Microwave ablation of primary and secondary liver tumours: ex vivo, in vivo, and clinical characterisation
Microwave ablation of primary and secondary liver tumours: ex vivo, in vivo, and clinical characterisation
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DOI：
10.1080/02656736.2016.1196830
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发表时间：
2017-02-01
影响因子：
3.1
通讯作者：
Goldberg, S. Nahum
中科院分区：
文献类型：
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作者：
Amabile, Claudio;Ahmed, Muneeb;Goldberg, S. Nahum
目的：本研究的目的是比较微波消融（MWA）设备在临床前和clinical setting.Materials和方法的性能：在整个研究中使用相同的商业2.45 GHz MWA设备。在离体牛肝脏上总共进行了108次消融，功率范围为20至130 W，持续时间为3至30 min;然后在体内猪模型中进行了28次60 W、80 W和100 W的消融，持续5和10 min。最后，46例患者中的32例肝细胞癌（HCC）和19例肝转移瘤通过给予60 W持续5分钟或10分钟进行治疗。治疗结果的特征在于诱导消融区的最大纵向和横向轴。离体消融体积随沉积能量线性增加（r（2）= 0.97），消融时间越长，在较低功率下获得的球度越高。与60 W治疗10 min的HCC相比，肝转移瘤获得了更大的消融（p < 0.003），因为转移瘤的消融直径为4.1 +/- 0.6 cm，HCC为3.7 +/- 0.3 cm，平均球度指数为0.70 +/- 0.04。在60 W下，体内猪模型的结果显著小于离体和临床结果（任一群体）。在60 W下的离体结果和HCC结果之间没有观察到统计学显著差异（p > 0.08）。结论：对于所选择的MW消融装置，关于牛肝脏的离体数据比体内猪模型更能预测肝脏恶性肿瘤的实际临床性能。等效MW治疗在较高沉积能量下对HCC和转移瘤产生了显著不同的反应，表明结局不仅具有器械特异性，而且还必须在逐个组织的基础上进行表征。
Purpose: The aim of this study was to compare the performance of a microwave ablation (MWA) apparatus in preclinical and clinical settings.Materials and method: The same commercial 2.45 GHz MWA apparatus was used throughout this study. In total 108 ablations at powers ranging from 20 to 130 W and lasting from 3 to 30 min were obtained on ex vivo bovine liver; 28 ablations at 60 W, 80 W and 100 W lasting 5 and 10 min were then obtained in an in vivo swine model. Finally, 32 hepatocellular carcinomas (HCCs) and 19 liver metastases in 46 patients were treated percutaneously by administering 60 W for either 5 or 10 min. The treatment outcome was characterised in terms of maximum longitudinal and transversal axis of the induced ablation zone.Results: Ex vivo ablation volumes increased linearly with deposited energy (r(2) = 0.97), with higher sphericity obtained at lower power for longer ablation times. Larger ablations were obtained on liver metastases compared to HCCs treated with 60 W for 10 min (p < 0.003), as ablation diameters were 4.1 +/- 0.6 cm for metastases and 3.7 +/- 0.3 cm for HCC, with an average sphericity index of 0.70 +/- 0.04. The results on the in vivo swine model at 60 W were substantially smaller than the ex vivo and clinical results (either populations). No statistically significant difference was observed between ex vivo results at 60 W and HCC results (p > 0.08).Conclusions: For the selected MW ablation device, ex vivo data on bovine liver was more predictive of the actual clinical performance on liver malignancies than an in vivo porcine model. Equivalent MW treatments yielded a significantly different response for HCC and metastases at higher deposited energy, suggesting that outcomes are not only device-specific but must also be characterised on a tissue -by-tissue basis.