SIR 2024
Interventional Oncology
Thomas Le, MD, MS
Associate Professor
Olive View-Ucla Medical Center
Financial relationships: Full list of relationships is listed on the CME information page.
Bruno C. Odisio, MD, FSIR (he/him/his)
Interventional Radiologist
MD Anderson Cancer Center
Disclosure information not submitted.
Roger Tomihama, MD
Associate Professor of Radiology
Loma Linda University Medical Center
Disclosure information not submitted.
Assess the impact of Ablation Confirmation (AC) software feedback on intra-procedural decision-making during microwave ablation (MWA) of liver lesions and resultant technical success (TS) and technique efficacy (TE).
Materials and Methods:
This prospective multicenter study (NCT03753789) treated adults with liver lesions using the NEUWAVETM MWA System and AC software. Outcomes included antenna repositions and re-ablations informed by AC due to sub-optimal placement and insufficient ablation margins, respectively, as well as TS (ablation zone completely covering the lesion plus adequate minimal margins, per physician discretion, immediately post-ablation) and TE (complete response of the lesion without residual tumor six weeks post-ablation).
Results:
Thirty-eight patients (68.4% male; median age 63 years [40-78]) underwent percutaneous MWA using AC for 47 lesions (60.9% hepatocellular carcinoma, 15.2% colorectal liver metastases, 23.9% other). Median lesion size was 1.8 cm (0.5-4.3). Each lesion received a median of 10 minutes (1-30) of microwave energy at a median of 65 watts (45-95).
AC evaluation indicated 18/47 (38.3%) lesions with sub-optimal antenna placement, of which users adjusted antenna placement for 16/18 (88.9%). AC indicated inadequate minimal margins in 10/47 (21.3%) lesions, leading to additional ablations for 2/10 (20.0%). TS and TE were achieved in 97.9% (46/47) and 100.0% (44/44) of lesions, respectively. No local tumor progression (LTP) was reported during study follow-up (median of 47.5 days [24-138]).
Conclusion:
Intraprocedural use of AC software led to actionable findings during MWA of liver lesions and was associated with excellent short-term efficacy. Long-term data is required to evaluate the impact of AC software on LTP-free survival.