The Pipeline

Are you on the cutting edge of interventional radiology?

David Gaffin and Cameron Ferrey, Technology Insights

Last week marked the conclusion of the sixth annual Symposium on Clinical Interventional Oncology (CIO), the fastest growing interventional oncology conference in North America. 

This year, CIO again highlighted the most viable new treatments and best practices in interventional oncology while showcasing the latest research and developments on progressive interventional oncology treatment technologies and procedures. This is the first in a series of posts covering studies presented at CIO this year.

New information on the safety of microwave ablation

Microwave ablation (MWA) procedures—used to treat hepatocellular carcinoma—may be uniquely associated with active venous extravasation immediately post ablation, according to an 18-month study involving 63 MWA cases presented at the 2014 Symposium on Clinical Interventional Oncology. 

According to the study authors, their findings may be a result of the higher heat deposition created by MWA when compared to the most widely used thermal ablative technique, radiofrequency ablation (RFA), resulting in increased tissue dehydration and damage to peripheral vessels.

Although inconclusive, these findings are significant because MWA is usually considered superior to RFA due to the higher temperatures, shorter treatment times, and larger, more predictable treatment zones afforded by MWA treatment. 

If MWA is indeed associated with higher chances of extravasation, and thereby higher rates of metastasis, it could call into question its clinical advantage over RFA treatment, which has been steadily replacing RFA in U.S. hospitals. As noted by the researchers, however, “further studies on the effects of MWA on the vessel wall are needed.”

Improving the accuracy, safety of microwave ablation procedures

Another study on MWA treatment of hepatic tumors presented at CIO focused on the benefits of hydrodissection in preventing thermal damage to vulnerable tissues adjacent to ablation zones. 

The researchers concluded that intraperitoneal fluid administration is a safe and effective way to protect non-target structures during hepatic MWA procedures, that it allows for more aggressive case selection, and that it is not associated with higher rates of post-operative complications.

If accurate, these findings could support hydrodissection as a viable method for mitigating some of the potential dangers associated with higher heat dissemination during MWA treatment compared to traditional RFA treatment. further supporting adoption of MWA as a superior treatment option without significant additional risks.

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