Volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastases

Background In thermal ablation of malignant liver tumors, ablation dimensions remain poorly predictable. This study aimed to investigate factors influencing volumetric ablation dimensions in patients treated with stereotactic microwave ablation (SMWA) for colorectal liver metastases (CRLM).Methods A...

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Main Authors: Iwan Paolucci, Simeon J. S. Ruiter, Jacob Freedman, Daniel Candinas, Koert P. de Jong, Stefan Weber, Pascale Tinguely
Format: Article
Language:English
Published: Taylor & Francis Group 2022-12-01
Series:International Journal of Hyperthermia
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Online Access:https://www.tandfonline.com/doi/10.1080/02656736.2021.1965224
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author Iwan Paolucci
Simeon J. S. Ruiter
Jacob Freedman
Daniel Candinas
Koert P. de Jong
Stefan Weber
Pascale Tinguely
author_facet Iwan Paolucci
Simeon J. S. Ruiter
Jacob Freedman
Daniel Candinas
Koert P. de Jong
Stefan Weber
Pascale Tinguely
author_sort Iwan Paolucci
collection DOAJ
description Background In thermal ablation of malignant liver tumors, ablation dimensions remain poorly predictable. This study aimed to investigate factors influencing volumetric ablation dimensions in patients treated with stereotactic microwave ablation (SMWA) for colorectal liver metastases (CRLM).Methods Ablation volumes from CRLM ≤3 cm treated with SMWA within a prospective European multicentre trial were segmented. Correlations between applied ablation energies and resulting effective ablation volumes (EAV) and ablation volume irregularities (AVI) were investigated. A novel measure for AVI, including minimum enclosing and maximum inscribed ellipsoid ablation volumes, and a surrogate parameter for the expansion of ablation energy (EAV per applied energy), was introduced. Potential influences of tumor and patient-specific factors on EAV per applied energy and AVI were analyzed using multivariable mixed-effects models.Results A total of 116 ablations from 71 patients were included for analyses. Correlations of EAV or AVI and ablation energy were weak to moderate, with a maximum of 25% of the variability in EAV and 13% in AVI explained by the applied ablation energy. On multivariable analysis, ablation expansion (EAV per applied ablation energy) was influenced mainly by the tumor radius (B = −0.03, [CI –0.04, –0.007]). AVI was significantly larger with higher applied ablation energies (B = 0.002 [CI 0.0007, 0.002]]); liver steatosis, KRAS mutation, subcapsular location or proximity to major blood vessels had no influence.Conclusions This study confirmed that factors beyond the applied ablation energy might affect volumetric ablation dimensions, resulting in poor predictability. Further clinical trials including tissue sampling are needed to relate physical tissue properties to ablation expansion.
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spelling doaj-art-99b80ee5a66146bca31002b56021ab8c2025-08-20T03:28:14ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572022-12-0139163964810.1080/02656736.2021.1965224Volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastasesIwan Paolucci0Simeon J. S. Ruiter1Jacob Freedman2Daniel Candinas3Koert P. de Jong4Stefan Weber5Pascale Tinguely6ARTORG Center for Biomedical Engineering, University of Bern, Bern, SwitzerlandDepartment of Hepato-Pancreato-Biliary Surgery, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartment of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, SwedenDepartment of Visceral Surgery and Medicine, Inselspital University Hospital Bern, University of Bern, Bern, SwitzerlandDepartment of Hepato-Pancreato-Biliary Surgery, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsARTORG Center for Biomedical Engineering, University of Bern, Bern, SwitzerlandDepartment of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, SwedenBackground In thermal ablation of malignant liver tumors, ablation dimensions remain poorly predictable. This study aimed to investigate factors influencing volumetric ablation dimensions in patients treated with stereotactic microwave ablation (SMWA) for colorectal liver metastases (CRLM).Methods Ablation volumes from CRLM ≤3 cm treated with SMWA within a prospective European multicentre trial were segmented. Correlations between applied ablation energies and resulting effective ablation volumes (EAV) and ablation volume irregularities (AVI) were investigated. A novel measure for AVI, including minimum enclosing and maximum inscribed ellipsoid ablation volumes, and a surrogate parameter for the expansion of ablation energy (EAV per applied energy), was introduced. Potential influences of tumor and patient-specific factors on EAV per applied energy and AVI were analyzed using multivariable mixed-effects models.Results A total of 116 ablations from 71 patients were included for analyses. Correlations of EAV or AVI and ablation energy were weak to moderate, with a maximum of 25% of the variability in EAV and 13% in AVI explained by the applied ablation energy. On multivariable analysis, ablation expansion (EAV per applied ablation energy) was influenced mainly by the tumor radius (B = −0.03, [CI –0.04, –0.007]). AVI was significantly larger with higher applied ablation energies (B = 0.002 [CI 0.0007, 0.002]]); liver steatosis, KRAS mutation, subcapsular location or proximity to major blood vessels had no influence.Conclusions This study confirmed that factors beyond the applied ablation energy might affect volumetric ablation dimensions, resulting in poor predictability. Further clinical trials including tissue sampling are needed to relate physical tissue properties to ablation expansion.https://www.tandfonline.com/doi/10.1080/02656736.2021.1965224Liver neoplasmsinterventional radiologyablation techniquescomputer-assisted therapiesstereotactic techniques
spellingShingle Iwan Paolucci
Simeon J. S. Ruiter
Jacob Freedman
Daniel Candinas
Koert P. de Jong
Stefan Weber
Pascale Tinguely
Volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastases
International Journal of Hyperthermia
Liver neoplasms
interventional radiology
ablation techniques
computer-assisted therapies
stereotactic techniques
title Volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastases
title_full Volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastases
title_fullStr Volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastases
title_full_unstemmed Volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastases
title_short Volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastases
title_sort volumetric analyses of ablation dimensions in microwave ablation for colorectal liver metastases
topic Liver neoplasms
interventional radiology
ablation techniques
computer-assisted therapies
stereotactic techniques
url https://www.tandfonline.com/doi/10.1080/02656736.2021.1965224
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