Skip to main content
Erschienen in: European Radiology 9/2012

01.09.2012 | Interventional

Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma: experimental and clinical studies

verfasst von: Guo-Jun Qian, Neng Wang, Qiang Shen, Yue Hong Sheng, Jie-Qiong Zhao, Ming Kuang, Guang-Jian Liu, Meng-Chao Wu

Erschienen in: European Radiology | Ausgabe 9/2012

Einloggen, um Zugang zu erhalten

Abstract

Objective

To prospectively compare microwave (MW) ablation using a modified internal cooled-shaft antenna with radiofrequency (RF) ablation in in vivo porcine liver and in patients with small hepatocellular carcinoma (sHCC).

Methods

In an animal study, MW and RF ablations using a cooled-shaft antenna or internally cooled electrode were performed in in vivo porcine liver. Coagulation diameters of both ablations were compared. For clinical study, 42 patients with sHCC were treated with MW or RF ablation. Complete ablation (CA) and local tumour progression (LTP) were compared.

Results

MW ablation produced significantly larger ablation zones than RF ablation in both porcine liver and sHCC with an ablated volume of 33.3 ± 15.6 cm3 vs. 18.9 ± 9.1 cm3 and 109.3 ± 58.3 cm3 vs. 48.7 ± 30.5 cm3, respectively. The CA rate was 95.5 % (21/22) for MW ablation and 95.0 % (19/20) for RF ablation. In a 5.1-month follow-up, the LTP rate was 18.2 % (4/22) in the MW ablation group and 15.0 % (3/20) in the RF ablation group.

Conclusion

MW ablation using a modified cooled-shaft antenna produces a larger ablation zone than RF ablation, with an efficacy similar to RF ablation in local tumour control. MW ablation is a safe and promising treatment of sHCC.

