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Small Methods May 2023Immunotherapy is an attractive approach for cancer therapy, while its antitumor efficacy is still limited, especially for non-immunogenic tumors. Nanomedicines can be... (Review)
Review
Immunotherapy is an attractive approach for cancer therapy, while its antitumor efficacy is still limited, especially for non-immunogenic tumors. Nanomedicines can be utilized to convert the non-immunogenic "cold" tumors to immunogenic "hot" tumors via inducing immunogenic cell death (ICD), thereby promoting the antitumor immune response. Some nanomedicines that can produce local heat and reactive oxygen species upon the stimulation of electromagnetic energy are the main candidates for inducing the ICD effect. However, their applications are often restricted due to the poor tissue penetration depths of electromagnetic energy, such as light. By contrast, ultrasound, X-ray, alternating magnetic field, and microwave show excellent tissue penetration depths and thereby can be used for sonodynamic therapy, radiotherapy, magnetic hyperthermia therapy, and microwave ablation therapy, all of which can effectively induce ICD. Herein, the combination of deep-tissue electromagnetic energy with nanomedicines for inducing ICD and cancer immunotherapy are summarized. In particular, the designs of nanomedicines to amplify ICD effect in the presence of deep-tissue electromagnetic energy and sensitize tumors to various immunotherapies will be discussed. At the end of this review, a brief conclusion and discussion of current challenges and further perspectives in this subfield are provided.
Topics: Immunogenic Cell Death; Nanomedicine; Immunotherapy; Microwaves; Hyperthermia, Induced; Neoplasms
PubMed: 36316270
DOI: 10.1002/smtd.202201083 -
International Journal of Hyperthermia :... 2020The goal of this study was to compare intra-procedural radiofrequency (RF) and microwave ablation appearance on non-contrast CT (NCCT) and ultrasound to the zone of...
The goal of this study was to compare intra-procedural radiofrequency (RF) and microwave ablation appearance on non-contrast CT (NCCT) and ultrasound to the zone of pathologic necrosis. Twenty-one 5-min ablations were performed in swine liver with (1) microwave at 140 W, (2) microwave at 70 W, or (3) RF at 200 W ( = 7 each). CT and US images were obtained simultaneously at 1, 3, and 5 min during ablation and 2, 5, and 10 min post-ablation. Each ablation was sectioned in the plane of the ultrasound image and underwent vital staining to delineate cellular necrosis. CT was reformatted to the same plane as the ultrasound transducer and transverse diameters of gas and hypoechoic/hypoattenuating zones at each time point were measured. CT, ultrasound and gross pathologic diameter measurements were compared using Student's -tests and linear regression. Visible gas and the hypoechoic zone on US images were more predictive of the pathologic ablation zone than on NCCT images ( < 0.05). The zone of necrosis was larger than the zone of visible gas on US (mean 3.2 mm for microwave, 6.4 mm for RF) and NCCT (7.6 mm microwave, 13.9 mm RF) images ( < 0.05). The zone of visible gas and hypoechoic zone on US are more predictive of pathology with microwave ablations when compared with RF ablations ( < 0.05). When evaluating images during energy delivery, US is more accurate than CT and microwave- more predictable than RF-ablation based on correlation with in-plane pathology.
Topics: Animals; Catheter Ablation; Liver; Microwaves; Radiofrequency Ablation; Swine; Tomography, X-Ray Computed
PubMed: 32620055
DOI: 10.1080/02656736.2020.1784471 -
Physics in Medicine and Biology Feb 2021Time-reversal (TR) is a known wideband array beam-forming technique that has been suggested as a treatment planning alternative in deep microwave hyperthermia for cancer...
Time-reversal (TR) is a known wideband array beam-forming technique that has been suggested as a treatment planning alternative in deep microwave hyperthermia for cancer treatment. While the aim in classic TR is to focus the energy at a specific point within the target, no assumptions are made on secondary lobes that might arise in the healthy tissues. These secondary lobes, together with tissue heterogeneity, may result in hot-spots (HSs), which are known to limit the efficiency of the thermal dose delivery to the tumor. This paper proposes a novel wideband TR focusing method that iteratively shifts the focus away from HSs and towards cold-spots from an initial TR solution, a procedure that improves tumor coverage and reduces HSs. We verify this method on two different applicator topologies and several target volume configurations. The algorithm is deterministic and runs within seconds, enabling its use for real-time applications. At the same time, it yields results comparable to those obtained with global stochastic optimizers such as Particle Swarm.
