A prospective randomized trial comparing microwave and radiofrequency ablation for the treatment of liver metastases using a dual ablation system ─ The Mira study. (2022)

• Record Type: Journal Article
• Authors: Vogl, Thomas J.; Jaraysa, Yousef; Martin, Simon S.; Gruber-Rouh, Tatjana; Savage, Rock H.; Nour-Eldin, Nour-Eldin A.; Mehmedovic, Amela
• Is Part Of: European journal of radiology open. Volume 9(2022)
• Publication Date: 2022
• Subjects: ADC apparent diffusion coefficient -- DR distant recurrence -- DWI diffusion-weighted imaging -- LTP local tumor progression -- MWA microwave ablation -- RFA radiofrequency ablation -- TACE transarterial chemoembolization; Ablation Techniques -- Liver -- Metastasis -- Magnetic resonance imaging -- Medical Oncology; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2022.100399
• Languages: English
• ISSNs: 2352-0477

Abstract

Abstract: Purpose: The aim of this study was to prospectively compare the therapy response and safety of microwave (MWA) and radiofrequency ablation (RFA) for the treatment of liver metastases using a dual ablation system. Methods: Fifty patients with liver metastases (23 men, mean age: 62.8 ± 11.8 years) were randomly assigned to MWA or RFA for thermal ablation using a one generator dual ablation system. Magnetic resonance imaging (MRI) was acquired before treatment and 24 h post ablation. The morphologic responses to treatment regarding size, volume, necrotic areas, and diffusion characteristics were evaluated by MRI. Imaging follow-up was obtained for one year in three months intervals, whereas clinical follow-up was obtained for two years in all patients. Results: Twenty-six patients received MWA and 24 patients received RFA (mean diameter: 1.6 cm, MWA: 1.7 cm, RFA: 1.5 cm). The mean volume 24 h after ablation was 37.0 cm 3 (MWA: 50.5 cm 3, RFA: 22.9 cm 3, P < 0.01). The local recurrence rate was 0% (0/26) in the MWA-group and 8.3% (2/24) in the RFA-group ( P = 0.09). The rate of newly developed malignant formations was 38.0% (19/50) for both groups (MWA: 38.4%, RFA: 37.5%, P = 0.07). The overall survival rate was 70.0% (35/50) after two years (MWA: 76.9%, RFA: 62.5%, P = 0.60). No major complications were reported. Conclusion: In conclusion, MWA and RFA are both safe and effective methods for the treatment of liver metastases with MWA generating greater volumes of ablation. No significant differences were found for overall survival, rate of neoplasm, or major complications between both groups. Highlights: A dual ablation system allows for MWA and RFA treatment using the same hardware. Both methods are safe and effective for the treatment of liver metastases. MWA generates greater volumes of ablation and larger ablative margins compared to RFA.