Microwave ablation is an emerging treatment option for many cancers, cardiac arrhythmias, and other medical conditions During treatment, microwaves are applied directly to tissues to produce rapid temperature elevations sufficient to produce immediate coagulative necrosis The engineering design criteria for each application differ, with individual consideration for factors such as desired ablation zone size, treatment duration, and procedural invasiveness Recent technological developments in applicator cooling, power control, and system optimization for specific applications promise to increase the utilization of microwave ablation in the future This article reviews the basic biophysics of microwave tissue heating, provides an overview of the design and operation of current equipment, and outlines areas for future research

Microwave Tissue Ablation: Biophysics, Technology and Applications

More than three decades have passed since utilization of radiofrequency (RF) ablation in the treatment of cardiac arrhythmias. Although several limitations and challenges still exist, with improvements in catheter designs and delivery of energy the way we do RF ablation now is much safer and more efficient. This review article aims to give an overview on historical advances on RF ablation and challenges in performing safe and efficient ablation.

Radiofrequency ablation: technological trends, challenges, and opportunities.

Evaluation of ablation catheter technology: Comparison between thigh preparation model and an in vivo beating heart.

Computer modeling of radiofrequency cardiac ablation: 30 years of bioengineering research.

Microwave ablation is a technique used in treating hepatocellular carcinoma, especially in cases where surgical removal is impossible. In the present study we are investigating the effects of design characteristics of a coaxial slot antenna (single- versus double-slot, slot-to-tip distance and slot size) on the ablation zone characteristics (dimensions and shape). The specific absorption rate field and the temperature rises are calculated for a variety of application times and powers. A plateau in the ablation zone dimensions in healthy and cirrhotic liver models is predicted, but not in malignant ones. It is found that the value of the perfusion rate (which is different for each clinical case) is of crucial importance in order to correctly estimate the ablation zone. An underestimation of dimensions is expected, if higher perfusion rates are used (i.e., values for healthy tissue rather than malignant). In contrast, an exact determination of the values of relative permittivity and conductivity is less significant for predicting the ablation zone.

http://iopscience.iop.org/article/10.1088/0031-9155/58/10/3191/pdf

Antenna design and tissue parameters considerations for an improved modelling of microwave ablation in the liver.

Background: Transcatheter microwave ablation is a novel technique for treating cardiac arrhythmias.



Methods: We investigated the effects of catheter temperature, application duration, and antenna length on lesion dimensions during catheter-based microwave ablation. In a swine thigh muscle preparation, microwave was delivered at targeted temperatures of 60°C (n = 18), 70°C (n = 27), 80°C (n = 43), or 90°C (n = 18) for 120 seconds with 10-mm antenna; and at targeted temperatures of 80°C for 120 seconds (n = 22), 150 seconds (n = 18), 180 seconds (n = 18), 210 seconds (n = 18), and 240 seconds (n = 17) with 20-mm antenna using 10 F catheter (MedWaves, San Diego, CA, USA) during parallel orientation. Conventional radiofrequency ablation (RF) using a 4-mm tip electrode was performed as control.



Results: With 120-second energy applications, lesion length and depth were significantly larger with targeted temperatures of 80°C and 90°C than 60°C (P< 0.05). Furthermore, lesion depth and width, but not length, were significantly increased by prolonging energy application duration from 120 to 240 seconds at targeted temperature of 80°C (P< 0.05). Compared to RF, microwave lesions were significantly longer but had comparable depth and width. A 20-mm microwave antenna produced longer lesions than either a 10-mm antenna or RF ablation catheter. Multivariate analysis demonstrated that targeted temperature ≥80°C, application duration ≥150 seconds, and use of 20-mm antenna were independent predictors for lesion depth and width (P< 0.05). Surface dessication was observed in 4/18 (22%) lesions at 90°C, as compared with 1/136 (0.7%) at 80°C targeted tip temperature (P < 0.05).



Conclusions: This study demonstrated that lesions size with transcatheter microwave ablation can be controlled by adjusting targeted temperature, energy application duration, and antenna length. A targeted temperature of 80°C for more than 150 seconds should provide optimal lesion dimensions and lower risk of surface dessication or charring.

Determinants of lesion dimensions during transcatheter microwave ablation.

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Determinants of lesion dimensions during transcatheter microwave ablation.