Search Results (211)

Thermal ablation has been widely used for patients with small colorectal liver metastases (CRLMs), even for resectable cases; however, solid evidence has been scarce. (1) Thermal ablation versus liver resection. Some propensity-score matching studies using patients with balanced baseline characteristics have confirmed less invasiveness and the comparable survival benefits of thermal ablation to liver resection. A more recent pivotal randomized controlled trial comparing thermal ablation and liver resection was presented during the American Society of Clinical Oncology 2024 meeting. Diameter ≤ 3 cm, ten or fewer resectable and ablatable CRLMs were assigned to thermal ablation or liver resection. No differences were observed in the overall survival and local and distant progression-free survival with less morbidity. (2) Combination of thermal ablation and liver resection. Four matching studies demonstrated comparable data between the combination and liver resection alone groups in the long-term survival and recurrence rates without increasing the postoperative complication rates. The selection of the two approaches depends primarily on the number, size, and location of the CRLMs. (3) Chemotherapy in combination with thermal ablation. A propensity-score matching study comparing thermal ablation ± neoadjuvant chemotherapy was conducted. The addition of neoadjuvant chemotherapy was an independent predictive factor for good progression-free survival without increasing morbidity. Two randomized controlled trials demonstrated that additional thermal ablation to systemic chemotherapy can improve the overall survival for initially unresectable CRLMs. (4) Conclusions. Thermal ablation can provide survival benefits for patients with CRLMs in various situations, keeping adequate indications. Full article

Background: The aim of this study was to compare microwave ablation (MWA) with and without prior placement of an intra-arterial catheter for the purpose of application of contrast medium (CM). Methods: 148 patients (45 female, 65.1 ± 14.9 years) with liver tumors who underwent CT-guided MWA were included. Of these, 25 patients had an IA catheter placed in the hepatic artery. Results: 37 patients underwent planning imaging for MWA without CM. A total of 86 patients received a standard dose of 80 mL intravenous (IV) CM for the planning scans. The patients with an IA catheter (n = 25) received an IA application of 10 mL CM. A total of 29 patients received contrast-enhanced scans in the PV phase for control of needle positioning after IV application of a standard dose of 80 mL CM. In patients with an IA catheter, control of the needle position was performed by single-slice scans. IA CM application during the ablation enabled monitoring of the ablation zone. Over the entire intervention, patients with IA catheters received less CM as compared to patients without an IA catheter (39.1 ± 10.4 mL vs. 141 ± 39.69 mL; p < 0.001). Conclusions: IA catheter placement was associated with a significant decrease of the amount of CM during MWA and enabled monitoring of the ablation zone. Full article

Carbon quantum dots (CQDs) are innovative carbon-based nanomaterials that can be synthesized from organic and inorganic sources using two approaches: “top-down” (laser ablation, arc discharge, electrochemical, and acidic oxidation) and “bottom-up” (hydrothermal, ultrasound-assisted, microwave, and thermal decomposition). Among these, hydrothermal synthesis stands out as the best option as it is affordable and eco-friendly and can produce a high quantum yield. Due to their exceptional physical and chemical properties, CQDs are highly promising materials for diverse applications, i.e., medicine, bioimaging, and especially in food safety, which is one of the thriving fields of recent research worldwide. As an innovative sensing tool, CQDs with different surface functional groups enable them to detect food contaminants, i.e., food additives in processed food, drug residues in honey, and mycotoxins in beer and flour, based on different sensing mechanisms (IFE, PET, and FRET). This article discussed the sources, fabrication methods, advantages, and limitations of CQDs as a sensing for the detection of food contaminants. In addition, the cost-effectiveness, eco-friendliness, high quantum yield, safety concerns, and future research perspectives to enhance food quality and security were briefly highlighted. This review also explored recent advancements in CQD applications in food safety, supported by a bibliometric analysis (2014–2024) using the PubMed database. Full article

The standard of care for early-stage NSCLC has historically been surgical resection. Given the association of lung cancer with smoking, a large number of early-stage patients also have active smoking-related medical comorbidities such as COPD precluding surgery. The current approach for treating such inoperable patients is frequently considered to be stereotactic body radiation therapy (SBRT). SBRT (also known as stereotactic ablative radiation therapy or SABR) is a curative modality that precisely delivers very high dose radiation in few (typically <5) sessions. That said, because of their minimal invasiveness and repeatable nature, image-guided thermal ablation therapies such as radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation (CA) have also been used to treat early-stage lung tumors. For those patients deemed to have “high operative risk” (i.e., those who cannot tolerate lobectomy, but are candidates for sublobar resection), the appropriateness of potential alternatives [e.g., SBRT; ablation] to surgery is an active area of investigation. In the absence of completed randomized phase III trials, the approach to comparing outcomes between surgery, SBRT, or ablative therapies by their efficacy or equivalence is complex. An overview of the role of SBRT and other non-surgical modalities in the management of early-stage lung cancer is the subject of the present review. Full article

