title: Microwave ablation of giant hepatic cavernous hemangiomas.
abstract: OBJECTIVE
  This study was designed to explore the safety and efficacy of percutaneous microwave (MW) ablation as an alternative treatment for symptomatic giant hepatic hemangiomas.
  
  
  METHODS
  Patients (n = 7; 6 females, 1 male; mean age = 44 years) with symptomatic, giant hemangiomas (n = 8) were treated with ultrasound-guided percutaneous MW ablation and followed for a mean of 18 months. Patient pain was recorded both before and after the procedure according to the 10-point visual analog scale. All patients were treated using one or three gas-cooled 17-gauge antennas powered by a 2.4-GHz generator (Neuwave Medical, Madison, WI). Mean ablation time was 11.6 min. Four patients received hydrodissection to protect the abdominal wall, colon, or gallbladder (5 % dextrose in water, mean volume 900 mL). Immediate postablation biphasic CT of the abdomen was performed, and four of seven patients have undergone delayed follow-up imaging.
  
  
  RESULTS
  All ablations were technically successful with no major or minor complications. Average pain score decreased from 4.6 to 0.9 (p < 0.05), and six of seven patients report resolution or improvement of symptoms at 18-month average follow-up (range 1-33 months). Immediately postablation, mean tumor diameter decreased 25 % (from 7.3 to 5.5 cm, p < 0.05) and volume decreased 62 % (from 301 to 113 cm(3), p < 0.05).
  
  
  CONCLUSIONS
  In this series, percutaneous MW ablation was safe, well-tolerated, and effective in markedly shrinking large hepatic hemangiomas and improving symptoms in most patients.
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/366, Madison, WI, 53792-3252, USA, tziemlewicz@uwhealth.org.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Ziemlewicz
authors.forename: Shane A
authors.initials: SA
authors.lastname: Wells
authors.forename: Meghan A
authors.initials: MA
authors.lastname: Lubner
authors.forename: Alexandru I
authors.initials: AI
authors.lastname: Musat
authors.forename: J Louis
authors.initials: JL
authors.lastname: Hinshaw
authors.forename: Alexandra R
authors.initials: AR
authors.lastname: Cohn
authors.forename: Fred T
authors.initials: FT
authors.lastname: Lee
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006392:Hemangioma, Cavernous / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000601:surgery; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008872:Microwaves; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods