Comparison of parallel and crossed placement of antennas in microwave ablation of 3–5 cm hepatocellular carcinoma

  • Li-nan Dong
  • Xiao-ling Yu
  • Zhi-gang Cheng
  • Zhi-yu Han
  • Fang-yi Liu
  • Gang Chen
  • Yan-chun Luo
  • Jie YuEmail author
  • Ping LiangEmail author



To evaluate the effects of ablation strategies on local tumor progression (LTP) after microwave ablation (MWA) of hepatocellular carcinomas (HCCs) measuring 3–5 cm.

Materials and methods

Between December 2011 and May 2017, 71 HCC patients with 71 nodules treated by ultrasound(US)-guided percutaneous MWA were divided into parallel (group A) and crossed (group B) antenna placement groups. All patients underwent MWA using two antennas with four insertions. LTP and overall survival (OS) rates were compared between the two groups.


The median follow-up time was 16.8 months. There was no significant difference in the complete ablation rate and treatment sessions between the two groups. LTP was diagnosed in 8 of 48 nodules (16.7%) in group A and 1 of 23 nodules (4.3%) in group B, with no significant difference between two groups (P = 0.115). The 1-, 2-, and 3-year OS rates were 88.5%, 79%, and 71.8% in group A and 93.8%, 87.5%, and 87.5% in group B, respectively (P = 0.236). Multivariate analysis showed that the tumor diameter (P = 0.017), the distance between the antennas (P = 0.032), and the total emission time (P = 0.015) were associated with LTP.


There were trends with lower LTP and improved OS in group B, despite the lack of statistically significant differences between the two strategies at a level of P < 0.05. The increase of distance between antennas and total emission time will facilitate reductions in LTP rate.


Ablation strategy Microwave ablation Hepatocellular carcinoma 



This work was supported by three Grants: [2017YFC0112000] from National Key R&D Program of China, and [81627803, 81671710, 81471683, and 81622024] from the national nature science foundation of China.


This work was supported by the National Key R&D Program of China (2017YFC0112000), and the National Natural Scientific Foundation of China (81627803, 81622024, 81671710, and 81471683).

Compliance with ethical standards

Conflict of interest

All the authors declare no conflict of interest.