Purpose: To evaluate the efficacy and safety of the Surgnova Dophi™ M150E microwave ablation system in a prospective single-center observational study. Methods: A cohort of 50 patients with 77 primary or secondary liver tumors underwent CT-navigated stereotactic percutaneous microwave ablation with curative intention using the Surgnova Dophi™ M150E system. The endpoints were primary technique efficacy (PTE), number of complications, ablation defect dimensions, and sphericity index compared to previously reported findings. Results: The PTE was 97.4%, with complete ablation in 75 out of 77 tumors. Complications occurred in 10% of patients, with 4% classified as major. A comparison with previous in vivo data confirmed the reliability of the system in achieving reproducible and predictable ablation results. Conclusions: Stereotactic percutaneous microwave ablation with the Surgnova Dophi™ M150E system is safe and effective for liver tumor treatment. Full article

Microwave ablation often involves the use of continuous energy-delivery protocols with a fixed power and time. To achieve larger ablation zones, a range of protocols and power levels have been studied in experimental studies. The objective of the present study was to develop and experimentally evaluate the performance of a coupled computational electromagnetic–bioheat transfer model of 2.45 GHz microwave ablation under a variety of continuous and pulsed power delivery schemes. The main aim was to obtain an in-depth knowledge of the influence of energy delivery settings on ablation zone profiles and thermal damage in the peri-ablation zone. In addition to the theoretical model, we evaluated the power delivery schemes using ex vivo experiments and compared them to previously published data from in vivo experiments. The results showed slight differences in terms of the ablation zone size for different power delivery schemes under ex vivo conditions, with the applied energy level being the most important factor that determines ablation zone size; however, under in vivo conditions, applying a high-power pulse prior to and following a longer constant power application (BOOKEND 95 W protocol) presented the most favorable ablation zones. Moreover, the modeling and experimental studies identified threshold applied power and ablation times beyond which increases did not yield substantive increases in ablation zone extents. Full article

Background/Objectives: Spinal metastases are a frequent and serious complication in cancer patients, often causing severe pain, instability, and neurological deficits. Thermal ablation techniques such as radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation (CA) have emerged as minimally invasive treatments. These techniques rely on precise imaging guidance to effectively target lesions while minimizing complications. This systematic review aims to compare the efficacy of different imaging modalities—computed tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, and mixed techniques—in guiding thermal ablation for spinal metastases, focusing on success rates and complications. Methods: A systematic literature search was conducted across PubMed, OVID, Google Scholar, and Web of Science databases, yielding 3733 studies. After screening, 51 studies met the eligibility criteria. Data on success rates, tumor recurrence, complications, and patient outcomes were extracted. Success was defined as no procedure-related mortality, tumor recurrence or expansion, or nerve injury. This systematic review followed PRISMA guidelines and was registered with PROSPERO (ID: CRD42024567174). Results: CT-guided thermal ablation demonstrated high success rates, especially with RFA (75% complete success). Although less frequently employed, MRI guidance showed lower complication rates and improved soft-tissue contrast. Fluoroscopy-guided procedures were effective but had a higher incidence of nerve injury and incomplete tumor control. Mixed imaging techniques, such as CBCT-MRI fusion, showed potential for reducing complications and improving targeting accuracy. Conclusions: CT remains the most reliable imaging modality for guiding thermal ablation in spinal metastases, while MRI provides enhanced safety in complex cases. Fluoroscopy, although effective for real-time guidance, presents limitations in soft-tissue contrast. Mixed imaging techniques like CBCT-MRI fusion offer promising solutions by combining the advantages of both CT and MRI, warranting further exploration in future studies. Full article

Background: Complications, particularly pneumothorax, are common following lung interventions and occasionally necessitate further examinations, extend hospital stays, increase treatment costs, and result in long-term health impairment or even death. A few lung intervention tract sealants have been explored to reduce procedure-related complications. Objectives: The primary objective of this prospective non-randomized study was to assess the complication rates and risk factors for computed tomography-guided lung microwave ablation (MWA) with autologous blood clot as a tract sealant. Methods: Twenty-one patients underwent a total of 26 MWA sessions for lung malignancy followed by injection of the patient’s clotted venous blood into the ablation tract while retracting the coaxial needle. Ablation tract sealing was successful in all MWA sessions. Results: Pneumothorax was the only complication observed in five (19.2%) sessions, with one patient (3.8%) requiring chest tube insertion. The male sex was a statistically significant risk factor for pneumothorax (p = 0.042), and patients with lung emphysema had almost fivefold higher odds of developing pneumothorax (OR 4.8; 95% CI, 0.617–37.351; p = 0.281). Conclusions: This study concludes that pneumothorax is the primary complication following lung MWA, and the male sex is a risk factor. Ablation tract sealing with autologous venous blood is a straightforward and inexpensive technique that can reduce the incidence of procedure-related pneumothorax. Full article

