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Hepatic Microwave Ablation With Multiple Antennae Results in Synergistically Larger Zones of Coagulation Necrosis

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Abstract

Background: Microwave ablation is a promising treatment for unresectable liver tumors. Unlike radiofrequency ablation, microwave ablation may be performed with multiple simultaneously active antennae.

Methods: Microwave ablation was performed in an in vivo porcine liver model by using a single antenna (n = 11) or three antennae in a triangular array, activated either sequentially (n = 11) or simultaneously (n = 13). Lesions were measured and assigned a qualitative shape score.

Results: Single-antenna microwave lesions had a mean volume of 7.4 +mn; 3.9 cm3, compared with 14.6 +mn; 5.2 cm3 and 43.1 +mn; 4.3 cm3 for sequential and simultaneous multiple-probe ablations, respectively (P < .001; analysis of variance). Simultaneous lesions were rounder than sequential ablations and were more effective near blood vessels. Simultaneous lesions created with probe separation of ≤1.7 cm were round and confluent, whereas clefts were present with distances >1.7 cm (P < .001).

Conclusions: Microwave ablation has several theoretical advantages over currently available radiofrequency devices. Simultaneous three-probe microwave ablation lesions were three times larger than sequential lesions and nearly six times greater in volume than single-probe lesions. Additionally, simultaneous multiple-probe ablation results in qualitatively better lesions, with more uniform coagulation and better performance near blood vessels. Simultaneous multiple-probe ablation may decrease inadequate treatment of large tumors and decrease recurrence rates after tumor ablation.

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Authors and Affiliations

  1. Department of Surgery, University of Wisconsin Medical School, Madison, Wisconsin

    Andrew S. Wright MD & David M. Mahvi MD

  2. Department of Radiology, University of Wisconsin Medical School, Madison, Wisconsin

    Fred T. Lee Jr MD

  3. H4/724 CSC, University of Wisconsin Hospital, 600 Highland Avenue, Madison, WI, 53792

    David M. Mahvi MD

Authors
  1. Andrew S. Wright MD
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  2. Fred T. Lee Jr MD
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  3. David M. Mahvi MD
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Correspondence to David M. Mahvi MD.

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Wright, A.S., Lee, F.T. & Mahvi, D.M. Hepatic Microwave Ablation With Multiple Antennae Results in Synergistically Larger Zones of Coagulation Necrosis. Ann Surg Oncol 10, 275–283 (2003). https://doi.org/10.1245/ASO.2003.03.045

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  • DOI: https://doi.org/10.1245/ASO.2003.03.045

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