Department of Radiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Center for Medical Imaging North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Eur Radiol. 2018 Aug;28(8):3228-3236. doi: 10.1007/s00330-017-5266-1. Epub 2018 Mar 13.
To study the ratio of ablation zone volume to applied energy in computed tomography (CT)-guided radiofrequency ablation (RFA) and microwave ablation (MWA) in patients with hepatocellular carcinoma (HCC) in a cirrhotic liver and in patients with colorectal liver metastasis (CRLM).
In total, 90 liver tumors, 45 HCCs in a cirrhotic liver and 45 CRLMs were treated with RFA or with one of two MWA devices (MWA_A and MWA_B), resulting in 15 procedures for each tumor type, per device. Device settings were recorded and the applied energy was calculated. Ablation volumes were segmented on the contrast-enhanced CT scans obtained 1 week after the procedure. The ratio of ablation zone volume in milliliters to applied energy in kilojoules was determined for each procedure and compared between HCC (R) and CRLM (R), stratified according to ablation device.
With RFA, R and R were 0.22 mL/kJ (0.14-0.45 mL/kJ) and 0.15 mL/kJ (0.14-0.22 mL/kJ; p = 0.110), respectively. With MWA_A, R was 0.81 (0.61-1.07 mL/kJ) and R was 0.43 (0.35-0.61 mL/kJ; p = 0.001). With MWA_B, R was 0.67 (0.41-0.85 mL/kJ) and R was 0.43 (0.35-0.61 mL/kJ; p = 0.040).
With RFA, there was no significant difference in energy deposition ratio between tumor types. With both MWA devices, the ratios were higher for HCCs. Tailoring microwave ablation device protocols to tumor type might prevent incomplete ablations.
• HCCs and CRLMs respond differently to microwave ablation • For MWA, CRLMs required more energy to achieve a similar ablation volume • Tailoring ablation protocols to tumor type might prevent incomplete ablations.
研究 CT 引导下射频消融（RFA）和微波消融（MWA）治疗肝硬化肝细胞癌（HCC）和结直肠癌肝转移（CRLM）患者时消融区体积与应用能量的比值。
共对 90 个肝肿瘤、45 个肝硬化 HCC 和 45 个 CRLM 进行 RFA 或两种 MWA 设备（MWA_A 和 MWA_B）治疗，每个肿瘤类型/设备各进行 15 次治疗。记录设备设置并计算应用能量。术后 1 周通过增强 CT 扫描对消融体积进行分割。确定每个程序的消融区体积（毫升）与应用能量（焦耳）的比值，并根据消融设备对 HCC（R）和 CRLM（R）进行分层比较。
采用 RFA 时，R 和 R 分别为 0.22 mL/kJ（0.14-0.45 mL/kJ）和 0.15 mL/kJ（0.14-0.22 mL/kJ；p = 0.110）。采用 MWA_A 时，R 为 0.81（0.61-1.07 mL/kJ），R 为 0.43（0.35-0.61 mL/kJ；p = 0.001）。采用 MWA_B 时，R 为 0.67（0.41-0.85 mL/kJ），R 为 0.43（0.35-0.61 mL/kJ；p = 0.040）。
采用 RFA 时，两种肿瘤类型之间的能量沉积比值无显著差异。采用两种 MWA 设备时，HCC 的比值较高。针对肿瘤类型调整微波消融设备方案可能会预防消融不完全。
HCC 和 CRLM 对微波消融的反应不同。
对于 MWA，CRLM 需要更多的能量来实现相似的消融体积。
根据肿瘤类型调整消融方案可能会预防消融不完全。
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