Multiple antenna placement in microwave ablation assisted by a three-dimensional fusion image navigation system for hepatocellular carcinoma

Abstract

2018) Multiple antenna placement in microwave ablation assisted by a three-dimensional fusion image navigation system ABSTRACT Purpose: This study was conducted to compare a three-dimensional (3D) fusion image navigation system (FINS) with ultrasound (US) for guiding percutaneous microwave ablation (PMWA) for treatment of hepatocellular carcinoma (HCC). Materials and methods: This is a retrospective, non-randomized, comparative study. Our team developed a 3D FINS and used it to guide PMWAs for HCCs in 19 patients (3D group) and compared the results to those of 24 PMWAs guided by US (US group). The complete ablation rate of the first session, the local tumor progression (LTP), intrahepatic recurrence and disease-free survival were compared between the groups. Results: The 3D FINS was successfully applied in all 19 patients. The mean size of HCCs was 4.14 cm ±0.95 in 3D the group and 4.07 cm ±0.91 in the US group. Major complications were identified at 5.3% in the 3D group and 4.2% in the US group (p ¼ .865). Average time of image fusion was 404.53 ± 161.84 s. There were more antenna insertions in the 3D group (3.68 ± 1.57) than in the US group (2.71 ± 1.12) (p ¼ .02). The complete ablation rate of the first session was higher in the 3D group (94.7%) than in the US group (62.5%) (p ¼ .034). The mean follow-up period was 11.4 months ±4.9 in the 3D group and 9.8 months ±5.5 in the US group. There were no significant differences in technique efficacy rate and LTP rate between the two groups. Conclusions: The 3D FINS could be a safe, feasible and effective technique for guiding PMWA of HCC, which could help an operator improve the complete ablation rate of the first session. ARTICLE HISTORY

Ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma adjacent to large vessels: a propensity score matching analysis

“…This strategy had comparable accuracy with CT or MRI scan at 24 h after ablation and can greatly reduce the re-treatments [34]. Another solution is to employ fusion imaging systems in guidance of thermal ablation, these techniques can provide better contrast resolution and improve intra-procedural evaluation of ablation margin [30,31,35]. Insertion of the antenna into the center of tumor is commonly used in clinical practice.…”

“…In our study, we performed multiple overlapping ablations by switching the insertion point, it can produce larger and more homogeneous ablation zone. Recently, multi-applicator ablation devices have been proved safe and effective in facilitating MWA [35]. It can result in simultaneous heat input into the target area and at the same time, shorten the total ablation time.…”

“…A combination of multiapplicator MWA and three-dimensional fusion imaging may be the future direction. This novel guiding technique can provide more accurate and objective pre-procedural planning and post-procedural evaluation, helping to achieve a higher complete ablation rate in the first MWA session [14,35].…”

Stereotactic and Robotic Minimally Invasive Thermal Ablation of Malignant Liver Tumours - A Systematic Review and Meta-Analysis

“…With respect to treatment e cacy, Zhang et al (42) showed a higher complete ablation rate in the rst session (3 days after ablation) when using stereotactic EM guidance, but equal primary technique e cacy at 1 month. Schaible et al (31) reported a signi cantly higher primary technique e cacy when using robotic targeting in a retrospective comparative study.…”

Geometrically variable three‐dimensional ultrasound for mechanically assisted image‐guided therapy of focal liver cancer tumors

“…Incorporating 3D visualizations can lead to complete ablations and higher clinical success rates on the first ablation attempt, as well as fewer sessions overall relative to 2D US when subsequent attempts are required. 16,18 Computed tomography images can provide 3D multiplanar images to visualize the needle-like applicators, but repeated CT scans are performed at the cost of increased procedure time and radiation dose to the patient. MR imaging has been used as it offers advantages such as improved soft-tissue contrast and the potential for real-time treatment monitoring, but can again increase procedure time and is not readily accessible in many countries due to the sophisticated technology required.…”