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World Journal of Gastroenterology Sep 2013Primary liver cancer and liver metastases are among the most frequent malignancies worldwide, with an increasing number of new cases and deaths every year. Traditional... (Review)
Review
Primary liver cancer and liver metastases are among the most frequent malignancies worldwide, with an increasing number of new cases and deaths every year. Traditional surgery is only suitable for a limited proportion of patients and imaging-guided percutaneous thermal ablation has achieved optimistic results for management of hepatic malignancy. This synopsis outlines the first clinical practice guidelines for ultrasound-guided percutaneous microwave ablation therapy for hepatic malignancy, which was created by a joint task force of the Society of Chinese Interventional Ultrasound. The guidelines aim at standardizing the microwave ablation procedure and therapeutic efficacy assessment, as well as proposing the criteria for the treatment candidates.
Topics: Ablation Techniques; Carcinoma, Hepatocellular; Combined Modality Therapy; Humans; Liver Neoplasms; Microwaves; Outcome Assessment, Health Care; Postoperative Care; Ultrasonography, Interventional
PubMed: 24023485
DOI: 10.3748/wjg.v19.i33.5430 -
Diagnostic and Interventional Radiology... Nov 2020There are many therapeutic options for primary hepatocellular carcinoma (HCC), but very limited options for unresectable HCC with a single lesion larger than 5 cm... (Meta-Analysis)
Meta-Analysis
There are many therapeutic options for primary hepatocellular carcinoma (HCC), but very limited options for unresectable HCC with a single lesion larger than 5 cm (Barcelona Clinic Liver Cancer [BCLC] stage A) or with 2-3 nodules beyond 5 cm (BCLC stage B). Transcatheter arterial chemoembolization (TACE) is considered the first-line treatment for these patients, and combination therapy has also been tried. However, the effectiveness of microwave ablation (MWA) combined with TACE in the treatment of the above tumors remains to be further confirmed. Therefore, this meta-analysis aimed to compare the effectiveness of combination therapy and TACE monotherapy on these patients. PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, and the Wan Fang electronic databases were retrieved to search for studies comparing combination therapy and TACE monotherapy, published between the earliest available date and August 20, 2019. A total of 20 articles (reporting 1736 patients) were included. Meta-analysis showed that, compared to TACE alone, TACE + MWA resulted in significantly higher 1-, 2-, and 3-year overall survival (OS) (1-year OS rate: RR = 1.36, 95% CI 1.28-1.44, P < 0.001; 2-year OS rate: RR = 1.56, 95% CI 1.40-1.74, P < 0.001 and 3-year OS rate: RR = 2.07, 95% CI: 1.67-2.57, P < 0.001). Complete response, partial response, and objective response rates were significantly higher in TACE + MWA than those in TACE alone (P < 0.001). Meanwhile, publication bias and sensitivity analysis were performed and did not show statistical significance.
Topics: Carcinoma, Hepatocellular; Chemoembolization, Therapeutic; Combined Modality Therapy; Humans; Liver Neoplasms; Microwaves; Radiofrequency Ablation; Treatment Outcome
PubMed: 32965220
DOI: 10.5152/dir.2020.19615 -
International Urology and Nephrology Sep 2023Thermal ablation, including microwave ablation (MWA) and radiofrequency ablation (RFA), has been recommended for the treatment of primary hyperparathyroidism (PHPT) and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Thermal ablation, including microwave ablation (MWA) and radiofrequency ablation (RFA), has been recommended for the treatment of primary hyperparathyroidism (PHPT) and refractory secondary hyperparathyroidism (SHPT). This meta-analysis was conducted to evaluate the efficacy and safety of MWA and RFA in patients with PHPT and refractory SHPT.
METHODS
Databases including PubMed, EMbase, the Cochrane Library, CNKI (China National Knowledge Infrastructure), and Wanfang were searched from inception to December 5, 2022. Eligible studies comparing MWA and RFA for PHPT and refractory SHPT were included. Data were analyzed using Review Manager software, version 5.3.
