Microwave ablation of ex vivo bovine tissues using a dual slot antenna with a floating metallic sleeve

An Analysis of Microwave Ablation Parameters for Treatment of Liver Tumors from the 3D-IRCADb-01 Database

Simulation techniques are powerful tools for determining the optimal conditions necessary for microwave ablation to be efficient and safe for treating liver tumors. Owing to the complexity and computational resource consumption, most of the existing numerical models are two-dimensional axisymmetric models that emulate actual three-dimensional cancers and the surrounding tissue, which is often far from reality. Different tumor shapes and sizes require different input powers and ablation times to ensure the preservation of healthy tissues that can be determined only by the full three-dimensional simulations. This study aimed to tailor microwave ablation therapeutic conditions for complete tumor ablation with an adequate safety margin, while avoiding injury to the surrounding healthy tissue. Three-dimensional simulations were performed for a multi-slot microwave antenna immersed in two tumors obtained from the 3D-IRCADb-01 liver tumors database. The temperature dependence of the dielectric and thermal properties of healthy and tumoral liver tissues, blood perfusion, and water content are crucial for calculating the correct ablation time and, thereby, the correct ablation process. The developed three-dimensional simulation model may help practitioners in planning patient-individual procedures by determining the optimal input power and duration of the ablation process for the actual shape of the tumor. With proper input power, necrotic tissue is placed mainly in the tumor, and only a small amount of surrounding tissue is damaged.

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.

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.

Roll-Off Displacement in Ex Vivo Experiments of RF Ablation With Refrigerated Saline Solution and Refrigerated Deionized Water

OBJECTIVE

The recurrence rate in the treatment of liver tumors using radio frequency ablation (RFA) is often related to incomplete tissue necrosis and consequently the limitation in the ablation volume. This paper proposes an ablation protocol combined with the infusion of saline solution and deionized water aiming at achieving a time displacement in the roll-off occurrence and consequently increasing the volume of ablation.

METHODS

An infusion of saline solution and deionized water at 5 and 23  ^°C was performed to evaluate the influence of these liquids on the RFA procedure in ex vivo bovine liver pieces. The obtained results were used to propose a mathematical model of the roll-off phenomenon by means of the system identification techniques.

RESULTS

The RFA combined with the infusion of saline solution 0.9% at 5  ^°C presented optimal results, with a time delay of the roll-off occurrence in 27.8% compared to pure RFA ( p = 0.002) and an increase in the necrotic volume of 51.2% ( p = 0.0002). Two Box-Jenkins models were obtained to describe the roll-off phenomenon: 1) pure RFA; and 2) RFA combined with the saline solution 0.9% at 5  ^°C.

CONCLUSION

The RFA therapy combined with the saline solution 0.9% at 5  ^°C increases the time range to the roll-off occurrence, leading to higher necrosis volumes in ex vivo bovine liver samples. The development of a mathematical model to describe the roll-off behavior demonstrated that the transient response is improved by the infusion of the saline solution 0.9% at 5  ^°C.

Increasing radiofrequency ablation volumes with the use of internally cooled electrodes and injected hydrochloric acid in ex vivo bovine livers

PURPOSE

We used an impedance-controlled generator with an internally cooled electrode to perform radiofrequency ablation (RFA) in ex vivo bovine livers, with a single injection of either 38.5% sodium chloride (NaCl) or 10% hydrochloric acid (HCl), to determine the relative effects of these two solutions on tissue impedance, temperature and ablation volume.

MATERIALS AND METHODS

We performed 10 ablations each with injections of NaCl (NaCl-RFA), HCl (HCl-RFA) or nothing (RFA-alone), with a power setting of 200 W for 15 minutes. We recorded tissue impedance before and after injection. We logged temperatures obtained from thermocouple probes positioned 5, 10, 15 and 20 mm from the internally cooled RF electrode. After ablation, we measured ablation zone longitudinal and transverse diameters, and we calculated a spherical ratio (SR) for each ablation.

RESULTS

Mean post-injection impedance of 30.3 (standard deviation [SD] 2.5) ohms for HCl was significantly lower than that of 55.4 (SD 3.5) ohms for NaCl (p < .001). Mean maximum temperatures recorded at each respective distance from the RFA electrode were all highest for HCl-RFA and lowest for RFA-alone (p < .001). Mean longitudinal and transverse diameters after HCl-RFA (5.50 [SD 0.25] cm and 5.28 [SD 0.22] cm, respectively) were significantly larger than those after NaCl-RFA (4.24 [SD 0.35] cm and 3.55 [SD 0.43] cm, respectively) and after RFA-alone (3.60 [SD 0.10] cm and 2.70 [SD 0.13] cm, respectively) (p < .001). Mean SR after HCl-RFA (0.93, SD 0.02) was significantly higher than mean SR after NaCl-RFA (0.76, SD 0.06) and RFA-alone (0.72, SD 0.04) (p < .001).

CONCLUSION

Monopolar, impedance-controlled RFA, with an internally cooled electrode and a single 10% HCl injection may allow larger tumors to be treated, potentially resulting in improved patient outcomes.