Lung

Lung

 

Thermal ablation is an increasingly attractive choice for the treatment of unresectable tumors in the lung. Radiofrequency (RF) ablation, the most widely used modality, has several technical limitations that make it suboptimal for treating lung tumors. Normal aerated lung tissue is characterized by high electrical impedance, which limits RF current flow and decreases the amount of energy that can be deposited. Less energy deposition leads to lower tissue temperatures and smaller ablation zones, which ultimately increase the risk of a treatment failure. RF ablation is also limited by an inability to heat charred or desiccated tissue and to overcome the heat sink effect of local blood flow. Microwaves have been shown to be better for thermal ablation of lung tissue1-2
 
  • Lung tissue properties favorable for microwaves: RF ablation is hindered by the low electrical and thermal conductivity of aerated lung tissue. Microwaves do not rely on electrical conductivity and are less reliant on thermal conductivity than RF. Microwave energy penetration is not limited by the lower electrical permittivity and conductivity of inflated lung, desiccated tissue, or charred tissue.
  • Microwave antennas can be tuned lung tissue: Unlike RF, microwave antennas can be designed based on the unique characteristics of lung tissue. Tuning an antenna for a specific tissue environment helps maximize the energy delivered and resulting volume of ablation.
  • Multiple-antenna support: Unlike RF, which requires a switching algorithm to overcome undesirable electrical interactions between closely spaced electrodes, multiple microwave antennas can be used simultaneously to create extremely large ablation zones. 

 

References: 

1.      Brace CL, Laeseke PF, Sampson LA, Frey TM, van der Weide DW, Lee FT Jr. Microwave ablation with a single small-gauge triaxial antenna: in vivo porcine liver model. Radiology.   2007 Feb;242(2):435-40.
2.      Brace CL, Laeseke PF, Sampson LA, Frey TM, van der Weide DW, Lee FT Jr. Microwave ablation with small-gauge triaxial antennas: Multiple simultaneously-powered antennas create large volumes of ablation in vivo. Radiology. 2007 July;244(1)151-6.
3.      Laeseke PF, Lee FT Jr, van der Weide DW, Brace CL. Multiple-Antenna Microwave Ablation: Spatially Distributing Power Improves Thermal Profiles and Reduces Invasiveness. Journal of Interventional Oncology, in press.
4.      Wright AS, Lee FT Jr, Mahvi DM. Hepatic microwave ablation with multiple antennae results in synergistically larger zones of coagulation necrosis. Ann Surg Oncol. 2003 Apr;10(3):275-83.
5.      Wright AS, Sampson LA, Warner TF, Mahvi DM, Lee FT Jr. Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology. 2005 Jul;236(1):132-9.
6.      Yu NC, Raman SS, Kim YJ, Lassman C, Chang X, Lu DS. Microwave liver ablation: influence of hepatic vein size on heat-sink effect in a porcine model. J Vasc Interv Radiol. 2008 Jul;19(7):1087-92.
7.      Brace CL, Hinshaw JL, Laeseke PF, Diaz TA, Sampson LA, Lee FT Jr. Pulmonary thermal ablation: Comparing radiofrequency and microwave devices using gross pathology and CT imaging. Radiology, 2009 March 31.
8.      Durick NA, Laeseke PF, Broderick LS, Lee FT Jr, Sampson LA, Frey TM, Warner TF, Fine JP, van der Weide DW, Brace CL. Microwave Ablation with Triaxial Antennas Tuned for Lung: Results in an in vivo Porcine Model. Radiology. 2008;247 80-87.

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