Topics: Algorithms; Humans; Hyperthermia, Induced; Microwaves; Neoplasms; Time Factors
PubMed: 33326945
DOI: 10.1088/1361-6560/abd41a -
Diagnostic and Interventional Radiology... Nov 2023To evaluate the efficacy of combination therapy using transarterial chemoembolization with microwave ablation (MWA) therapy vs. MWA monotherapy for hepatocellular... (Observational Study)
Observational Study
Combination transarterial chemoembolization and microwave ablation vs. microwave ablation monotherapy for hepatocellular carcinomas greater than 3 cm: a comparative study.
PURPOSE
To evaluate the efficacy of combination therapy using transarterial chemoembolization with microwave ablation (MWA) therapy vs. MWA monotherapy for hepatocellular carcinomas (HCCs) >3 cm in size.
METHODS
This two-arm retrospective observational study included patients with HCCs >3 cm who underwent either combination therapy (29 patients) or MWA monotherapy (35 patients) between 2014 and 2020. The treatment outcomes related to primary treatment efficacy, local tumor progression (LTP), tumor control rate, and overall survival were compared between each cohort.
RESULTS
The technical success and primary efficacy were 96.56% and 100.00% in the combination therapy cohort, and 91.42% and 100.00% in the MWA cohort, respectively, over a mean follow-up period of 27.6 months. The 1- and 3-year rates of LTP-free survival were 78.57% and 69.56% in the combination therapy cohort, vs. 72.45% and 35.44% in the MWA cohort, respectively ( = 0.001). The overall progression-free survival was longer in the combination therapy cohort compared with the MWA cohort (median: 56.0 vs. 13.0 months; = 0.017). With the incorporation of additional locoregional therapy, the overall survival rates were not significantly different, with 1- and 3-year overall survival rates of 100.00% and 88.71% in the combination therapy cohort and rates of 90.15% and 82.76% in the MWA cohort, respectively ( = 0.235).
CONCLUSION
The combination therapy provided significantly longer upfront LTP-free survival in HCCs >3 cm when compared with the MWA treatment alone, albeit with similar local tumor control and overall survival rates when accounting for additional locoregional therapies.
Topics: Humans; Carcinoma, Hepatocellular; Liver Neoplasms; Microwaves; Chemoembolization, Therapeutic; Radiofrequency Ablation; Treatment Outcome; Retrospective Studies; Catheter Ablation
PubMed: 37665139
DOI: 10.4274/dir.2023.232159 -
Journal of Vascular Surgery. Venous and... May 2023To assess the feasibility, safety, and effectiveness of microwave ablation (MWA) for soft tissue venous malformations (VMs).
OBJECTIVE
To assess the feasibility, safety, and effectiveness of microwave ablation (MWA) for soft tissue venous malformations (VMs).
METHODS
We retrospectively analyzed 20 patients with symptomatic VMs in the lower extremities and trunk. MWA was performed in all 20 patients. Contrast-enhanced ultrasound (CEUS) was performed immediately and 1 month after ablation. The data on the complete ablation rate, symptom improvement, and patient satisfaction were collected. Follow-up examinations began 1 month after ablation and continued for 2 to 19 months.
RESULTS
MWA was performed on 20 patients. The overall complete ablation rate was 75% (15/20). The complete ablation rate for the 11 patients with lesions <5 cm and the 9 patients with lesions >5 cm were 100% (11/11) and 44% (4/9), respectively. The complete ablation rate for the 14 patients with localized and 6 patients with extensive lesions was 93% (13/14) and 33% (2/6), respectively. Five patients had experienced incomplete ablation; 1 had a lesion >5 cm with ectopic drainage vessels, one had multiple lesions adherent to blood vessels and nerves, and three had large and extensive lesions. Thirteen patients had experienced significant improvements in clinical symptoms; 6 showed slight improvement; and 1 showed no change in symptoms. No complications or recurrences were observed. All 20 patients were satisfied with the therapeutic effect (100%). Twelve patients were significantly satisfied and 8 were slightly satisfied.
