title: Microwave ablation in a hepatic porcine model: correlation of CT and histopathologic findings.
abstract: BACKGROUND
  Thermal ablative techniques have gained increasing popularity in recent years as safe and effective options for patients with unresectable solid malignancies. Microwave ablation has emerged as a relatively new technique with the promise of larger and faster burns without some of the limitations of radiofrequency ablation (RFA). Here we study a new microwave ablation device in a living porcine model using gross, histologic, and radiographic analysis.
  
  
  METHODS
  The size and shape of ablated lesions were assessed using six pigs in a non-survival study. Liver tissue was ablated using 2, 4, and 8 min burns, in both peripheral and central locations, with and without vascular inflow occlusion. To characterize the post-ablation appearance, three additional pigs underwent several 4 min ablations each followed by serial computed tomography (CT) imaging at 7, 14, and 28 days postoperatively.
  
  
  RESULTS
  The 2 and 4 min ablations resulted in lesions that were similar in size, 33.5 cm(3) and 37.5 cm(3), respectively. Ablations lasting 8 min produced lesions that were significantly larger, 92.0 cm(3) on average. Proximity to hepatic vasculature and inflow occlusion did not significantly change lesion size or shape. In follow-up studies, CT imaging showed a gradual reduction in lesion volume over 28 days to 25-50% of the original volume.
  
  
  CONCLUSIONS
  Microwave ablation with a novel device results in consistently sized and shaped lesions. Importantly, we did not observe any significant heat-sink effect using this device, a major difference from RFA techniques. This system offers a viable alternative for creating fast, large ablation volumes for treatment in liver cancer.
authors.affiliation: Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Awad
authors.forename: Lara
authors.initials: L
authors.lastname: Devgan
authors.forename: Ihab R
authors.initials: IR
authors.lastname: Kamel
authors.forename: Michael
authors.initials: M
authors.lastname: Torbensen
authors.forename: Michael A
authors.initials: MA
authors.lastname: Choti