Background: Several locoregional treatments approaches, including thermoablation, have been tested for the treatment of intrahepatic cholangiocarcinoma (ICC) and have shown encouraging results. However, data are heterogeneous in terms of tumor number, size, and ablation technique. Objective: The aim of this study was to investigate the efficacy and prognostic factors in ICC treated by monopolar radiofrequency (RF) or microwave ablation (MW). Methods: This was a retrospective study including patients treated with RF or MW for ICC in six participating centers. DFS and OS were evaluated by the Kaplan–Meier method and prognostic factors by log-rank test and Cox modeling. Results: From January 2015 to October 2023, 24 patients with 31 nodules were treated with RFA or MW. Overall, 70% had chronic liver disease, with 50% at cirrhosis stage. The median size of lesions was 17 mm (6–35 mm). After a median follow-up of 33 months (5–85), the median DFS was 10.5 months. The median OS was 40.8 months. On univariate and multivariate analysis, only lesion size > 17 mm was associated with a poor OS (HR 3.09; IC [1.02; 9.37] (p = 0.04). Conclusions: Monopolar radiofrequency or microwave ablation is an alternative to surgery for small ICCs. Tumors < 17 mm were associated with better OS. Full article

Background: Robotic hepatectomy represents an appealing treatment modality for resectable hepatocellular carcinoma (HCC). A contemporary review of robotic hepatectomy compared to laparoscopic/open hepatectomy is necessary. Methods: We performed a literature review to identify studies between 2018–2024 comparing robotic to laparoscopic/open hepatectomy for HCC with measurable outcomes. Results: A total of 10 studies were identified, including 943 patients undergoing robotic hepatectomy compared to 1678 patients undergoing laparoscopic/open hepatectomy. Generally, while similar short/long-term survival was noted across all resection modalities, robotic hepatectomy was associated with longer operative time, shorter length of stay, and less post-operative complications. An additional 4 studies were evaluated in the context of HCC, reviewing the prognostic value of robotic hepatectomy margins, robotic hepatectomy in the context of metabolic syndrome, “huge” (>10 cm) HCCs, and robotic hepatectomy vs. microwave ablation. Conclusions: Robotic hepatectomy is a safe alternative to laparoscopic/open hepatectomy for HCC that provides similar oncological/long-term outcomes, while potentially decreasing post-operative complications and length of stay. Full article

Microwave ablation is becoming a standard procedure for treating tumors based on heat generation, causing an elevation in the tissue temperature level from 50 to 60 °C, causing tissue death. Microwave ablation is associated with uniform cell killing within ablation zones, multiple-antenna capability, low complication rates, and long-term survival. Several reports have demonstrated that multiple-antenna microwave ablation is a promising strategy for safely, rapidly, and effectively treating large tumors. The key advantage of multi-antenna tumor microwave ablation is the creation of a large, well-defined ablation zone without excessively long treatment times or high power that can damage healthy tissue. The strategic positioning of multiple probes provides a fully ablated volume, even in regions where individual probe damage is incomplete. Accurate modeling of the complex thermal and electromagnetic behaviors of tissue is critical for optimizing microwave ablation because material parameters and tissue responses can change significantly during the procedure. In the case of multi-antenna microwave ablation, the calculation complexity increases significantly, requiring significant computational resources and time. This study aimed to evaluate the efficacy and safety of liver percutaneous microwave ablation using the simultaneous activation of three antennas for the treatment of lesions larger than 3 cm. Based on the known results from a single-probe setup, researchers can estimate and evaluate various spatial configurations of the three-probe array to identify the optimal arrangement. Due to the synergistic effects of the combined radiation from the three antennas, the resulting ablation zone can be significantly larger, leading to better outcomes in terms of treatment time and effectiveness. The obtained results revealed that volumetric damage and the amount of damaged healthy tissue are smaller for a three-antenna configuration than for microwave ablation using a single-antenna and two-antenna configurations. Full article