Key Points

Microwave ablation with a cooled-shaft antenna produces a larger ablation zone than radiofrequency ablation.
Microwave and radiofrequency ablation showed similar local tumour control in small HCC.
Microwave ablation seems safe and efficient for small liver cancers (<3 cm).
Literatur
1.
2.
Zurück zum Zitat Llovet JM, Bruix J (2008) Novel advancements in the management of hepatocellular carcinoma in. J Hepatol 48:S20–S37PubMedCrossRef Llovet JM, Bruix J (2008) Novel advancements in the management of hepatocellular carcinoma in. J Hepatol 48:S20–S37PubMedCrossRef
3.
Zurück zum Zitat Lau WY, Leung TW, Yu SC, Ho SK (2003) Percutaneous local ablative therapy for hepatocellular carcinoma: a review and look into the future. Ann Surg 237:171–179PubMed Lau WY, Leung TW, Yu SC, Ho SK (2003) Percutaneous local ablative therapy for hepatocellular carcinoma: a review and look into the future. Ann Surg 237:171–179PubMed
4.
Zurück zum Zitat Poon RT, Fan ST, Tsang FH, Wong J (2002) Locoregional therapies for hepatocellular carcinoma: a critical review from the surgeon’ perspective. Ann Surg 235:466–486PubMedCrossRef Poon RT, Fan ST, Tsang FH, Wong J (2002) Locoregional therapies for hepatocellular carcinoma: a critical review from the surgeon’ perspective. Ann Surg 235:466–486PubMedCrossRef
5.
Zurück zum Zitat Goldberg S, Ahmed M (2002) Minimally invasive image-guided therapies for hepatocellular carcinoma. J Clin Gastroenterol 35:S115–S129PubMedCrossRef Goldberg S, Ahmed M (2002) Minimally invasive image-guided therapies for hepatocellular carcinoma. J Clin Gastroenterol 35:S115–S129PubMedCrossRef
6.
Zurück zum Zitat Dodd GD III, Soulen M, Kane R et al (2000) Minimally invasive treatment of malignant hepatic tumours: at the threshold of major breakthrough. Radiographics 20:9–27PubMed Dodd GD III, Soulen M, Kane R et al (2000) Minimally invasive treatment of malignant hepatic tumours: at the threshold of major breakthrough. Radiographics 20:9–27PubMed
7.
Zurück zum Zitat Livraghi T, Goldberg S, Lazzaroni S, Meloni F, Solbiati L, Gazelle GS (1999) Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 210:655–661PubMed Livraghi T, Goldberg S, Lazzaroni S, Meloni F, Solbiati L, Gazelle GS (1999) Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 210:655–661PubMed
8.
Zurück zum Zitat Ikeda M, Okada S, Ueno H, Kuriyama H, Okusaka T, Kuriyama H et al (2001) Radiofrequency ablation and percutaneous ethanol injection in patients with small hepatocellular carcinoma: a comparative study. Jpn J Clin Oncol 31:322–326PubMedCrossRef Ikeda M, Okada S, Ueno H, Kuriyama H, Okusaka T, Kuriyama H et al (2001) Radiofrequency ablation and percutaneous ethanol injection in patients with small hepatocellular carcinoma: a comparative study. Jpn J Clin Oncol 31:322–326PubMedCrossRef
9.
Zurück zum Zitat Lencioni R, Allgaier HP, Cioni D et al (2003) Small hepatocellular carcinoma in cirrhosis: randomized comparison of radiofrequency thermal ablation versus percutaneous ethanol injection. Radiology 228:235–240PubMedCrossRef Lencioni R, Allgaier HP, Cioni D et al (2003) Small hepatocellular carcinoma in cirrhosis: randomized comparison of radiofrequency thermal ablation versus percutaneous ethanol injection. Radiology 228:235–240PubMedCrossRef
10.
Zurück zum Zitat Dong B, Liang P, Yu X et al (2003) Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma: results in 234 patients. AJR Am J Roentgenol 180:1547–1555PubMed Dong B, Liang P, Yu X et al (2003) Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma: results in 234 patients. AJR Am J Roentgenol 180:1547–1555PubMed
11.
Zurück zum Zitat Yin XY, Lu MD (2009) Percutaneous ablation for small hepatocellular carcinoma. Expert Rev Gastroenterol Hepatol 3:121–130PubMedCrossRef Yin XY, Lu MD (2009) Percutaneous ablation for small hepatocellular carcinoma. Expert Rev Gastroenterol Hepatol 3:121–130PubMedCrossRef
12.
Zurück zum Zitat Crocetti L, Lencioni R (2008) Thermal ablation of hepatocellular carcinoma. Canc Imag 27:19–26CrossRef Crocetti L, Lencioni R (2008) Thermal ablation of hepatocellular carcinoma. Canc Imag 27:19–26CrossRef
13.
Zurück zum Zitat Simon CJ, Dupuy DE, Mayo-Smith WW (2005) Microwave ablation: principles and applications. Radiographics 25:S69–S83PubMedCrossRef Simon CJ, Dupuy DE, Mayo-Smith WW (2005) Microwave ablation: principles and applications. Radiographics 25:S69–S83PubMedCrossRef
14.
Zurück zum Zitat Wright AS, Sampson LA, Warner TF, Mahvi DM, Lee FT Jr (2005) Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology 236:132–139PubMedCrossRef Wright AS, Sampson LA, Warner TF, Mahvi DM, Lee FT Jr (2005) Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology 236:132–139PubMedCrossRef
15.
Zurück zum Zitat Lu MD, Chen JW, Xie XY (2001) Hepatocellular carcinoma: US guided percutaneous microwave coagulation therapy. Radiology 221:167–172PubMedCrossRef Lu MD, Chen JW, Xie XY (2001) Hepatocellular carcinoma: US guided percutaneous microwave coagulation therapy. Radiology 221:167–172PubMedCrossRef
