Sebek Jan, Kramer Steve, Rocha Rob, Yu Kun-Chang, Bortel Radoslav, Beard Warren L, Biller David S, Hodgson David S, Ganta Charan K, Wibowo Henky, Yee John, Myers Renelle, Lam Stephen, Prakash Punit
Dept of Electrical and Computer Engineering, Kansas State University Manhattan, Manhattan, KS, USA.
Dept of Circuit Theory, Czech Technical University in Prague, Prague, Czech Republic.
ERJ Open Res. 2020 Oct 13;6(4). doi: 10.1183/23120541.00146-2020. eCollection 2020 Oct.
Percutaneous microwave ablation is clinically used for inoperable lung tumour treatment. Delivery of microwave ablation applicators to tumour sites within lung parenchyma under virtual bronchoscopy guidance may enable ablation with reduced risk of pneumothorax, providing a minimally invasive treatment of early-stage tumours, which are increasingly detected with computed tomography (CT) screening. The objective of this study was to integrate a custom microwave ablation platform, incorporating a flexible applicator, with a clinically established virtual bronchoscopy guidance system, and to assess technical feasibility for safely creating localised thermal ablations in porcine lungs .
Pre-ablation CTs of normal pigs were acquired to create a virtual model of the lungs, including airways and significant blood vessels. Virtual bronchoscopy-guided microwave ablation procedures were performed with 24-32 W power (at the applicator distal tip) delivered for 5-10 mins. A total of eight ablations were performed in three pigs. Post-treatment CT images were acquired to assess the extent of damage and ablation zones were further evaluated with viability stains and histopathologic analysis.
The flexible microwave applicators were delivered to ablation sites within lung parenchyma 5-24 mm from the airway wall a tunnel created under virtual bronchoscopy guidance. No pneumothorax or significant airway bleeding was observed. The ablation short axis observed on gross pathology ranged 16.5-23.5 mm and 14-26 mm on CT imaging.
We have demonstrated the technical feasibility for safely delivering microwave ablation in the lung parenchyma under virtual bronchoscopic guidance in an porcine lung model.
经皮微波消融术在临床上用于治疗无法手术切除的肺部肿瘤。在虚拟支气管镜引导下将微波消融电极针送达肺实质内的肿瘤部位，可能会降低气胸风险，从而实现对早期肿瘤的微创治疗，而早期肿瘤越来越多地通过计算机断层扫描（CT）筛查发现。本研究的目的是将一个集成了柔性电极针的定制微波消融平台与一个临床已确立的虚拟支气管镜引导系统相结合，并评估在猪肺中安全创建局部热消融灶的技术可行性。
获取正常猪的消融前CT图像，以创建包括气道和重要血管的肺部虚拟模型。在虚拟支气管镜引导下进行微波消融操作，电极针远端尖端的功率为24 - 32W，持续5 - 10分钟。对三头猪共进行了八次消融。获取治疗后的CT图像以评估损伤范围，并通过活力染色和组织病理学分析进一步评估消融灶。
柔性微波电极针通过在虚拟支气管镜引导下创建的通道被送达距气道壁5 - 24mm的肺实质内的消融部位。未观察到气胸或明显的气道出血。大体病理观察到的消融短轴范围为16.5 - 23.5mm，CT成像上为14 - 26mm。
我们已经证明了在猪肺模型中，在虚拟支气管镜引导下安全地在肺实质内进行微波消融的技术可行性。
