Coupled field analysis of heat flow in the near field of a microwave applicator for tumor ablation.

Microwave tumor ablation (MTA) offers a new approach for the treatment of hepatic neoplastic disease. Reliable and accurate information regarding the heat distribution inside biological tissue subjected to microwave thermal ablation is important for the efficient design of microwave applicators and for optimizing experiments, which aim to assess the effects of therapeutic treatments. Currently there are a variety of computational methods based on different vascular structures in tissue, which aim to model heat distribution during ablation. This paper presents results obtained from two such computational models for temperature distributions produced by a clinical 2.45 GHz MTA applicator immersed in unperfused ex vivo bovine liver, and compares them with measured results from a corresponding ex vivo experiment. The computational methods used to model the temperature distribution in tissue caused by the insertion of a 5.6 mm diameter "wandlike" microwave applicator are the Green's function method and the finite element method (FEM), both of which provide solutions of the heat diffusion partial differential equation. The results obtained from the coupled field simulations are shown to be in good agreement with a simplified analysis based on the bio-heat equation and with ex vivo measurements of the heat distribution produced by the clinical MTA applicator.

Microwave ablation: results with a 2.45-GHz applicator in ex vivo bovine and in vivo porcine liver.

PURPOSE: To characterize the relationship between applied power and treatment duration in their effect on extent of coagulation produced with a 2.45-GHz microwave applicator in both an ex vivo and a perfused in vivo liver model. MATERIALS AND METHODS: All experimentation was approved by the Institute of Animal Care and Use Committee. Multiple tissue ablations were performed in ex vivo bovine liver (120 ablations) and in vivo porcine liver (45 ablations) with a 5.7-mm-diameter 2.45-GHz microwave applicator. The applied power was varied from 50 to 150 W (in 25-W increments ex vivo and 50-W increments in vivo), while treatment duration varied from 2 to 20 minutes (in eight time increments for ex vivo and five for in vivo liver). Three-dimensional contour maps of the resultant short- and long-axis coagulation diameters were constructed to identify the optimal parameters to achieve maximum coagulation in both ex vivo and in vivo models. Multivariate analysis was performed to characterize the relationship between applied power and treatment duration. RESULTS: Power and treatment duration were both associated with coagulation diameter in a sigmoidal fashion (ex vivo, R(2) = 0.78; in vivo, R(2) = 0.74). For ex vivo liver, the maximum short-axis coagulation diameter (7.6 cm +/- 0.2 [standard deviation] by 12.3 cm +/- 0.8) was achieved at greatest power (150 W) and duration (20 minutes). In vivo studies revealed a sigmoidal relationship between duration and coagulation size, with a relative plateau in coagulation size achieved within 8 minutes duration at all power levels. After 8 minutes of treatment at 150 W, the mean short-axis coagulation diameter for in vivo liver was 5.7 cm +/- 0.2 by 6.5 cm +/- 1.7, which was significantly larger than the corresponding result for ex vivo liver (P < .05). CONCLUSION: Large zones of ablation can be achieved with the 2.45-GHz microwave applicator used by the authors. For higher-power ablations, larger zones of coagulation were achieved for in vivo liver than for ex vivo liver with short energy applications, a finding previously not seen with other ablation devices, to the authors' knowledge.

Rapid microwave ablation of large hepatocellular carcinoma in a high-risk patient.

A 74-year-old male with an inoperable, large (6 cm in diameter) primary hepatocellular carcinoma of the liver was successfully treated using a novel microwave ablating system. Using a single applicator, the tumour was treated at 150 W for 4 minutes. An ablation zone 8 cm in diameter was achieved, which gradually shrunk to form scar tissue that remained unchanged without tumour recurrence for 2 years.

The histological features of microwave coagulation therapy: an assessment of a new applicator design.

Microwave ablation of tumours within the liver may become an adjunct or alternative to resection in patients with primary or secondary cancers. This technique combines the benefits of a large, localized coagulative effect with a single insertion of the applicator, in a significantly shorter time than comparable treatments. A new range of microwave applicators were developed and tested in animal models and both ex-vivo and in-vivo specimens of human liver at resection. At laparotomy, the applicator tip was inserted into normal liver parenchyma and tumours, with each specimen subjected to irradiation for 180 s or more and at varying power outputs. On sectioning an area of spherical blanching was observed around the applicator cavity. Microscopically a zone of coagulative necrosis was seen adjacent to the site of probe insertion. Damage to blood vessels and bile ducts occurred distal to the probe cavity suggesting the passage of heated fluid, a finding that was diminished by temporary occlusion of the hepatic vasculature (a Pringle manoeuvre). Ultra-structural damage was confirmed within the burn zone and selected liver enzymes were shown to be functioning beyond this region. We suggest this indicates the surrounding liver parenchyma is functioning normally and therefore the volume of microwave-induced damage is controllable. We are confident that the new applicator design will allow the effective treatment of larger tumours in a safe and controlled manner with a single application of energy.