16.
Zurück zum Zitat Chen MH, Wei Y, Kun Y et al (2004) Large liver tumors: protocol for radiofrequency ablation and its clinical application in 110 patients—mathematic model, overlapping mode, and electrode placement process. Radiology 232:260–271PubMedCrossRef Chen MH, Wei Y, Kun Y et al (2004) Large liver tumors: protocol for radiofrequency ablation and its clinical application in 110 patients—mathematic model, overlapping mode, and electrode placement process. Radiology 232:260–271PubMedCrossRef
17.
Zurück zum Zitat Xu HX, Xie XY, Lu MD et al (2004) Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation. Clin Radiol 59:52–60CrossRef Xu HX, Xie XY, Lu MD et al (2004) Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation. Clin Radiol 59:52–60CrossRef
18.
Zurück zum Zitat Shibata T, Iimuro Y, Yamamoto Y et al (2002) Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy. Radiology 223:331–337PubMedCrossRef Shibata T, Iimuro Y, Yamamoto Y et al (2002) Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy. Radiology 223:331–337PubMedCrossRef
19.
Zurück zum Zitat Kuang M, Lu MD, Xie XY et al (2007) Liver cancer: increased microwave delivery to ablation zone with cooled-shaft antenna–experimental and clinical studies. Radiology 242:914–924PubMedCrossRef Kuang M, Lu MD, Xie XY et al (2007) Liver cancer: increased microwave delivery to ablation zone with cooled-shaft antenna–experimental and clinical studies. Radiology 242:914–924PubMedCrossRef
20.
Zurück zum Zitat Andreano A, Huang Y, Meloni MF, Lee FT Jr, Brace C (2010) Microwaves create larger ablations than radiofrequency when controlled for power in ex vivo tissue. Med Phys 37:2967–2973PubMedCrossRef Andreano A, Huang Y, Meloni MF, Lee FT Jr, Brace C (2010) Microwaves create larger ablations than radiofrequency when controlled for power in ex vivo tissue. Med Phys 37:2967–2973PubMedCrossRef
21.
Zurück zum Zitat Shibata T, Niinobu T, Ogata N (2000) Comparison of the effects of in-vivo thermal ablation of pig liver by microwave and radiofrequency coagulation. J Hepatobiliary Pancreat Surg 88:302–311 Shibata T, Niinobu T, Ogata N (2000) Comparison of the effects of in-vivo thermal ablation of pig liver by microwave and radiofrequency coagulation. J Hepatobiliary Pancreat Surg 88:302–311
22.
Zurück zum Zitat Llovet JM, Fuster J, Bruix J; Barcelona-Clinic Liver Cancer Group (2004) The Barcelona approach: diagnosis, staging, and treatment of hepatocellular carcinoma. Liver Transpl 10:S115–S120CrossRef Llovet JM, Fuster J, Bruix J; Barcelona-Clinic Liver Cancer Group (2004) The Barcelona approach: diagnosis, staging, and treatment of hepatocellular carcinoma. Liver Transpl 10:S115–S120CrossRef
23.
Zurück zum Zitat Lu MD, Xu HX, Xie XY et al (2005) Percutaneous microwave and radiofrequency ablation for hepatocellular carcinoma: a retrospective comparison study. J Gastroenterol 40:1054–1060PubMedCrossRef Lu MD, Xu HX, Xie XY et al (2005) Percutaneous microwave and radiofrequency ablation for hepatocellular carcinoma: a retrospective comparison study. J Gastroenterol 40:1054–1060PubMedCrossRef
24.
Zurück zum Zitat Seki S, Sakaguchi H, Iwai S et al (2005) Five-year survival of patients with hepatocellular carcinoma treated with laparoscopic microwave coagulation therapy. Endoscopy 37:1220–1225PubMedCrossRef Seki S, Sakaguchi H, Iwai S et al (2005) Five-year survival of patients with hepatocellular carcinoma treated with laparoscopic microwave coagulation therapy. Endoscopy 37:1220–1225PubMedCrossRef
25.
Zurück zum Zitat Yamashiki N, Kato T, Bejarano PA et al (2003) Histopathological changes after microwave coagulation therapy for patients with hepatocellular carcinoma: review of 15 explanted livers. Am J Gastroenterol 98:2052–2059PubMedCrossRef Yamashiki N, Kato T, Bejarano PA et al (2003) Histopathological changes after microwave coagulation therapy for patients with hepatocellular carcinoma: review of 15 explanted livers. Am J Gastroenterol 98:2052–2059PubMedCrossRef
26.
Zurück zum Zitat Inokuchi R, Seki T, Ikeda K et al (2010) Percutaneous microwave coagulation therapy for hepatocellular carcinoma: increased coagulation diameter using a new electrode and microwave generator. Oncol Rep 24:621–627PubMed Inokuchi R, Seki T, Ikeda K et al (2010) Percutaneous microwave coagulation therapy for hepatocellular carcinoma: increased coagulation diameter using a new electrode and microwave generator. Oncol Rep 24:621–627PubMed
Metadaten
Titel
Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma: experimental and clinical studies
verfasst von
Guo-Jun Qian
Neng Wang
Qiang Shen
Yue Hong Sheng
Jie-Qiong Zhao
Ming Kuang
Guang-Jian Liu
Meng-Chao Wu
Publikationsdatum
01.09.2012
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 9/2012
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2442-1

Weitere Artikel der Ausgabe 9/2012

European Radiology 9/2012 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.