Original Research

A New-Designed Microwave Ablation System: Testing in ex vivo and in vivo Liver Model

  • He, MS Danni ,
  • Ji, MD Qiao ,
  • Lin, MD Huitong ,
  • Liang, MM Xuankun ,
  • Li, MM Lujing ,
  • Liang, MM Fengping ,
  • Wang, MM Xianxiang ,
  • Yuan, MS Kun ,
  • Xu, MD Zuofeng
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  • aDepartment of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China

Received date: 2020-03-13

  Revised date: 2020-05-10

  Online published: 2021-03-25

Abstract

Objective: The present study aimed to determine the efficacy and safety of a newly designed microwave ablation (MWA) system in ex vivo and in vivo liver model.
Methods: A new MWA system (HRMW-01, Hengrui Medical, Guangzhou, China) was tested on porcine liver ex vivo with different parameter settings (50-70 W for 5-20 min). Ablation volums were measured on the gross specimens. In an in vivo study, MWA was performed at 60 W for 5 min in canine liver. Ablation volumes were identified and measured using contrast-enhanced ultrasound (CEUS) 1 w after the ablation. All animals underwent routine hematological, biochemical, and coagulation tests before ablation at 1 d and 1 w after ablation. For comparison, radiofrequency ablation (RFA) was performed using a Cool-tip system (Valleylab, Boulder, CO, USA) with an automated power setting for 12 min in both ex vivo and in vivo studies.
Results: In ex vivo studies, the mean volumes of MWA coagulation ranged from 27.8 ± 7.3 cm3 to 144.6 ± 35.9 cm 3 and increased with ablation duration and power output. MWA was prone to creating larger volume but less spherical ablation shape than RFA (P < 0.05). In in vivo studies, MWA created larger ablation volumes with shorter ablation time compared to RFA (P < 0.05). Laboratory data showed significantly higher alanine aminotransferase and aspartate aminotransferase levels 1 d after ablation than based line levels (P < 0.05) while the levels decreased close to pre-ablation levels 1 w after ablation (P > 0.05).
Conclusion: The newly designed MWA system is safe and more efficient than a commonly used RFA system. However, further clinical studies are warranted.

Cite this article

He, MS Danni , Ji, MD Qiao , Lin, MD Huitong , Liang, MM Xuankun , Li, MM Lujing , Liang, MM Fengping , Wang, MM Xianxiang , Yuan, MS Kun , Xu, MD Zuofeng . A New-Designed Microwave Ablation System: Testing in ex vivo and in vivo Liver Model[J]. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY, 2021 , 5(1) : 39 -46 . DOI: 10.37015/AUDT.2021.200014

