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Image-guided microwave ablation of hepatic tumours: preliminary experience

Termoablazione imaging-guidata con microonde (MWA) di neoplasie epatiche: esperienza preliminare

  • Abdominal Radiology / Radiologia Addominale
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

Microwave thermal ablation (MWA) opens up a new scenario in the field of image-guided tumour ablation thanks to its potential advantages over validated radiofrequency ablation (RFA). In this pilot study, we assessed the technical success, safety and efficacy of MWA in treating hepatic malignancies.

Materials and methods

After obtaining informed consent, we enrolled 15 inoperable patients, for a total of 19 lesions (ten metastases, nine hepatocellular carcinoma) with a mean diameter of 47 mm (range 14–78 mm). Mean follow-up was 8 (range 1–14) months.

Results

Technical success reached 100%. Complications (one major and one minor) occurred in two cases. Complete ablation, obtained in 68.4% of cases, showed no significant correlation with either cancer histological type or with lesion diameter. At follow-up, treatment failures occurred in 60% of cases; lesion diameter was the only prognostic factor for maintaining complete ablation.

Conclusions

Our preliminary results should encourage further trials of this technique. MWA proved to be feasible and safe in treating advanced-stage liver tumours and represented an additional therapeutic attempt to be validated in further and larger efficacy studies.

Riassunto

Obiettivo

La termoablazione con microonde (MWA) prospetta un nuovo scenario nel campo delle ablazioni tumorali imaging-guidate per i potenziali vantaggi rispetto all’ormai validata termoablazione con radiofrequenze (RFA). Con questo studio pilota ne abbiamo valutato successo tecnico, sicurezza ed efficacia nel trattamento dei tumori epatici maligni.

Materiali e metodi

Previo consenso informato, abbiamo arruolato 15 pazienti non operabili, portatori di 19 lesioni (10 metastasi [MTS], 9 carcinomi epatici [HCC]) con diametro medio di 47 mm (range 14–78 mm). Il follow-up medio è stato di 8 mesi (range 1–14 mesi).

Risultati

Il successo tecnico è stato del 100%. In due casi sono state registrate complicanze (1 maggiore e 1 minore). L’ablazione completa (AC), ottenuta nel 68,4% dei casi, non ha dimostrato correlazioni statisticamente significativa né con l’istotipo, né con il diametro delle lesioni. Nel follow-up, il fallimento del trattamento (FT) si è verificato complessivamente nel 60% dei casi; il diametro delle lesioni è stato l’unico fattore prognostico per l’AC mantenuta nel tempo.

Conclusioni

I risultati preliminari del nostro studio incoraggiano la sperimentazione di questa tecnica. La MWA è stata fattibile e sicura nel trattamento di neoplasie epatiche avanzate, e ha costituito un tentativo terapeutico oltre i protocolli oncologici standard da sottoporre al vaglio di più ampi studi di efficacia.

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Authors and Affiliations

  1. Istituto di Radiologia, Università di Torino, Facoltà San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano, Torino, Italy

    A. Veltri & M. Busso

  2. Istituto di Radiologia Diagnostica e Interventistica, Università di Torino, Via Genova 3, 10126, Torino, Italy

    C. Gazzera, C. Rotondella, F. Camerano & G. Gandini

Authors
  1. A. Veltri
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  2. C. Gazzera
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  3. C. Rotondella
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  4. F. Camerano
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  5. M. Busso
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  6. G. Gandini
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Correspondence to A. Veltri.

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Veltri, A., Gazzera, C., Rotondella, C. et al. Image-guided microwave ablation of hepatic tumours: preliminary experience. Radiol med 117, 378–392 (2012). https://doi.org/10.1007/s11547-011-0745-y

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  • DOI: https://doi.org/10.1007/s11547-011-0745-y

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