Volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastases.

Paolucci, Iwan; Ruiter, Simeon J S; Freedman, Jacob; Candinas, Daniel; de Jong, Koert P; Weber, Stefan; Tinguely, Pascale (2022). Volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastases. International journal of hyperthermia, 39(1), pp. 639-648. Taylor & Francis 10.1080/02656736.2021.1965224

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BACKGROUND

In thermal ablation of malignant liver tumors, ablation dimensions remain poorly predictable. This study aimed to investigate factors influencing volumetric ablation dimensions in patients treated with stereotactic microwave ablation (SMWA) for colorectal liver metastases (CRLM).

METHODS

Ablation volumes from CRLM ≤3 cm treated with SMWA within a prospective European multicentre trial were segmented. Correlations between applied ablation energies and resulting effective ablation volumes (EAV) and ablation volume irregularities (AVI) were investigated. A novel measure for AVI, including minimum enclosing and maximum inscribed ellipsoid ablation volumes, and a surrogate parameter for the expansion of ablation energy (EAV per applied energy), was introduced. Potential influences of tumor and patient-specific factors on EAV per applied energy and AVI were analyzed using multivariable mixed-effects models.

RESULTS

A total of 116 ablations from 71 patients were included for analyses. Correlations of EAV or AVI and ablation energy were weak to moderate, with a maximum of 25% of the variability in EAV and 13% in AVI explained by the applied ablation energy. On multivariable analysis, ablation expansion (EAV per applied ablation energy) was influenced mainly by the tumor radius (B = -0.03, [CI -0.04, -0.007]). AVI was significantly larger with higher applied ablation energies (B = 0.002 [CI 0.0007, 0.002]]); liver steatosis, KRAS mutation, subcapsular location or proximity to major blood vessels had no influence.

CONCLUSIONS

This study confirmed that factors beyond the applied ablation energy might affect volumetric ablation dimensions, resulting in poor predictability. Further clinical trials including tissue sampling are needed to relate physical tissue properties to ablation expansion.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy

UniBE Contributor:

Paolucci, Iwan; Candinas, Daniel; Weber, Stefan and Tinguely, Pascale Marie Pia

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1464-5157

Publisher:

Taylor & Francis

Language:

English

Submitter:

Pubmed Import

Date Deposited:

26 Apr 2022 14:05

Last Modified:

26 Apr 2022 14:14

Publisher DOI:

10.1080/02656736.2021.1965224

PubMed ID:

35465802

Uncontrolled Keywords:

Liver neoplasms ablation techniques computer-assisted therapies interventional radiology stereotactic techniques

BORIS DOI:

10.48350/169515

URI:

https://boris.unibe.ch/id/eprint/169515

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