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Microwave in the Treatment of Primary Liver Cancers

  • Liang Ping
  • Yu Jie
Reference work entry

Abstract

The majority of patients suffering from liver tumors are not candidates for surgery. Currently, minimal invasive techniques have become available for local destruction of hepatic tumors. Microwave ablation (MWA) is a relatively low-risk procedure that utilizes high temperatures to ablate tumors. The aim of this chapter is to review the basic principles; the state of the art of different device technologies, approaches, and treatment strategies; current therapeutic status; and future trends of microwave ablation for primary liver cancer. MWA has achieved similar effect compared with surgery, radiofrequency ablation (RFA), and ethanol injection treatment for hepatocellular carcinoma (HCC). For tumors adjacent to vital structures, MWA has achieved favorable results with low complications as well. Because of several advantages including high thermal efficiency, higher capability of coagulating blood vessels, faster ablation time, and simultaneous application of multiple antennae, MWA could be a promising minimally invasive technique for the treatment of HCC. Long-term survival data and large-scale prospectively RCTs comparing it with other modalities, especially with RFA for ultimately determining its effectiveness, are earnestly anticipated.

Keywords

Ablation Zone Primary Liver Cancer Percutaneous Ethanol Injection Local Tumor Progression Microwave Ablation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Tabuse K, Katsumi M, Kobayashi Y, et al. Microwave surgery: hepatectomy using a microwave tissue coagulator. World J Surg. 1985;9:136–43.CrossRefPubMedGoogle Scholar
  2. 2.
    Seki T, Wakabayashi M, Nakagawa T, et al. Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma. Cancer. 1994;74:817–25.CrossRefPubMedGoogle Scholar
  3. 3.
    Lu MD, Chen JW, Xie XY, et al. Hepatocellular carcinoma: US-guided percutaneous microwave coagulation therapy. Radiology. 2001;221:167–72.CrossRefPubMedGoogle Scholar
  4. 4.
    Liang P, Dong B, Yu X, et al. Prognostic factors for survival in patients with hepatocellular carcinoma after percutaneous microwave ablation. Radiology. 2005;235:299–307.CrossRefPubMedGoogle Scholar
  5. 5.
    Martin RC, Scoggins CR, McMasters KM. Safety and efficacy of microwave ablation of hepatic tumors: a prospective review of a 5-year experience. Ann Surg Oncol. 2010;17(1):171–8.CrossRefPubMedGoogle Scholar
  6. 6.
    English NJ, MacElroy JM. Molecular dynamics simulations of microwave heating of water. J Chem Phys. 2003;118:1589–92.CrossRefGoogle Scholar
  7. 7.
    Diederich CJ. Thermal ablation and high-temperature thermal therapy: overview of technology and clinical implementation. Int J Hyperthermia. 2005;21:745–53.CrossRefPubMedGoogle Scholar
  8. 8.
    Goldberg SN, Gazelle GS, Mueller PR. Thermal ablation therapy for focal malignancies: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol. 2000;174:323–31.CrossRefPubMedGoogle Scholar
  9. 9.
    Yu J, Liang P, Yu X, Liu F, Chen L, Wang Y, et al. A comparison of microwave ablation and bipolar radiofrequency ablation both with an internally cooled probe: results in ex vivo and in vivo porcine livers. Eur J Radiol. 2011;79:124–30.CrossRefPubMedGoogle Scholar
  10. 10.
    Haines DE, Watson DD. Tissue heating during radiofrequency catheter ablation: a thermodynamic model and observations in isolated perfused and superfused canine right ventricular free wall. Pacing Clin Electrophysiol. 1989;12:962–76.CrossRefPubMedGoogle Scholar
  11. 11.
    Organ LW. Electrophysiologic principles of radiofrequency lesion marking. Appl Neurophysiol. 1976;39:69–76.PubMedGoogle Scholar
  12. 12.
    Skinner MG, Iizuka MN, Kolios MC, Sherar MD. A theoretical comparison of energy sources–microwave, ultrasound and laser–for interstitial thermal therapy. Phys Med Biol. 1998;43:3535–47.CrossRefPubMedGoogle Scholar
  13. 13.
    Wright AS, Sampson LA, Warner TF, Mahvi DM, Lee Jr FT. Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology. 2005;236:132–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Garrean S, Hering J, Saied A, Hoopes PJ, Helton WS, Ryan TP, Espat NJ. Ultrasound monitoring of a novel microwave ablation (MWA) device in porcine liver: lessons learned and phenomena observed on ablative effects near major intrahepatic vessels. J Gastrointest Surg. 2009;13(2):334–40.CrossRefPubMedGoogle Scholar