CONCLUSIONS
MWA with ultrasound guidance is a safe, effective, and minimally invasive therapy for symptomatic soft tissue VMs and may be a promising approach in the future.
Topics: Humans; Microwaves; Retrospective Studies; Radiofrequency Ablation; Ultrasonography; Ultrasonography, Interventional; Catheter Ablation; Treatment Outcome
PubMed: 36574903
DOI: 10.1016/j.jvsv.2022.11.003 -
Clinics and Research in Hepatology and... Aug 2023To study the efficacy of microwave ablation (MWA) and radiofrequency ablation (RFA) for colorectal liver metastases (CRLM) by meta-analysis. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To study the efficacy of microwave ablation (MWA) and radiofrequency ablation (RFA) for colorectal liver metastases (CRLM) by meta-analysis.
METHODS
PubMed, Web of Science, Embase, CNKI and the Cochrane Library were searched from the establishment to May 2023, and studies that report outcomes with comparison between MWA and RFA in CRLM treatment were selected by inclusion and exclusion criteria. Furthermore, the perioperative and survival data were statistically summarized and analyzed by Review Manager 5.4.
RESULTS
Five studies (MWA: 316 patients; RFA: 332 patients) were evaluated. The results of meta-analysis showed that local tumor progression in MWA group was significantly lower than that in RFA group (P < 0.05). The1-year and 2-year disease-free survival (DFS) of the MWA group was significantly better than that of the RFA group with HR of 1.77 (95% CI: 1.04-3.02; P = 0.04) and1.60 (95% CI: 1.09-2.35; P = 0.02), respectively.
CONCLUSION
The local tumor progression and 1-year and 2-year DFS of MWA were superior to RFA. The included articles were retrospective, offering low-quality evidence and limited conclusions.
Topics: Humans; Retrospective Studies; Microwaves; Treatment Outcome; Radiofrequency Ablation; Liver Neoplasms; Colorectal Neoplasms; Catheter Ablation; Carcinoma, Hepatocellular
PubMed: 37479137
DOI: 10.1016/j.clinre.2023.102182 -
Thoracic Cancer Sep 2022This retrospective study aimed to assess the safety and efficacy of microwave ablation for lung tumors adjacent to the interlobar fissures.
BACKGROUND
This retrospective study aimed to assess the safety and efficacy of microwave ablation for lung tumors adjacent to the interlobar fissures.
METHODS
From May 2020 to April 2021, 59 patients with 66 lung tumors (mean diameter, 16.9 ± 7.7 mm; range, 6-30 mm) adjacent to the interlobar fissures who underwent microwave ablation at our institution were identified and included in this study. Based on the relationship between the tumor and the interlobar fissure, tumors can be categorized into close to the fissure, causing the fissure, and involving the fissure. The complete ablation rate, local progression-free survival, complications, and associated factors were analyzed.
RESULTS
All 66 histologically proven tumors were treated using computed tomography-guided microwave ablation. The complete ablation rate was 95.5%. Local progression-free survival at 3, 6, 9, and 12 months were 89.4%, 83.3%, 74.2%, and 63.6%, respectively. The complications included pneumothorax (34.8%), pleural effusion (24.2%), cavity (18.2%), and pulmonary infection (7.6%). There were statistical differences in the incidence of pneumothorax, cavity, and delayed complications between the groups with and without antenna punctures through the fissure.
CONCLUSIONS
Microwave ablation is a safe and effective treatment for lung tumor adjacent to the interlobar fissure. Antenna puncturing though the interlobar fissure may be a potential risk factor for pneumothorax, cavity, and delayed complications.
