Hebrew University Medical Centre, Jerusalem, Israel
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Chen CN, Liang P, Yu J, Yu XL, Cheng ZG, Han ZY, Liu FY, Li X. Contrast-enhanced ultrasound-guided percutaneous microwave ablation of renal cell carcinoma that is inconspicuous on conventional ultrasound. Int J Hyperthermia 2016; 32:607-13. [PMID: 27269816 DOI: 10.3109/02656736.2016.1172118] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Chao-nan Chen
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiao-ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang-yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xin Li
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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Wells SA, Wheeler KM, Mithqal A, Patel MS, Brace CL, Schenkman NS. Percutaneous microwave ablation of T1a and T1b renal cell carcinoma: short-term efficacy and complications with emphasis on tumor complexity and single session treatment. Abdom Radiol (NY) 2016; 41:1203-11. [PMID: 27167230 DOI: 10.1007/s00261-016-0776-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE To update the oncologic outcomes and safety for microwave (MW) ablation of T1a (≤4.0 cm) and T1b (4.1-7.0 cm) renal cell carcinoma (RCC) with emphasis on tumor complexity and single session treatment. MATERIALS AND METHODS Retrospective review of 29 consecutive patients (30 tumors) with localized (NOMO) RCC (23 T1a; 7 T1b) treated with percutaneous MW ablation between 3/2013 and 6/2014. Primary outcomes investigated were technical success, local tumor progression (LTP), and complications. Technical success was assessed with contrast-enhanced computed tomography (CECT) immediately after MW ablation. Presence of LTP was assessed with CECT or contrast-enhanced magnetic resonance at 6-month target intervals for the first two years and annually thereafter. Complications were categorized using the Clavien-Dindo classification system. RESULTS Median tumor diameter was 2.8 cm [IQR 2.1-3.3] for T1a and 4.7 cm [IQR 4.1-5.7] for T1b tumors. Median RENAL nephrometry score was 7 [IQR 4-8] for T1a tumors and 9 [IQR 6.25-9.75] for T1b tumors. Technical success was achieved for 22 T1a (96%) and 7 T1b (100%) tumors. There were no LTP during a median imaging follow-up of 12.0 months [IQR 6-18] for the 23 patients (24 tumors) with greater than 6 months of follow-up. There were three Clavien-Dindo grade I-II complication (10%) and no Clavien-Dindo grade III-V complications (0%). All but two patients (93%) are alive without metastatic disease; two patients died after 12-month follow-up of causes unrelated to the MW ablation. CONCLUSION Percutaneous MW ablation appears to be a safe and effective treatment option for low, moderate, and highly complex T1a and T1b RCC in early follow-up.
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Thermal Ablative Techniques in Renal Cell Carcinoma. KIDNEY CANCER 2015. [DOI: 10.1007/978-3-319-17903-2_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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