Shaping the future of microwave tumor ablation: a new direction in precision and control of device performance
Shaping the future of microwave tumor ablation: a new direction in precision and control of device performance
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DOI：
10.1080/02656736.2021.1991012
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发表时间：
2022-12-31
影响因子：
3.1
通讯作者：
Prakash, Punit
中科院分区：
文献类型：
--
作者：
Pfannenstiel, Austin;Iannuccilli, Jason;Prakash, Punit
微波消融（MWA）正成为许多器官系统中局部肿瘤的一种越来越重要的微创治疗选择，因为微波技术的最新进展赋予了其他肿瘤消融方式许多优势。尽管针对特定部位肿瘤应用的涂抹器在技术和开发方面取得了这些进步，但绝大多数商用MWA涂抹器通常被设计为创建大体积、对称、椭球或球形的治疗区域，并且通常缺乏一致性、可预测性和空间控制，无法治疗靠近易受意外热损伤的关键结构的肿瘤靶点。然而，相对较新的发展和正在进行的定向微波消融（DMWA）技术有可能赋予相对于涂抹器位置的治疗区域形状的额外控制水平，并显示出扩大MWA在治疗挑战性部位肿瘤的临床适用性的巨大希望。本文介绍了工业标准的商用MWA技术，其临床应用及其在医学实践中用于微创肿瘤治疗时的局限性，然后讨论了实验定向微波消融（DMWA）技术的新进展，各种技术和方法的使用。以及该技术如何用于治疗具有挑战性部位的肿瘤的例子，否则这些肿瘤可能无法通过传统的全方位MWA设备进行安全治疗。
Microwave ablation (MWA) is becoming an increasingly important minimally invasive treatment option for localized tumors in many organ systems due to recent advancements in microwave technology that have conferred many advantages over other tumor ablation modalities. Despite these improvements in technology and development of applicators for site-specific tumor applications, the vast majority of commercially available MWA applicators are generally designed to create large-volume, symmetric, ellipsoid or spherically-shaped treatment zones and often lack the consistency, predictability, and spatial control needed to treat tumor targets near critical structures that are vulnerable to inadvertent thermal injury. The relatively new development and ongoing translation of directional microwave ablation (DMWA) technology, however, has the potential to confer an added level of control over the treatment zone shape relative to applicator position, and shows great promise to expand MWA's clinical applicability in treating tumors in challenging locations. This paper presents a review of the industry-standard commercially available MWA technology, its clinical applications, and its limitations when used for minimally-invasive tumor treatment in medical practice followed by discussion of new advancements in experimental directional microwave ablation (DMWA) technology, various techniques and approaches to its use, and examples of how this technology may be used to treat tumors in challenging locations that may otherwise preclude safe treatment by conventional omni-directional MWA devices.