  15. 15.
    Yu NC, Raman SS, Kim YJ, Lassman C, Chang X, Lu DS. Microwave liver ablation: influence of hepatic vein size on heat-sink effect in a porcine model. J Vasc Interv Radiol. 2008;19(7):1087–92.CrossRefPubMedGoogle Scholar
  16. 16.
    Solbiati L, Ierace T, Goldberg SN, Sironi S, Livraghi T, Fiocca R, Servadio G, Rizzatto G, Mueller PR, Del Maschio A, Gazelle GS. Percutaneous US-guided radio-frequency tissue ablation of liver metastases: treatment and follow-up in 16 patients. Radiology. 1997;202(1):195–203.CrossRefPubMedGoogle Scholar
  17. 17.
    Wright AS, Lee Jr FT, Mahvi DM. Hepatic microwave ablation with multiple antennae results in synergistically larger zones of coagulation necrosis. Ann Surg Oncol. 2003;10:275–83.CrossRefPubMedGoogle Scholar
  18. 18.
    Ikeda K, Seki T, Umehara H, Inokuchi R, Tamai T, Sakaida N, Uemura Y, Kamiyama Y, Okazaki K. Clinicopathologic study of small hepatocellular carcinoma with microscopic satellite nodules to determine the extent of tumor ablation by local therapy. Int J Oncol. 2007;31(3):485–91.PubMedGoogle Scholar
  19. 19.
    Bertram JM, Yang D, Converse MC, Webster JG, Mahvi D. A review of coaxial-based interstitial antennas for hepatic microwave ablation. Crit Rev Biomed Eng. 2006;34:187–213.CrossRefPubMedGoogle Scholar
  20. 20.
    Longo I, Gentili GB, Cerretelli M, Tosoratti N. A coaxial antenna with miniaturized choke for minimally invasive interstitial heating. IEEE Trans Biomed Eng. 2003;50:82–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Dong BW, Liang P, Yu XL, Zeng XQ, Wang PJ, Su L, Wang XD, Xin H, Li S. Sonographically guided microwave coagualtion treatment of liver cancer: an experimental and clinical study. AJR Am J Roentgenol. 1998;171:449–54.CrossRefPubMedGoogle Scholar
  22. 22.
    He N, Wang W, Ji Z, Li C, Huang B. Microwave ablation: an experimental comparative study on internally cooled antenna versus non-internally cooled antenna in liver models. Acad Radiol. 2010;17(7):894–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Kuang M, Lu MD, Xie XY, et al. Liver cancer: increased microwave delivery to ablation zone with cooled-shaft antenna – experimental and clinical studies. Radiology. 2007;242:914–24.CrossRefPubMedGoogle Scholar
  24. 24.
    Wang Y, Sun Y, Feng L, Gao Y, Ni X, Liang P. Internally cooled antenna for microwave ablation: results in ex vivo and in vivo porcine livers. Eur J Radiol. 2008;67(2):357–61.CrossRefPubMedGoogle Scholar
  25. 25.
    Jiao D, Qian L, Zhang Y, et al. Microwave ablation treatment of liver cancer with 2,450-MHz cooled-shaft antenna: an experimental and clinical study. J Cancer Res Clin Oncol. 2010;136:1507–16.CrossRefPubMedGoogle Scholar
  26. 26.
    Sun Y, Wang Y, Ni X, et al. Comparison of ablation zone between 915- and 2,450-MHz cooled-shaft microwave antenna: results in in vivo porcine livers. AJR Am J Roentgenol. 2009;192(2):511–14.CrossRefPubMedGoogle Scholar
  27. 27.
    Shock SA, Meredith K, Warner TF, Sampson LA, et al. Microwave ablation with loop antenna: in vivo porcine liver model. Radiology. 2004;231:143–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Brace CL, Laeseke PF, Sampson LA, Frey TM, van der Weide DW, Lee Jr FT. Microwave ablation with a single small-gauge triaxial antenna: in vivo porcine liver model. Radiology. 2007;242:435–40.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Yin XY, Xie XY, Lu MD, et al. Percutaneous thermal ablation of medium and large hepatocellular carcinoma: long-term outcome and prognostic factors. Cancer. 2009;115(9):1914–23.CrossRefPubMedGoogle Scholar
  30. 30.
    Aramaki M, Kawano K, Ohno T, et al. Microwave coagulation therapy for unresectable hepatocellular carcinoma. Hepatogastroenterology. 2004;51:1784–7.PubMedGoogle Scholar
  31. 31.
    Sato M, Watanabe Y, Tokui K, Kawachi K, Sugata S, Ikezoe J. CT-guided treatment of ultrasonically invisible hepatocellular carcinoma. AJR Am J Roentgenol. 2000;95:2102–6.Google Scholar
  32. 32.
    Kurumi Y, Tani T, Naka S, et al. MR-guided microwave ablation for malignancies. Int J Clin Oncol. 2007;12:85–93.CrossRefPubMedGoogle Scholar
  33. 33.