Background: Intrathoracic goiters (ITGs) are usually managed by surgical excision, However, over recent years, non-surgical strategies are emerging as an alternatives for treating this condition. Methods: A systematic review of research published since 2017 in the PubMed database was conducted and a total of 39 articles were retrieved, along with methodological issues and future directions in the research on ITGs. Results: Several non-surgical treatments exist, including radio-iodine ablation (RIA) and mini-invasive approaches, such as transcervical microwave ablation (TcMA), transcervical radiofrequency ablation (TcRfA), or selective embolization of the thyroid arteries (SETA). Despite encouraging reports, their current use remains limited. Conclusions: Treatment of ITGs requires a multidisciplinary thyroid team, and when non-surgical options are chosen, patients need to be carefully selected, and their outcomes must be prudently considered and discussed with the patient. Full article

The triboelectric nanogenerator (TENG) has demonstrated exceptional efficiency in harvesting diverse forms of mechanical energy and converting it into electrical energy. This technology is particularly valuable for powering low-energy electronic devices and self-powered sensors. Most traditional TENGs use single-sided patterned friction pairs, which restrict their effective contact area and overall performance. Here, we propose a novel TENG that incorporates microwave patterned aluminum (MC-Al) foil and microcone structured polydimethylsiloxane (MC-PDMS). This innovative design utilizes two PMMA molds featuring identical micro-hole arrays ablated by a CO₂ laser, making it both cost-effective and easy to fabricate. A novel room imprinting technique has been employed to create the micromorphology of aluminum (Al) foil using the PMMA mold with shallower micro-hole arrays. Compared to TENGs with flat friction layers and single-side-patterned friction layers, the double-side-patterned MW-MC-TENG demonstrates superior output performance due to increased cone deformation and contact area. The open-circuit voltage of the MW-MC-TENG can reach 141 V, while the short-circuit current can attain 71.5 μA, corresponding to a current density of 2.86 µA/cm². The power density reaches 1.4 mW/cm² when the resistance is 15 MΩ, and it can charge a 0.1 μF capacitor to 2.01 V in 2.28 s. In addition, the MW-MC-TENG can function as an insole device to harvest walking energy, power 11 LED bulbs, monitor step speed, and power a timer device. Therefore, the MW-MC-TENG has significant application potential in micro-wearable devices. Full article

Hepatocellular carcinoma (HCC), the most prevalent form of liver cancer, represents a significant global health challenge due to its rising incidence, complex management, as well as recurrence rates of up to 70% or more. Early and accurate imaging diagnosis, through modalities such as ultrasound, CT, and MRI, is crucial for effective treatment. Minimally invasive therapies, including thermal ablation methods such as radiofrequency ablation, microwave ablation, laser ablation, high-intensity focused ultrasound, and cryoablation, as well as non-thermal methods like percutaneous ethanol injection and irreversible electroporation, have shown promise in treating early and intermediate stages of HCC. Some studies have reported complete response in more than 90% of nodules and survival rates of up to 60–85% at 5 years after the procedure. These therapies are increasingly employed and induce specific morphological and physiological changes in the tumor and surrounding liver tissue, which are critical to monitor for assessing treatment efficacy and detecting recurrence. This review highlights the imaging characteristics of HCC following non-surgical treatments, focusing on the common features, challenges in post-treatment evaluation, and the importance of standardized imaging protocols such as the Liver Imaging Reporting and Data System. Understanding these imaging features is essential for radiologists to accurately assess tumor viability and guide further therapeutic decisions, ultimately improving patient outcomes. Full article

Background/Objectives: Microwave ablation (MWA) is the leading therapy method for treating patients with liver cancer. MWA simulation is used to further improve the therapy and to help develop new devices. Methods: A water-cooled ablation needle was reconstructed. MWA simulations of a polyacrylamide phantom were carried out and compared with a representative clinical example (tumor diameter: 8.75 mm). The Arrhenius damage model and a critical temperature approach of 60 °C were applied to assess the necrosis zones. Finally, the simulation results were compared to the corresponding MR measurements. Results: Most of the heating in the simulation took place at a distance of 5 mm along the transverse axis and 20 mm along the longitudinal axis above the needle tip. The calculated Dice scores for the Arrhenius model were 0.77/0.53 for the phantom/clinical case. For the critical temperature approach, Dice scores of 0.60/0.66 for the phantom/clinical case were achieved. Conclusions: The comparison between simulated and measured temperature increases showed an excellent agreement. However, differences in the predicted necrosis volume might be caused by omitting consideration of the heat sink effect, especially in the clinical case. Nevertheless, this workflow enables short MWA simulation times (approximately 3 min) and demonstrates a step towards possible integration into daily clinical use. Full article