Accuracy of liver ablation zone prediction in a single 2450 MHz 100 Watt generator model microwave ablation system: An in human study

Young, Shamar; Rivard, Mark J.; Kimyon, Rebecca S.; Sanghvi, Tina

doi:10.1016/j.diii.2019.10.007

Cited by 10 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This increase in ablation volume with increasing fat has been clinically observed and has often been called the "oven effect" with surrounding low thermally conducting tissue retaining high temperatures near the probe-enhancing ablation. These results are consistent with recent clinical findings demonstrating increased ablative critical diameters in both MWA and RFA in fibrosis and fatty liver disease (Amabile et al, 2017;Heerink et al, 2018;Wang et al, 2020;Young et al, 2020;Tsochatzis et al, 2021) as compared to a liver without these conditions. When comparing the simulations with a tumor to that without a tumor, the ablation volumes with the tumor present increased by approximately 4.6%.…”

Section: Ablation and Fatty Liver Diseasesupporting

confidence: 92%

“…The authors state that "these data clearly demonstrate that the manufacturers' algorithms based solely on power level and duration of application need to be adapted to the type of tumor in its specific environment." Another study by Young et al (2020), involving 86 patients and 103 instances of MWA, identified that greater than 50% of HCC treated resulted in an ablation that was either <85% or >115% of the prediction provided by the manufacturer. The authors report anterior-posterior and transverse dimensions that significantly differed from manufacturer predictions and that correlated with the presence of NAFLD, and fibrosis, respectively.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Fat Quantification Imaging and Biophysical Modeling for Patient-Specific Forecasting of Microwave Ablation Therapy

et al. 2022

View full text Add to dashboard Cite

Computational tools are beginning to enable patient-specific surgical planning to localize and prescribe thermal dosing for liver cancer ablation therapy. Tissue-specific factors (e.g., tissue perfusion, material properties, disease state, etc.) have been found to affect ablative therapies, but current thermal dosing guidance practices do not account for these differences. Computational modeling of ablation procedures can integrate these sources of patient specificity to guide therapy planning and delivery. This paper establishes an imaging-data-driven framework for patient-specific biophysical modeling to predict ablation extents in livers with varying fat content in the context of microwave ablation (MWA) therapy. Patient anatomic scans were segmented to develop customized three-dimensional computational biophysical models and mDIXON fat-quantification images were acquired and analyzed to establish fat content and determine biophysical properties. Simulated patient-specific microwave ablations of tumor and healthy tissue were performed at four levels of fatty liver disease. Ablation models with greater fat content demonstrated significantly larger treatment volumes compared to livers with less severe disease states. More specifically, the results indicated an eightfold larger difference in necrotic volumes with fatty livers vs. the effects from the presence of more conductive tumor tissue. Additionally, the evolution of necrotic volume formation as a function of the thermal dose was influenced by the presence of a tumor. Fat quantification imaging showed multi-valued spatially heterogeneous distributions of fat deposition, even within their respective disease classifications (e.g., low, mild, moderate, high-fat). Altogether, the results suggest that clinical fatty liver disease levels can affect MWA, and that fat-quantitative imaging data may improve patient specificity for this treatment modality.

show abstract

Section: Ablation and Fatty Liver Diseasesupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Fat Quantification Imaging and Biophysical Modeling for Patient-Specific Forecasting of Microwave Ablation Therapy

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Ablation volumes have been recognized as irregular shapes but are clinically characterized using Feret measurements, i.e., largest diameter lengths. While they are necessary measurements, they are recognized as approximations [68] , [75] , [76] .…”

Section: Discussionmentioning

confidence: 99%

“…The exploration conducted within this manuscript is intriguing. While conventional MWA therapy has patient stratification constraints that limit its use to what is perceived as the most efficacious use, these decisions limit the deployment of the technology due to a lack of perceived controllability [76] , [114] . The digital twin model presented in this work is considered a tool of discovery, where the goal is to comprehensively document the effects of tissue composition on forecasted ablation volumes.…”

Section: Discussionmentioning

confidence: 99%

Simulation of Image-Guided Microwave Ablation Therapy Using a Digital Twin Computational Model

Servin,

Collins,

Heiselman

et al. 2024

IEEE Open J. Eng. Med. Biol.

View full text Add to dashboard Cite

Emerging computational tools such as healthcare digital twin modeling are enabling the creation of patient-specific surgical planning, including microwave ablation to treat primary and secondary liver cancers. Healthcare digital twins (DTs) are anatomically one-to-one biophysical models constructed from structural, functional, and biomarker-based imaging data to simulate patient-specific therapies and guide clinical decision-making. In microwave ablation (MWA), tissue-specific factors including tissue perfusion, hepatic steatosis, and fibrosis affect therapeutic extent, but current thermal dosing guidelines do not account for these parameters. This study establishes an MR imaging framework to construct three-dimensional biophysical digital twins to predict ablation delivery in livers with 5 levels of fat content in the presence of a tumor. Four microwave antenna placement strategies were considered, and simulated microwave ablations were then performed using 915 MHz and 2450 MHz antennae in Tumor Naïve DTs (control), and Tumor Informed DTs at five grades of steatosis. Across the range of fatty liver steatosis grades, fat content was found to significantly increase ablation volumes by approximately 29–l42% in the Tumor Naïve and 55–60% in the Tumor Informed DTs in 915 MHz and 2450 MHz antenna simulations. The presence of tumor did not significantly affect ablation volumes within the same steatosis grade in 915 MHz simulations, but did significantly increase ablation volumes within mild-, moderate-, and high-fat steatosis grades in 2450 MHz simulations. An analysis of signed distance to agreement for placement strategies suggests that accounting for patient-specific tumor tissue properties significantly impacts ablation forecasting for the preoperative evaluation of ablation zone coverage.

show abstract

“…Thermal tumor ablation techniques include radio-frequency ablation, microwave ablation, Laser ablation, high-intensity focused ultrasound and cryoablation, which can be used for the treatment of a variety of tumors, particularly in the liver, kidney, bone, and lung [1] [2]. During thermal ablation, complete tissue necrosis is achieved by heating or cooling the targeted tissue to a cytotoxic temperature (less than -40°C or more than 60°C).…”

mentioning

confidence: 99%

Irreversible electroporation and electrochemotherapy in oncology: State of the art

Tasu

Tougeron

Rols

2022

Diagnostic and Interventional Imaging

View full text Add to dashboard Cite

Accuracy of liver ablation zone prediction in a single 2450 MHz 100 Watt generator model microwave ablation system: An in human study

Cited by 10 publications

References 27 publications

Fat Quantification Imaging and Biophysical Modeling for Patient-Specific Forecasting of Microwave Ablation Therapy

Fat Quantification Imaging and Biophysical Modeling for Patient-Specific Forecasting of Microwave Ablation Therapy

Simulation of Image-Guided Microwave Ablation Therapy Using a Digital Twin Computational Model

Irreversible electroporation and electrochemotherapy in oncology: State of the art

Contact Info

Product

Resources

About