Volume 33, Issue 12 pp. 2007-2014
Hepatology

New microwave ablation system for unresectable liver tumors that forms large, spherical ablation zones

Kento Imajo

Kento Imajo

Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

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Wataru Tomeno

Wataru Tomeno

Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

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Mineo Kanezaki

Mineo Kanezaki

Department of Gastroenterology, Kanto Medical Center Tokyo, Tokyo, Japan

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Yasushi Honda

Yasushi Honda

Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

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Takaomi Kessoku

Takaomi Kessoku

Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

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Yuji Ogawa

Yuji Ogawa

Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

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Keisuke Yoshida

Keisuke Yoshida

Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

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Masato Yoneda

Masato Yoneda

Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

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Hiroyuki Kirikoshi

Hiroyuki Kirikoshi

Department of Clinical Laboratory, Yokohama City University Hospital, Yokohama, Japan

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Masafumi Ono

Masafumi Ono

Department of Gastroenterology and Hepatology, Kochi Medical School, Nankoku, Kochi, Japan

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Tomohiro Kaneta

Tomohiro Kaneta

Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

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Tomio Inoue

Tomio Inoue

Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

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Takuma Teratani

Takuma Teratani

Department of Gastroenterology, Kanto Medical Center Tokyo, Tokyo, Japan

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Satoru Saito

Satoru Saito

Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

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Atsushi Nakajima

Corresponding Author

Atsushi Nakajima

Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

Correspondence

Dr Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Email: [email protected]

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First published: 30 May 2018
Citations: 17
Declaration of conflict of interest: The authors have no competing interests to disclose. No writing assistance was provided in the production of this manuscript.
Author contribution: Kento Imajo, Wataru Tomeno, and Atsushi Nakajima contributed in the study conception and design; Yasushi Honda, Takaomi Kessoku, Yuji Ogawa, Hiroyuki Kirikoshi, Masato Yoneda, and Satoru Saito in the collection of data; Kento Imajo and Atsushi Nakajima in the data analysis; Kento Imajo, Masato Yoneda, and Atsushi Nakajima in the contribution of reagents, materials, and analytical tools; and Kento Imajo, Takaomi Kessoku, Masato Yoneda, Masafumi Ono, and Atsushi Nakajima in the manuscript preparation. All authors read and approved the final manuscript.
Financial support: The work in the author's laboratory was supported by the “Step A” program of the Japan Science and Technology Agency (JST) and Kiban-B, Shingakujuturyouiki. In addition, this work was supported in part by grants-in-aid from the Japanese Ministry of Health, Labour and Welfare.

Abstract

Background and Aim

The aim of this study was to assess the efficacy of a new microwave ablation (MWA) system, the Emprint Ablation System, for the ablation of unresectable large liver tumors (≥ 30 mm).

Methods

Twenty-one hepatic tumors (mean diameter, 34.7 mm) from 21 patients who underwent percutaneous MWA were included in this cross-sectional study. A volume analyzer based on computed tomography imaging was used for all patients within the month before and month after the procedure to evaluate the shape and volume of ablation zones. In addition, computed tomography imaging was performed again 3 months after the procedure to evaluate the presence of residual tumors and local recurrence.

Results

Mean ablation time was 11.3 min, and mean overall procedure time was 33.4 min. An ablated adrenal gland-induced Takotsubo (stress) cardiomyopathy occurred immediately after MWA as a major complication in one patient. Roundness index A, B, and C presented a mean value of 0.94, 0.94, and 1.01, respectively (all values near 1 is a perfect sphere), indicating that a spherical ablation zone was achieved. The mean ablation volume was larger than the volume of tumors (24.5 vs 41.7 cm3). Residual tumors were confirmed in only 4.8% of tumors after a single ablation session. There was no local recurrence.

Conclusions

In our experience, the new MWA system provides an effective treatment option for unresectable large liver tumors. However, to ablate the liver tumors safely, it is necessary to consider the surrounding organs, such as the adrenal glands.

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