title: Safety and Efficacy of Percutaneous Microwave Hepatic Ablation Near the Heart.
abstract: OBJECTIVE
  To evaluate safety and efficacy of percutaneous hepatic microwave (MW) ablation performed near the heart.
  
  
  METHODS
  This study reviewed 118 consecutive peripheral (ablation zone margins within 5 mm of liver capsule) percutaneous MW hepatic ablations performed between June 2010 and August 2015. Ablation zones of 27 tumors (22.8%) extended to ≤ 5 mm from myocardium, and these ablations comprised the study group; the remaining ablations formed the control group. The study cohort included 14 men and 10 women (mean age, 59 y) with 16 hepatocellular carcinomas, 9 metastases, and 2 hemangiomas. Periprocedural imaging was used to evaluate tumor size and distance from the heart, ablation zone size, and complications. Mean tumor size and distance to myocardium were 2.6 cm ± 1.7 and 1.1 cm ± 1.1, respectively. The electronic medical record was used to retrospectively assess local tumor progression (LTP) and electrocardiogram and hemodynamic alterations during and after ablation. Statistical analysis was performed with Fisher exact test and t test.
  
  
  RESULTS
  Median follow-up was 13.6 months (range, 1.2-38.7 months). No arrhythmias occurred during or after ablation in the follow-up period (0/27). There was no difference between groups in frequency of alterations in periprocedural blood pressure (25.9% vs 29.6%, p=0.81) or heart rate (18.5% vs 24.2%, P = .61) or rate of LTP (12.0% vs 10.8%, P = 1.0).
  
  
  CONCLUSIONS
  Percutaneous MW ablation near the heart may be safe and effective, without increased risk of cardiac complications and with similar rates of LTP, compared with a control group of peripheral liver ablations.
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792; Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792. Electronic address: gcarberry@uwhealth.org.
authors.forename: George A
authors.initials: GA
authors.lastname: Carberry
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Smolock
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792.
authors.forename: Mircea
authors.initials: M
authors.lastname: Cristescu
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792.
authors.forename: Shane A
authors.initials: SA
authors.lastname: Wells
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Ziemlewicz
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792.
authors.forename: Meghan G
authors.initials: MG
authors.lastname: Lubner
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792.
authors.forename: J Louis
authors.initials: JL
authors.lastname: Hinshaw
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792; Department of Radiology Biomedical Engineering, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Brace
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792; Department of Radiology Biomedical Engineering, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792.
authors.forename: Fred T
authors.initials: FT
authors.lastname: Lee
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D057286:Electronic Health Records; D005260:Female; D006335:Heart Injuries / Q000209:etiology / Q000517:prevention & control*; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D000072662:Margins of Excision; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden