1. Microwave ablation of the liver in a live porcine model: the impact of power, time and total energy on ablation zone size and shape
- Author
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Lawrence Han Hwee Quek, Uei Pua, Fred T. Lee, Justin Kwan, Ivan Kuang Hsin Huang, Christopher L. Brace, J. Louis Hinshaw, Terrence Chi Hong Hui, and Gavin Hock Tai Lim
- Subjects
Cancer Research ,Materials science ,Swine ,Physiology ,Quantitative Biology::Tissues and Organs ,Physics::Medical Physics ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Medical technology ,medicine ,Animals ,R855-855.5 ,Total energy ,Microwaves ,Radiofrequency Ablation ,Microwave ablation ,medicine.disease ,Hepatic malignancy ,Power (physics) ,Cold Temperature ,percutaneous thermal ablation ,microwave ablation ,in-vivo swine model ,hepatocellular carcinoma ,hepatic malignancy ,neuwave medical ,Liver ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Catheter Ablation ,Female ,Pig liver ,Microwave ,Biomedical engineering ,Ablation zone - Abstract
Objective To explore various microwave (MW) time/power combinations to achieve maximum single-probe system performance in a live pig liver model. Methods Fifty-one microwave ablations performed in 12 female pigs using the following time/power combinations: 65 W for 10 min (65W 10MIN), ramped from 20 to 65 W (RAMPED), 95 W pulses with cooling periods (95W PULSED), 40 W for 16 min 15 s (LOW POWER), 1 min 95 W pulse then 8 min 65 W then a second 1 min 95 W pulse (BOOKEND 95W) and 65 W for 15 min (65W 15MIN). Temperatures 1.5 cm from the antenna were measured. Livers were excised, and ablations were measured and compared. Results At fixed overall energy, LOW POWER produced ablation zones with the smallest volume compared to 65W 10MIN, RAMPED and 95W PULSED. At a fixed time of 10-min, BOOKEND 95W protocol achieved wider and larger ablation zones than 65W 10MIN (p = 0.038, p = 0.008) and 95W PULSED (p = 0.049, p = 0.004). The 65W 15MIN combination had significantly larger diameters (p = 0.026), larger lengths (p = 0.014) and larger volumes (p = 0.005) versus 65W 10MIN. Maximum temperatures were highest with BOOKEND 95W (62.9 °C) and 65 W 15 MIN (63.0 °C) and lowest with LOW POWER (45.9 °C), p = 0.009. Conclusions Low power ablations, even if controlled for total energy delivery, create small ablation zones. High peak powers are associated with larger ablation zones and high margin temperatures if cooling pauses are avoided. Ramping and pulsing protocols with interleaved cooling appear to be of no benefit versus continuous 65 W for creating large ablation zones.
- Published
- 2020
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