Author of 1 Presentation
SS 7.1 - Stereotactic image-guided microwave ablation for malignant liver tumours: a multivariable accuracy and efficacy analysis
Abstract
Purpose
Therapeutic success of microwave ablation for liver lesions depends on precise placement of ablation probes and complete tumor destruction. We investigated factors influencing targeting accuracy and efficacy of percutaneous stereotactic image-guided microwave ablation (SMWA) for malignant liver tumors.
Material and methods
All malignant liver tumors treated with SMWA over 3 years were analyzed in this observational study. A computed tomography-based navigation system was used for ablation probe trajectory planning, stereotactic probe positioning and validation of probe positions and ablation zones. Factors potentially influencing target positioning errors (TPE) of ablation probes, and local tumor progression (LTP) within 6 months, were analyzed using a multivariable regression model including challenging lesion locations (liver segments I, VII and VIII; subphrenic location).
Results
301 lesions (174 HCC, 87 CRLM, 17 NET, 23 other) were targeted in 191 interventions in 153 patients. Median TPE per ablation probe was 2.9 millimeters (0.2 - 14.1 mm) (n=384). Factors significantly influencing TPE were cirrhosis (R 0.668, CI 0.218 - 1.119) and targeting trajectory length in centimeters (R 0.205, CI 0.118 - 0.291). Overall technique efficacy was 96% and LTP within 6 months 22%. Factors significantly influencing early LTP were lesion size >30 mm (OR 5.221, CI 2.435 - 11.192) and TPE >5 mm (OR 2.480, CI 1.064 – 5.784). Challenging intrahepatic lesion locations had no significant influence on TPE or early LTP.
Conclusion
SMWA allows precise and effective treatment of malignant liver tumors, with targeting accuracy independently predicting efficacy, while unaffected by challenging lesion locations. This might broaden treatment eligibility for otherwise difficult-to-target liver tumors.
Author of 1 Presentation
SS 7.1 - Stereotactic image-guided microwave ablation for malignant liver tumours: a multivariable accuracy and efficacy analysis (ID 912)
Abstract
Purpose
Therapeutic success of microwave ablation for liver lesions depends on precise placement of ablation probes and complete tumor destruction. We investigated factors influencing targeting accuracy and efficacy of percutaneous stereotactic image-guided microwave ablation (SMWA) for malignant liver tumors.
Material and methods
All malignant liver tumors treated with SMWA over 3 years were analyzed in this observational study. A computed tomography-based navigation system was used for ablation probe trajectory planning, stereotactic probe positioning and validation of probe positions and ablation zones. Factors potentially influencing target positioning errors (TPE) of ablation probes, and local tumor progression (LTP) within 6 months, were analyzed using a multivariable regression model including challenging lesion locations (liver segments I, VII and VIII; subphrenic location).
Results
301 lesions (174 HCC, 87 CRLM, 17 NET, 23 other) were targeted in 191 interventions in 153 patients. Median TPE per ablation probe was 2.9 millimeters (0.2 - 14.1 mm) (n=384). Factors significantly influencing TPE were cirrhosis (R 0.668, CI 0.218 - 1.119) and targeting trajectory length in centimeters (R 0.205, CI 0.118 - 0.291). Overall technique efficacy was 96% and LTP within 6 months 22%. Factors significantly influencing early LTP were lesion size >30 mm (OR 5.221, CI 2.435 - 11.192) and TPE >5 mm (OR 2.480, CI 1.064 – 5.784). Challenging intrahepatic lesion locations had no significant influence on TPE or early LTP.
Conclusion
SMWA allows precise and effective treatment of malignant liver tumors, with targeting accuracy independently predicting efficacy, while unaffected by challenging lesion locations. This might broaden treatment eligibility for otherwise difficult-to-target liver tumors.