RESULTS
Five studies were included in the meta-analysis. Two were retrospective cohort studies, and three were RCTs. Overall, 294 patients were included in the MWA group, and 194 patients were included in the RFA group. Compared with RFA for refractory SHPT, MWA had a shorter operation time for a single lesion (P < 0.01) and a higher complete ablation rate for a single lesion ≥ 15 mm (P < 0.01) but did not show a difference in the complete ablation rate for a single lesion < 15 mm (P > 0.05). There were no significant differences between MWA and RFA for refractory SHPT concerning parathyroid hormone (P > 0.05), calcium (P > 0.05), and phosphorus levels (P > 0.05) within 12 months after ablation, except that calcium (P < 0.01) and phosphorus levels (P = 0.02) in the RFA group were lower than those in the MWA group at one month after ablation. There was no significant difference between MWA and RFA concerning the cure rate of PHPT (P > 0.05). There were no significant differences between MWA and RFA for PHPT and refractory SHPT concerning the complications of hoarseness (P > 0.05) and hypocalcaemia (P > 0.05).
CONCLUSION
MWA had a shorter operation time for single lesions and a higher complete ablation rate for large lesions in patients with refractory SHPT. However, there was no significant difference in efficacy and safety between MWA and RFA in cases of both PHPT and refractory SHPT. Both MWA and RFA are effective treatment methods for PHPT and refractory SHPT.
Topics: Humans; Calcium; Ablation Techniques; Retrospective Studies; Microwaves; Radiofrequency Ablation; Hyperparathyroidism, Secondary; Treatment Outcome; Phosphorus; Catheter Ablation
PubMed: 36892812
DOI: 10.1007/s11255-023-03543-y -
Tomography (Ann Arbor, Mich.) Mar 2022Imaging-guided percutaneous ablative treatments, such as radiofrequency ablation (RFA), cryoablation and microwave ablation (MWA), have been developed for the treatment...
Imaging-guided percutaneous ablative treatments, such as radiofrequency ablation (RFA), cryoablation and microwave ablation (MWA), have been developed for the treatment of unresectable primary and secondary lung tumors in patients with advanced-stage disease or comorbidities contraindicating surgery. Among these therapies, MWA has recently shown promising results in the treatment of pulmonary neoplasms. The potential advantages of MWA over RFA include faster ablation times, higher intra-tumoral temperatures, larger ablation zones and lower susceptibility to the heat sink effect, resulting in greater efficacy in proximity to vascular structures. Despite encouraging results supporting its efficacy, there is a relative paucity of data in the literature regarding the role of computer tomography (CT) to monitor MWA-treated lesions, and the CT appearance of their morphologic evolution and complications. For both interventional and non-interventional radiologists, it is crucial to be familiar with the CT features of such treated lesions in order to detect incomplete therapy or recurrent disease at early stage, as well as to recognize initial signs of complications. The aim of this pictorial essay is to describe the typical CT features during follow-up of lung lesions treated with percutaneous MWA and how to interpret and differentiate them from other radiological findings, such as recurrence and complications, that are commonly encountered in this setting.
Topics: Computers; Humans; Lung; Lung Neoplasms; Microwaves; Radiofrequency Ablation; Tomography, X-Ray Computed
PubMed: 35314628
DOI: 10.3390/tomography8020051 -
Journal of the American Heart... May 2024Transcatheter renal denervation (RDN) has had inconsistent efficacy and concerns for durability of denervation. We aimed to investigate long-term safety and efficacy of... (Comparative Study)
Comparative Study
BACKGROUND
Transcatheter renal denervation (RDN) has had inconsistent efficacy and concerns for durability of denervation. We aimed to investigate long-term safety and efficacy of transcatheter microwave RDN in vivo in normotensive sheep in comparison to conventional radiofrequency ablation.
METHODS AND RESULTS
Sheep underwent bilateral RDN, receiving 1 to 2 microwave ablations (maximum power of 80-120 W for 240 s-480 s) and 12 to 16 radiofrequency ablations (180 s-240 s) in the main renal artery in a paired fashion, alternating the side of treatment, euthanized at 2 weeks (acute N=15) or 5.5 months (chronic N=15), and compared with undenervated controls (N=4). Microwave RDN produced substantial circumferential perivascular injury compared with radiofrequency at both 2 weeks [area 239.8 (interquartile range [IQR] 152.0-343.4) mm versus 50.1 (IQR, 32.0-74.6) mm, <0.001; depth 16.4 (IQR, 13.9-18.9) mm versus 7.5 (IQR, 6.0-8.9) mm <0.001] and 5.5 months [area 20.0 (IQR, 3.4-31.8) mm versus 5.0 (IQR, 1.4-7.3) mm, =0.025; depth 5.9 (IQR, 1.9-8.8) mm versus 3.1 (IQR, 1.2-4.1) mm, =0.005] using mixed models. Renal denervation resulted in significant long-term reductions in viability of renal sympathetic nerves [58.9% reduction with microwave (=0.01) and 45% reduction with radiofrequency (=0.017)] and median cortical norepinephrine levels [71% reduction with microwave ( <0.001) and 72.9% reduction with radiofrequency ( <0.001)] at 5.5 months compared with undenervated controls.