References

[1] Yin XY, Lu MD. Percutaneous ablation for small hepatocellular carcinoma. Expert Rev Gastroenterol Hepatol 2009; 3:121-30.
[2] Wang GZ, He XH, Wang Y, Xu LC, Huang HZ, Wang YH, et al. Clinical practice guideline for image-guided multimode tumour ablation therapy in hepatic malignant tumours. Curr Oncol 2019; 26:e658-e64.
[3] Chua JME, Lam YMP, Tan BS, Tay KH, Gogna A, Irani FG, et al. Single-centre retrospective review of risk factors for local tumour progression and complications in radiofrequency ablation of 555 hepatic lesions. Singapore Med J 2019; 60:188-92.
[4] Shiina S, Sato K, Tateishi R, Shimizu M, Ohama H, Hatanaka T, et al. Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and Surgery. Can J Gastroenterol Hepatol 2018; 2018:4756147.
[5] Ahmed M, Brace CL, Lee FT, Jr., Goldberg SN. Principles of and advances in percutaneous ablation. Radiology 2011; 258:351-69.
[6] Lubner MG, Brace CL, Hinshaw JL, Lee FT,Jr. Microwave tumor ablation: mechanism of action, clinical results, and devices. J Vasc Interv Radiol 2010; 21:S192-203.
[7] Ihnát P, Ihnát Rudinská L, Zon?a P. Radiofrequency energy in surgery: state of the art. Surg Today 2014; 44:985-91.
[8] Decadt B, Siriwardena AK. Radiofrequency ablation of liver tumours: systematic review. Lancet Oncol 2004; 5:550-60.
[9] Brace CL. Radiofrequency and microwave ablation of the liver, lung, kidney, and bone: what are the differences? Curr Probl Diagn Radiol 2009; 38:135-43.
[10] Glassberg MB, Ghosh S, Clymer JW, Qadeer RA, Ferko NC, Sadeghirad B, et al. Microwave ablation compared with radiofrequency ablation for treatment of hepatocellular carcinoma and liver metastases: a systematic review and meta-analysis. Onco Targets Ther 2019; 12:6407-38.
[11] Yu J, Liang P, Yu X, Liu F, Chen L, Wang Y. 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.
[12] Mann CD, Metcalfe MS, Lloyd DM, Maddern GJ, Dennison AR. The safety and efficacy of ablative techniques adjacent to the hepatic vasculature and biliary system. ANZ J Surg 2010; 80:41-9.
[13] Bailey CW, Sydnor MK, Jr. Current State of Tumor Ablation Therapies. Dig Dis Sci 2019; 64:951-58.
[14] Izzo F, Granata V, Grassi R, Fusco R, Palaia R, Delrio P, et al. Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update. Oncologist 2019; 24:e990-e1005.
[15] Kang TW, Lim HK, Cha DI. Percutaneous ablation for perivascular hepatocellular carcinoma: Refining the current status based on emerging evidence and future perspectives. World J Gastroenterol 2018; 24:5331-37.
[16] Zhang B, Moser M, Zhang E, Zhang WJ. Radiofrequency ablation technique in the treatment of liver tumours: review and future issues. J Med Eng Technol 2013; 37:150-9.
[17] Kovács A, Iezzi R, Cellini F, Lancellotta V, Bischoff P, Carchesio F, et al. Critical review of multidisciplinary non-surgical local interventional ablation techniques in primary or secondary liver malignancies. J Contemp Brachytherapy 2019; 11:589-600.
[18] Brace CL, Laeseke PF, Sampson LA, Frey TM, van der Weide DW, Lee FT, Jr. Microwave ablation with a single small-gauge triaxial antenna: in vivo porcine liver model. Radiology 2007; 242:435-40.
[19] Kuang M, Lu MD, Xie XY, Xu HX, Mo LQ, Liu GJ, et al. Liver cancer: increased microwave delivery to ablation zone with cooled-shaft antenna--experimental and clinical studies. Radiology 2007; 242:914-24.
[20] Morimoto M, Sugimori K, Shirato K, Kokawa A, Tomita N, Saito T, et al. Treatment of hepatocellular carcinoma with radiofrequency ablation: radiologic-histologic correlation during follow-up periods. Hepatology 2002; 35:1467-75.
[21] Shi W, Liang P, Zhu Q, Yu X, Shao Q, Lu T, et al. Microwave ablation: results with double 915 MHz antennae in ex vivo bovine livers. Eur J Radiol 2011; 79:214-7.
[22] Jiao DC, Zhou Q, Han XW, Wang YF, Wu G, Ren JZ, et al. Microwave ablation treatment of liver cancer with a 2,450-MHz cooled-shaft antenna: pilot study on safety and efficacy. Asian Pac J Cancer Prev 2012; 13:737-42.
[23] Sun Y, Cheng Z, Dong L, Zhang G, Wang Y, Liang P. Comparison of temperature curve and ablation zone between 915- and 2450-MHz cooled-shaft microwave antenna: results in ex vivo porcine livers. Eur J Radiol 2012; 81:553-7.
[24] Lubner MG, Ziemlewicz TJ, Hinshaw JL, Lee FT, Jr, Sampson LA, Brace CL. Creation of short microwave ablation zones: in vivo characterization of single and paired modified triaxial antennas. J Vasc Interv Radiol 2014; 25:1633-40.
[25] Liang P, Wang Y, Yu X, Dong B. Malignant liver tumors: treatment with percutaneous microwave ablation--complications among cohort of 1136 patients. Radiology 2009; 251:933-40.
[26] Jiao D, Qian L, Zhang Y, Zhang F, Li C, Huang Z, 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.
[27] Solbiati L, Goldberg SN, Ierace T, Livraghi T, Meloni F, Dellanoce M, et al. Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes. Radiology 1997; 205:367-73.
[28] Shibata T, Shibata T, Maetani Y, Isoda H, Hiraoka M. Radiofrequency ablation for small hepatocellular carcinoma: prospective comparison of internally cooled electrode and expandable electrode. Radiology 2006; 238:346-53.
[29] Claudon M, Cosgrove D, Albrecht T, Bolondi L, Bosio M, Calliada F, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) - update 2008. Ultraschall Med 2008; 29:28-44.
[30] Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nols?e CP, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall Med 2013; 34:11-29.
[31] Ding J, Zhou Y, Wang Y, Zhou H, X J. Clinical value of contrast enhanced ultrasound in differential diagnosis of early hepatocellular carcinoma and dysplastic nodules. Advanced Ultrasound in Diagnosis and Therapy 2017; 1:14-20.
[32] Lu MD, Yu XL, Li AH, Jiang TA, Chen MH, Zhao BZ, 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; 33:1736-49.
[33] Frieser M, Kiesel J, Lindner A, Bernatik T, Haensler JM, Janka R, et al. Efficacy of contrast-enhanced US versus CT or MRI for the therapeutic control of percutaneous radiofrequency ablation in the case of hepatic malignancies. Ultraschall Med 2011; 32:148-53.
[34] Sriharsha Gummadi, John Eisenbrey, Jingzhi Li, Zhaojun Li, Flemming Forsberg, Andrej Lyshchik, et al. Advances in Modern Clinical Ultrasound. Advanced Ultrasound in Diagnosis and Therapy 2018; 2:51-63.
[35] Poulou LS, Botsa E, Thanou I, Ziakas PD, Thanos L. Percutaneous microwave ablation vs radiofrequency ablation in the treatment of hepatocellular carcinoma. World J Hepatol 2015; 7:1054-63.
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