Microwave Ablation of Small Hepatic Metastases Using MR Guidance and Monitoring: Clinical Safety and Efficacy

Cancer Manag Res. 2021 Apr 16:13:3357-3366. doi: 10.2147/CMAR.S301856. eCollection 2021.

Abstract

Background: To evaluate the technical success and clinical safety of magnetic resonance (MR)-guided microwave ablation (MWA) of small hepatic metastases.

Materials and methods: Institutional review board approval and informed patient consent were obtained. A retrospective analysis of the patient data revealed 50 patients with small hepatic metastases (34 men, 16 women) who underwent MWA under MR guidance and monitoring. After the procedure, the intervention-related complications were classified according to the Common Terminology Criteria for Adverse Events (CTCAE) and Society of Interventional Radiology (SIR) classification system. Furthermore, the overall survival (OS) and local tumor-free survival (LTP) of the patients were analyzed.

Results: The patients who underwent MR-guided MWA achieved technical success. The mean energy, ablation duration per tumor, and procedure duration were 55.3 ± 9.4 kJ, 11.7 ± 5.6 min and 89.5 ± 30.9 min, respectively. Most adverse events and complications were CTCAE grade 1 or 2 or SIR classification grade A or B. The 1-, 2-, and 3-year local tumor progression (LTP) rates were 65.9%, 31.5% and 18.5%, respectively, with a mean LTP of 19.216 months (95% CI: 16.208, 22.224); and the 1-, 2- and 3-year overall survival (OS) rates were 81.8%, 60.8% and 44.7%, respectively, with a mean OS of 26.378 months (95% CI: 23.485, 29.270). Multivariate Cox's regression analysis further illustrated that tumor location (challenging locations vs ordinary locations) and the anesthesia (general anesthesia VS local anesthesia) were important factors affecting LTP and OS.

Conclusion: MR-guided MWA can successfully treat small hepatic metastases with potentially favorable safety and technical efficacy.

Keywords: hepatic malignancies; liver tumors; magnetic resonance imaging; microwave ablation; tumor ablation.

Grants and funding

The present study was supported by the Science and technology project of the Henan Province (2017–2019) (172102310388) and the Key Scientific Research Projects of the Higher Education Institutions in the Henan Province (20A320024). This work was supported by the Provincial and ministerial youth projects and the Henan Medical Science and Technology Public Relations Program 2019 (SB201902015).