Department of radiology, Tenon hospital, 4, rue de la Chine, 75020 Paris, France.
Department of radiology, Pellegrin hospital, place Amélie-Raba-Léon, 33076 Bordeaux, France.
Diagn Interv Imaging. 2017 Apr;98(4):287-297. doi: 10.1016/j.diii.2016.12.002. Epub 2016 Dec 20.
The purpose of this review was to identify the specific technical considerations to adequately perform microwave ablations (MWA) of renal tumors and analyze the currently available clinical results.
Using Medline, a systematic review was performed including articles published between January 2000 and September 2016. English language original articles, reviews and editorials were selected based on their clinical relevance.
MWA has several theoretical advantages over radiofrequency ablation in consistently providing higher intratumoral temperatures. MWA is less dependent of electrical conductivities of tissues and the delivered energy is less limited by desiccation of heated tissues. While there are insufficient data, especially because of a lack of studies with mid- to long-term follow-up, to determine the oncologic effectiveness of MWA, this technique appears safe and effective for the ablation of T1 renal tumors. There is evidence for using mid-level settings based on experimental and clinical data. Power set at 50-65W for 5-15min appears adequate in kidney but close clinical and imaging follow-up have to be performed.
Renal MWA offers theoretical advantages by comparison with other available techniques to treat renal tumors. However, MWA suffers of less cumulative data compared to radiofrequency ablation or cryoablation. Moreover, microwaves still require further studies to identify the optimal tumor characteristics and device settings leading to predictable ablation.
本综述旨在确定充分实施肾脏肿瘤微波消融（MWA）所需的特定技术注意事项，并分析目前可获得的临床结果。
使用 Medline，进行了一项系统综述，包括 2000 年 1 月至 2016 年 9 月期间发表的文章。根据其临床相关性，选择了英语原创文章、综述和社论。
MWA 与射频消融相比具有几个理论优势，可始终提供更高的肿瘤内温度。MWA 对组织电导率的依赖性较小，并且由于加热组织的干燥，所传递的能量受到的限制较小。尽管缺乏足够的数据，尤其是缺乏具有中至长期随访的研究，无法确定 MWA 的肿瘤学有效性，但该技术对于 T1 肾脏肿瘤的消融似乎是安全有效的。基于实验和临床数据，有证据表明可以使用中能级设置。在肾脏中，功率设置为 50-65W 持续 5-15 分钟似乎足够，但需要进行密切的临床和影像学随访。
与其他可用于治疗肾脏肿瘤的现有技术相比，肾脏 MWA 具有理论优势。然而，与射频消融或冷冻消融相比，MWA 的累积数据较少。此外，微波仍需要进一步的研究来确定导致可预测消融的最佳肿瘤特征和设备设置。