CONCLUSIONS
Transcatheter microwave RDN produces deep circumferential perivascular ablations without significant arterial injury to provide effective and durable RDN at 5.5 months compared with radiofrequency RDN.
Topics: Animals; Microwaves; Sympathectomy; Renal Artery; Kidney; Sheep; Catheter Ablation; Time Factors; Disease Models, Animal; Blood Pressure; Female; Radiofrequency Ablation
PubMed: 38664237
DOI: 10.1161/JAHA.123.031795 -
Frontiers in Endocrinology 2021Large benign thyroid nodules often lead to cosmetic problems and compression on trachea. Thermal ablation is an effective method for benign thyroid nodules treatment....
BACKGROUND
Large benign thyroid nodules often lead to cosmetic problems and compression on trachea. Thermal ablation is an effective method for benign thyroid nodules treatment. Among all the thermal ablation techniques, microwave and radiofrequency are frequently used energy sources. However, treatment outcomes of the two ablation types have not been compared in detail. Therefore, we conducted this study aiming for comparing the safety and efficacy of the two ablation techniques in benign thyroid nodules treatment.
METHODS
Information was retrospectively collected from patients with benign thyroid nodules, who received radiofrequency ablation or microwave ablation between January 1, 2018, and December 31, 2019, in a main hospital in South China. Patients were divided into microwave ablation group and radiofrequency ablation group according to the techniques applied. A propensity score matching was performed to balance the baseline indexes between the two groups. We also recorded and analyzed the operative variables including operative duration, intraoperative blood loss, hospitalization time, and overall costs. Postoperative quality of life, volume reduction rates, and complication rates were routinely evaluated during the follow-up by asking patients to fulfil questionnaires at the 1, 3, 6, 12, and 18 postoperative month.
RESULTS
A total of 943 patients receiving microwave ablation or radiofrequency ablation in the years of 2018 and 2019 met our inclusion criteria. After 1:1 propensity score matching, 289 pairs of patients were matched. There was no significant difference between the two groups in operative duration, intraoperative blood loss, hospitalization time, overall cost, quality of life scores, complication rates or volume reduction rates.
CONCLUSION
There was no significant difference between microwave and radiofrequency ablation in terms of safety and efficacy. Both of the two techniques` are ideal therapeutic methods in benign thyroid nodules treatment.
REGISTRATION NUMBER
ChiCTR2000034764.
Topics: Ablation Techniques; Adult; Aged; Aged, 80 and over; China; Female; Humans; Male; Microwaves; Middle Aged; Postoperative Complications; Propensity Score; Radiofrequency Ablation; Retrospective Studies; Thyroid Nodule; Treatment Outcome
PubMed: 33767666
DOI: 10.3389/fendo.2021.584972 -
International Journal of Hyperthermia :... Feb 2017The use of microwaves (MW) for thermal cancer treatment began in the late 1970s. At first, hyperthermia was induced by using single antennas applied interstitially. This... (Review)
Review
The use of microwaves (MW) for thermal cancer treatment began in the late 1970s. At first, hyperthermia was induced by using single antennas applied interstitially. This was followed by arrays of multiple interstitial antennas driven synchronously at 915 or 2450 MHz. This early work focused on hyperthermia as an adjuvant therapy, but more recently has evolved into a thermally ablative monotherapy. Increased power required to thermally ablate tissues required additional developments such as internally cooled antennas. Larger tumours have also been ablated with MW antenna arrays activated synchronously or non-synchronously. Numerical modelling has provided clinical treatment planning guidance and device design insight throughout this history. MW thermal therapy systems, treatment planning, navigation and image guidance continue to evolve to provide better tools and options for clinicians and patients in order to provide targeting optimisation with the goal of improved treatment for the patient and durable cancer eradication. This paper reviews the history and related technological developments, including antenna design, of MW heating for both hyperthermia and ablation.
