The long-term objective of this project is to improve devices and techniques for microwave tumor ablation and extend its application into new patient populations by optimizing system design and energy delivery in several tissue types. Microwave ablation is superior to currently available technologies in many respects: microwaves provide rapid volumetric heating, leading to more precise and complete treatments;microwave heating is less dependent on tissue properties, making it more suitable for emerging targets (e.g., lung and bone);and using multiple antennas improves treatment control, precision and efficacy. Unfortunately, current systems have failed to deliver on these promises and patients who could benefit from improved therapies have suffered. This proposal is based on the idea that understanding more about microwave tissue heating will facilitate development of optimized systems and techniques that will enhance patient benefit and expand the role of microwave ablation in cancer care. As microwave ablation systems begin to enter the marketplace, optimized treatment protocols will be required to enhance patient benefit and expand the role of microwave ablation in clinical cancer care. To this end, we propose to: 1) Create improved numerical models of tissue to more accurately predict device performance. Hypothesis: Accurate tissue models improve numerical simulations, easing design and treatment optimization. 2) Optimize antenna designs and power delivery for tissue-specific treatments Hypotheses: Antenna design and frequencies can be optimized for specific tissues or treatment targets. Applying high-power pulses will more rapidly coagulate tissue microvasculature to improve efficacy. When combined, these optimizations will create ablations 50% faster and 25% larger than current systems. 3) Develop multiple-antenna application techniques to optimize treatment speed and specificity. Hypotheses: Multiple-antenna techniques improve efficacy and precision, allowing more tailored treatments without increasing invasiveness. Ablations can be created by 50% faster and 40% larger than current systems. 4) Facilitate real-time adaptive power control by using integrated treatment monitoring Hypothesis: Treatment monitoring can be accomplished without imaging, using only the interstitial applicator. If successful, this project will advance knowledge of microwave tissue heating, and create innovative and unique approaches to power delivery that utilize all of the advantages that microwaves offer.
These aims will substantially change clinical practice by increasing the size of tumors that can be treated with microwaves, further broadening the scope of microwave ablation to areas outside the liver and increasing the number of patients benefiting from minimally invasive treatments.
This proposal will combine the best of engineering and medicine to better understand how ablations are created, develop tools for improved system design, and create a cancer treatment platform that requires minimal invasiveness to provide maximal patient benefit.
|Klapperich, Marki E; Abel, E Jason; Ziemlewicz, Timothy J et al. (2017) Effect of Tumor Complexity and Technique on Efficacy and Complications after Percutaneous Microwave Ablation of Stage T1a Renal Cell Carcinoma: A Single-Center, Retrospective Study. Radiology 284:272-280|
|Liu, Dong; Brace, Christopher L (2017) Numerical simulation of microwave ablation incorporating tissue contraction based on thermal dose. Phys Med Biol 62:2070-2086|
|Chiang, Jason; Nickel, Kwang; Kimple, Randall J et al. (2017) Potential Mechanisms of Vascular Thrombosis after Microwave Ablation in an in Vivo Liver. J Vasc Interv Radiol 28:1053-1058|
|Harari, Colin M; Magagna, Michelle; Bedoya, Mariajose et al. (2016) Microwave Ablation: Comparison of Simultaneous and Sequential Activation of Multiple Antennas in Liver Model Systems. Radiology 278:95-103|
|Potretzke, Theodora A; Ziemlewicz, Timothy J; Hinshaw, J Louis et al. (2016) Microwave versus Radiofrequency Ablation Treatment for Hepatocellular Carcinoma: A Comparison of Efficacy at a Single Center. J Vasc Interv Radiol 27:631-8|
|Chiang, Jason; Cristescu, Mircea; Lee, Matthew H et al. (2016) Effects of Microwave Ablation on Arterial and Venous Vasculature after Treatment of Hepatocellular Carcinoma. Radiology 281:617-624|
|Wells, Shane A; Hinshaw, J Louis; Lubner, Meghan G et al. (2015) Liver Ablation: Best Practice. Radiol Clin North Am 53:933-71|
|Chiang, Jason; Birla, Sohan; Bedoya, Mariajose et al. (2015) Modeling and validation of microwave ablations with internal vaporization. IEEE Trans Biomed Eng 62:657-63|
|Ziemlewicz, Timothy J; Hinshaw, J Louis; Lubner, Meghan G et al. (2015) Percutaneous microwave ablation of hepatocellular carcinoma with a gas-cooled system: initial clinical results with 107 tumors. J Vasc Interv Radiol 26:62-8|
|Moreland, Anna J; Lubner, Meghan G; Ziemlewicz, Timothy J et al. (2015) Evaluation of a thermoprotective gel for hydrodissection during percutaneous microwave ablation: in vivo results. Cardiovasc Intervent Radiol 38:722-30|
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