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Letter to Editor

Microwave coagulation therapy: the future is quite rosy

Paola Tombesi, Francesca Di Vece, Sergio Sartori

Department of Medical, Section of Interventional Ultrasound, St. Anna Hospital, 44100 Ferrara, Italy

Address for correspondence:
Prof. Sergio Sartori, Department of Medical, Section of Interventional Ultrasound, St. Anna Hospital, Via A. Moro, 44100 Ferrara, Italy.
E-mail: srs@unife.it
Received: 29-10-2015, Accepted: 09-11-2015

Prof. Sergio Sartori was born on June 22, 1954, and graduated cum laude in 1979. He is specialist in
Gastroenterology and in Clinical Pharmacology, is dealing with interventional ultrasonography from 1990,
and from 2002 is Chief of the Section of Interventional Ultrasound, St. Anna Hospital, Ferrara, Italy. He is
author of 246 scientific papers.

[5]
TO THE EDITOR device not suitable for percutaneous applications.
In the very last years, a miniaturized device for MW
We read with great interest the review of Guan on confinement has been developed (Mini Choke®),
[1]
microwave coagulation therapy (MCT) of hepatocellular that enables to minimize back heating effects using
carcinoma (HCC), and we strongly agree with his slender MW antennas and allowing for percutaneous
conclusion that MCT has a great promise for future applications (AMICA MWA System, HS Hospital Service,
use, especially with further technical improvements. Aprilia, Italy). In an experimental study, this system
produced thermal lesions of 6.5 cm × 4.5 cm in ex vivo
In this regard, one of the main limits of MCT [which bovine liver by delivering 60 W for 10 min. A randomized
[6]
discouraged its clinical application in many western prospective comparison of MCT and RFA reported
countries in favor of radiofrequency ablation (RFA)] significantly larger coagulation areas in vivo with MCT than
was the back heating effect, due to reflected waves with internally-cooled RFA, using a 16-gauge internally-
along the coaxial line. Such a drawback imposed to use cooled, minichoked MCT antenna with a power output of
large antennas and to deliver energy for a short time, 60-70 W and ablation time of 10 min. Although energy
[7]
achieving small ablation areas and requiring multiple delivery was underpowered with respect to the maximum
insertions even in the presence of small tumors. [2,3] power output of the system, MCT yielded ablation areas
Internally-cooled MCT partially reduced this problem, comparable to those previously reported by other authors
allowing for the increase of the ablation time and the who performed MCT using a power output of 100 W and
amount of power that could be safely delivered. The a 14-gauge cooled shaft antenna without choke device.
[4]
[8]
introduction into the distal portion of the antenna As the minichoked MWA system can also use a 14-gauge
of a choke coil was proposed to reduce back heating antenna with a power output of 100 W, it is hypothesizable
effects. However, this remedy caused remarkable that ablation areas even larger than those obtained
thickening of the antenna (9-10 gauge), making the in the above-mentioned in vivo comparison between
Access this article online MCT and RFA could be achieved using the maximum
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DOI:
10.4103/2394-5079.170543 How to cite this article: Tombesi P, Di Vece F, Sartori S. Microwave
coagulation therapy: the future is quite rosy. Hepatoma Res 2016;2:107-8.

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