Topics: Catheter Ablation; Humans; Lung Neoplasms; Microwaves; Pneumothorax; Radiofrequency Ablation; Retrospective Studies; Treatment Outcome
PubMed: 35909365
DOI: 10.1111/1759-7714.14589 -
Proceedings of the Institution of... Oct 2014Percutaneous thermal ablation has been widely used as a minimally invasive treatment for tumors. Treatment monitoring is essential for preventing complications while... (Review)
Review
Percutaneous thermal ablation has been widely used as a minimally invasive treatment for tumors. Treatment monitoring is essential for preventing complications while ensuring treatment efficacy. Mechanical testing measurements on tissue reveal that tissue stiffness increases with temperature and ablation duration. Different types of imaging methods can be used to monitor ablation procedures, including temperature or thermal strain imaging, strain imaging, modulus imaging, and shear modulus imaging. Ultrasound elastography demonstrates the potential to become the primary imaging modality for monitoring percutaneous ablation. This review briefly presented the state-of-the-art ultrasound elastography approaches for monitoring radiofrequency ablation and microwave ablation. These techniques were divided into four groups: quasi-static elastography, acoustic radiation force elastography, sonoelastography, and applicator motion elastography. Their advantages and limitations were compared and discussed. Future developments were proposed with respect to heat-induced bubbles, tissue inhomogeneities, respiratory motion, three-dimensional monitoring, multi-parametric monitoring, real-time monitoring, experimental data center for percutaneous ablation, and microwave ablation monitoring.
Topics: Catheter Ablation; Elasticity Imaging Techniques; Electrocoagulation; Humans; Microwaves; Monitoring, Intraoperative; Surgery, Computer-Assisted
PubMed: 25332155
DOI: 10.1177/0954411914554438 -
Cardiovascular and Interventional... Oct 2018Variability exists among institutions and physicians regarding the use of prophylactic antibiotics for ablation of renal tumors. The literature was reviewed for... (Review)
Review
INTRODUCTION
Variability exists among institutions and physicians regarding the use of prophylactic antibiotics for ablation of renal tumors. The literature was reviewed for infectious complications vis-à-vis the reported use of prophylactic antibiotics for tumor ablation of renal neoplasms.
MATERIALS AND METHODS
PubMed was searched for articles reporting radiofrequency ablation, cryoablation, and microwave ablation of renal masses, both by percutaneous and laparoscopic approaches. Data regarding potentially infectious outcomes, prophylactic antibiotic use or not, patient information, lesion characteristics, and procedural specifics were extracted from relevant articles.
RESULTS
Fifty-one articles met the inclusion criteria. Potentially infectious complications occurred in 74/6952 patients (1.06%) if fever is included, but only 29 patients (0.42%) if fever is excluded. Prophylactic antibiotics were reported in 373 patients and were not mentioned in 6579 patients. The incidence of fever was higher with the laparoscopic radiofrequency ablation and cryoablation compared to the percutaneous approach (p < 0.001).
CONCLUSION
Prophylactic antibiotics seldom are used and/or reported in renal tumor ablation, and when they are, the antibiotic regimens vary widely. Even so, infectious complications in renal tumor ablation are uncommon. The similar and very low rates of infectious outcomes among ablation types and the two access approaches (laparoscopic and percutaneous) suggest that prophylactic antibiotics for routine renal tumor ablation are unnecessary.
Topics: Adult; Antibiotic Prophylaxis; Catheter Ablation; Cryosurgery; Female; Fever; Humans; Kidney Neoplasms; Laparoscopy; Male; Microwaves; Middle Aged; Postoperative Complications; Risk Factors; Surgery, Computer-Assisted; Surgical Wound Infection
PubMed: 30062444
DOI: 10.1007/s00270-018-2043-8 -
Therapeutic Delivery Dec 2016Novel modified pharmaceutical materials with desired functionalities are required for the development of drug delivery systems. Excipients are no more inert ingredients... (Review)
Review
Novel modified pharmaceutical materials with desired functionalities are required for the development of drug delivery systems. Excipients are no more inert ingredients but these are playing crucial roles in modifying physicochemical properties of drugs and for imparting desired functionalities in the delivery system. In this review article, modified materials such as grafted, composite and coprocessed have been discussed along with the updated reported literature on the same. Applications of grafted materials as drug release retardant, mucoadhesive polymer and tablet superdisintegrant have been elaborated. Use of composite materials in the development of transdermal films, hydrogels, microspheres, beads and nanoparticles have been discussed. Methods for the preparation of coprocessed materials along with commercial products of different coprocessed excipients have also been enlisted.
Topics: Chemistry, Pharmaceutical; Drug Delivery Systems; Excipients; Humans; Microspheres; Microwaves; Tablets
PubMed: 27854180
DOI: 10.4155/tde-2016-0055