    Godlewski G, Rouy S, Pignodel C, Ould-Said H, Eledjam JJ, Bourgeois JM, Sambuc P. Deep localized neodymium (Nd)-YAG laser photocoagulation in liver using a new water cooled and echoguided handpiece. Lasers Surg Med. 1998;8(5):501–9.CrossRefGoogle Scholar
  34. 34.
    Lu MD, Yu XL, Li AH, et al. Comparison of contrast enhanced ultrasound and contrast enhanced CT or MRI in monitoring percutaneous thermal ablation procedure in patients with hepatocellular carcinoma: a multi-center study in China. Ultrasound Med Biol. 2007;33(11):1736–49.CrossRefPubMedGoogle Scholar
  35. 35.
    Ikai I, Itai Y, Okita K, et al. Report of the 15th follow-up survey of primary liver cancer. Hepatol Res. 2004;28:21–9.CrossRefPubMedGoogle Scholar
  36. 36.
    Zhang X, Chen B, Hu S, et al. Microwave ablation with cooled-tip electrode for liver cancer: an analysis of 160 cases. Hepatogastroenterology. 2008;55(88):2184–7.PubMedGoogle Scholar
  37. 37.
    Iannitti DA, Martin RC, Simon CJ, et al. Hepatic tumor ablation with clustered microwave antennae: the US Phase II Trial. HPB (Oxford). 2007;9(2):120–4.CrossRefGoogle Scholar
  38. 38.
    Zhou P, Liang P, Yu X, Wang Y, Dong B. Percutaneous microwave ablation of liver cancer adjacent to the gastrointestinal tract. J Gastrointest Surg. 2009;13(2):318–24.CrossRefPubMedGoogle Scholar
  39. 39.
    Simon CJ, Dupuy DE, Iannitti DA, et al. Intraoperative triple antenna hepatic microwave ablation. AJR Am J Roentgenol. 2006;187:W333–40.CrossRefPubMedGoogle Scholar
  40. 40.
    Shiomi H, Naka S, Sato K, et al. Thoracoscopy-assisted magnetic resonance guided microwave coagulation therapy for hepatic tumors. Am J Surg. 2008;195(6):854–60.CrossRefPubMedGoogle Scholar
  41. 41.
    Shimada S, Hirota M, Beppu T, et al. A new procedure of percutaneous microwave coagulation therapy under artificial hydrothorax for patients with liver tumors in the hepatic dome. Surg Today. 2001;31(1):40–4.CrossRefPubMedGoogle Scholar
  42. 42.
    Ohmoto K, Tsuzuki M, Yamamoto S. Percutaneous microwave coagulation therapy with intraperitoneal saline infusion for hepatocellular carcinoma in the hepatic dome. AJR Am J Roentgenol. 1999;172(1):65–6.CrossRefPubMedGoogle Scholar
  43. 43.
    Shibata T, Iimuro Y, Yamamoto Y, Maetani Y, Ametani F, Itoh K, Konishi J. Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy. Radiology. 2002;223:331–7.CrossRefPubMedGoogle Scholar
  44. 44.
    Lu MD, Xu HX, Xie XY, et al. Percutaneous microwave and radiofrequency ablation for hepatocellular carcinoma: a retrospective comparative study. J Gastroenterol. 2005;40:1054–60.CrossRefPubMedGoogle Scholar
  45. 45.
    Ohmoto K, Yoshioka N, Tomiyama Y, et al. Comparison of therapeutic effects between radiofrequency ablation and percutaneous microwave coagulation therapy for small hepatocellular carcinomas. J Gastroenterol Hepatol. 2009;24(2):223–7.CrossRefPubMedGoogle Scholar
  46. 46.
    Wang ZL, Liang P, Dong BW, Yu XL, Yu DJ. Prognostic factors and recurrence of small hepatocellular carcinoma after hepatic resection or microwave ablation: a retrospective study. J Gastrointest Surg. 2008;12(2):327–37.CrossRefPubMedGoogle Scholar
  47. 47.
    Seki T, Wakabayashi M, Nakagawa T, et al. Percutaneous microwave coagulation therapy for patients with small hepatocellular carcinoma: comparison with percutaneous ethanol injection therapy. Cancer. 1999;85:1694–702.CrossRefPubMedGoogle Scholar
  48. 48.
    Shimada S, Hirota M, Beppu T, Matsuda T, Hayashi N. Complications and management of microwave coagulation therapy for primary and metastatic liver tumors. Surg Today. 1998;28:1130–7.CrossRefPubMedGoogle Scholar
  49. 49.
    Liang P, Wang Y, Yu X, Dong B. Malignant Liver Tumors: treatment with percutaneous microwave ablation–complications among cohort of 1136 patients. Radiology. 2009;251(3):933–40.CrossRefPubMedGoogle Scholar
  50. 50.
    Dong B, Liang P, Yu X, et al. Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma: results in 234 patients. AJR Am J Roentgenol. 2003;180(6):1547–55.CrossRefPubMedGoogle Scholar
  51. 51.
    Sakaguchi H, Seki S, Tsuji K, et al. Endoscopic thermal ablation therapies for hepatocellular carcinoma: a multi-center study. Hepatol Res. 2009;39(1):47–52.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Interventional UltrasoundChinese PLA General HospitalBeijingChina

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