Topics: Ablation Techniques; Animals; Equipment Design; Humans; Hyperthermia, Induced; Microwaves; Neoplasms
PubMed: 27492859
DOI: 10.1080/02656736.2016.1214884 -
Current Problems in Diagnostic Radiology 2009Microwave ablation is a relatively new technology under development and testing to treat the same types of cancer that can be treated with radiofrequency ablation.... (Review)
Review
Microwave ablation is a relatively new technology under development and testing to treat the same types of cancer that can be treated with radiofrequency ablation. Microwave energy has several possible benefits over radiofrequency energy for tumor ablation but, because clinical microwave ablation systems are not widespread, the underlying principles and technologies may not be as familiar. The basic microwave ablation system contains many of the same components as a radiofrequency ablation system: a generator, a power distribution system, and an interstitial applicator. This article attempts to provide an overview of each of these components, outline their functions and roles, and provide some insight into what every potential microwave ablation user should know about systems in development.
Topics: Ablation Techniques; Humans; Microwaves; Neoplasms
PubMed: 19179193
DOI: 10.1067/j.cpradiol.2007.08.011 -
International Journal of Hyperthermia :... Feb 2017Microwave thermal ablation (MTA) is a minimally invasive therapeutic technique aimed at destroying pathologic tissues through a very high temperature increase induced by... (Review)
Review
Microwave thermal ablation (MTA) is a minimally invasive therapeutic technique aimed at destroying pathologic tissues through a very high temperature increase induced by the absorption of an electromagnetic field at microwave (MW) frequencies. Open problems, which are delaying MTA applications in clinical practice, are mainly linked to the extremely high temperatures, up to 120 °C, reached by the tissue close to the antenna applicator, as well as to the ability of foreseeing and controlling the shape and dimension of the thermally ablated area. Recent research was devoted to the characterisation of dielectric, thermal and physical properties of tissue looking at their changes with the increasing temperature, looking for possible developments of reliable, automatic and personalised treatment planning. In this paper, a review of the recently obtained results as well as new unpublished data will be presented and discussed.
Topics: Ablation Techniques; Animals; Humans; Hyperthermia, Induced; Microwaves; Models, Biological; Monitoring, Intraoperative; Patient Care Planning
PubMed: 27431328
DOI: 10.1080/02656736.2016.1214883 -
AJNR. American Journal of Neuroradiology Jul 2018Painful spinal metastases are a common cause of cancer-related morbidity. Percutaneous ablation presents an attractive minimally invasive alternative to conventional...
BACKGROUND AND PURPOSE
Painful spinal metastases are a common cause of cancer-related morbidity. Percutaneous ablation presents an attractive minimally invasive alternative to conventional therapies. We performed a retrospective review of 69 patients with 102 painful spinal metastases undergoing microwave ablation and cementoplasty to determine the efficacy and safety of this treatment.
MATERIALS AND METHODS
Procedures were performed between January 2015 and October 2016 with the patient under general anesthesia using image guidance for 102 spinal metastases in 69 patients in the following areas: cervical ( = 2), thoracic ( = 50), lumbar ( = 34), and sacral ( = 16) spine. Tumor pathologies included the following: multiple myeloma ( = 10), breast ( = 27), lung ( = 12), thyroid ( = 6), prostate ( = 5), colon ( = 4), renal cell ( = 3), oral squamous cell ( = 1), and adenocarcinoma of unknown origin ( = 1). Procedural efficacy was determined using the visual analog scale measured preprocedurally and at 2-4 weeks and 20-24 weeks postprocedure. Tumor locoregional control was assessed on follow-up cross-sectional imaging. Procedural complications were recorded to establish the safety profile.
RESULTS
The median ablation time was 4 minutes 30 seconds ± 7 seconds, and energy dose, 4.1 ± 1.6 kJ. Median visual analog scale scores were the following: 7.0 ± 1.8 preprocedurally, 2 ± 1.6 at 2-4 weeks, and 2 ± 2.1 at 20-24 weeks. Eight patients died within 6 months following the procedure. Follow-up imaging in the surviving patients at 20-24 weeks demonstrated no locoregional progression in 59/61 patients. Two complications were documented (S1 nerve thermal injury and skin burn).
CONCLUSIONS
Microwave ablation is an effective and safe treatment technique for painful spinal metastases. Further studies may be helpful in determining the role of microwave ablation in locoregional control of metastases.
Topics: Aged; Catheter Ablation; Cementoplasty; Combined Modality Therapy; Female; Humans; Male; Microwaves; Middle Aged; Multiple Myeloma; Retrospective Studies; Spinal Neoplasms; Treatment Outcome
PubMed: 29794238
DOI: 10.3174/ajnr.A5680