  1. 1.
    Liang P, Jie Yu, Ming-De L, et al. (2013) Practice guidelines for ultrasound-guided percutaneous microwave ablation for hepatic malignancy. World J Gastroenterol 19(33):5430–5438CrossRefGoogle Scholar
  2. 2.
    Bruix J, Sherman M (2011) Management of hepatocellular carcinoma: An update. Hepatology 53:1020–1022CrossRefGoogle Scholar
  3. 3.
    Makuuchi M, Kokudo N, Arii S, et al. (2008) Development of evidence based clinical guidelines for the diagnosis and treatment of hepatocellular carcinoma in Japan. Hepatol Res 38:37–51CrossRefGoogle Scholar
  4. 4.
    Sakaguchi H, Seki S, Tsuji K, et al. (2009) Endoscopic thermal ablation therapies for hepatocellular carcinoma: a multi-center study. Hepatol Res 39:47–52CrossRefGoogle Scholar
  5. 5.
    Liang P, Yu J, Yu X-l, et al. (2011) Percutaneous cooled-tip microwave ablation under ultrasound guidance for primary liver cancer: a multicentre analysis of 1363 treatment-naive lesions in 1007 patients in China. Gut 61:1100–1101CrossRefGoogle Scholar
  6. 6.
    Swan RZ, Sindram D, Martinie JB, Iannitti DA (2013) Operative microwave ablation for hepatocellular carcinoma: complications, recurrence, and long-term outcomes. J Gastrointest Surg 17:719–729CrossRefGoogle Scholar
  7. 7.
    Wright AS, Sampson LA, Warner TF, Mahvi DM, Lee FT Jr (2005) Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology 236:132–139CrossRefGoogle Scholar
  8. 8.
    Wright AS, Lee FT Jr, Mahvi DM (2003) Hepatic microwave ablation with multiple antennae results in synergistically larger zones of coagulation necrosis. Ann Surg Oncol 10:275–283CrossRefGoogle Scholar
  9. 9.
    Vogl TJ, Nour-Eldin NA, Hammerstingl RM, Panahi B, Naguib NNN (2017) Microwave ablation (MWA): basics, technique and results in primary and metastatic liver neoplasms. Rofo 189(11):1055–1066CrossRefGoogle Scholar
  10. 10.
    Meloni MF, Galimberti S, Dietrich CF, et al. (2016) Microwave ablation of hepatic tumors with a third generation system: loco-regional efficacy in a prospective cohort study with intermediate term follow-up. Z Gastroenterol 54(6):541–547CrossRefGoogle Scholar
  11. 11.
    Lu MD, Xu HX, Xie XY, et al. (2005) Percutaneous microwave and radiofrequency ablation for hepatocellular carcinoma: a retrospective comparative study. J Gastroenterol 40:1054–1060CrossRefGoogle Scholar
  12. 12.
    Zhang L, Wang N, Shen Q, Cheng W, Qian GJ (2013) Therapeutic efficacy of percutaneous radiofrequency ablation versus microwave ablation for hepatocellular carcinoma. PLoS ONE 8(10):e76119CrossRefGoogle Scholar
  13. 13.
    Yin XY, Xie XY, Lu MD, et al. (2009) Percutaneous thermal ablation of medium and large hepatocellular carcinoma: long-term outcome and prognostic factors. Cancer 115(9):1914–1923CrossRefGoogle Scholar
  14. 14.
    Liu Y, Zheng Y, Li S, et al. (2013) Percutaneous microwave ablation of larger hepatocellular carcinoma. Clin Radiol 68:21–26CrossRefGoogle Scholar
  15. 15.
    Jie Yu, Liang P, Xiao-ling Yu, et al. (2015) Local tumour progression after ultrasound-guided microwave ablation of liver malignancies: risk factors analysis of 2529 tumours. Eur Radiol 25:1119–1126CrossRefGoogle Scholar
  16. 16.
    Mulier S, Ni Y, Jamart J, et al. (2005) Local recurrence after hepatic radiofrequency coagulation: multivariate meta-analysis and review of contributing factors. Ann Surg 242:158e71CrossRefGoogle Scholar
  17. 17.
    Liu F-Y, Xiao-Ling Yu, Liang P, et al. (2010) Comparison of percutaneous 915 MHz microwave ablation and 2450 MHz microwave ablation in large hepatocellular carcinoma. Int J Hyperthermia 26(5):448–455CrossRefGoogle Scholar
  18. 18.
    Jie Yu, Liang P, Xiao-ling Yu, et al. (2014) US-guided percutaneous microwave ablation versus open radical nephrectomy for small renal cell carcinoma: intermediate-term results 1. Radiology 270:880–887CrossRefGoogle Scholar
  19. 19.
    Oshima F, Yamakado K, Nakatsuka A, et al. (2008) Simultaneous microwave ablation using multiple antennas in explanted bovine livers: relationship between ablative zone and antenna. Radiat Med 26(7):408–414CrossRefGoogle Scholar
  20. 20.
    Kim YS, Lee WJ, Rhim H, et al. (2010) The minimal ablative margin of radiofrequency ablation of hepato-cellular carcinoma (> 2 and < 5 cm) needed to prevent local tumor progression: 3D quantitative assessment using CT image fusion. AJR Am J Roentgenol 195(3):758–765CrossRefGoogle Scholar
  21. 21.
    Liu CH, Arellano RS, Uppot RN, et al. (2010) Radiofrequency ablation of hepatic tumours: effect of post-ablation margin on local tumour progression. Eur Radiol 20(4):877–885CrossRefGoogle Scholar
  22. 22.
    Yu J, Liang P, Xiaoling Y, et al. (2011) A comparison of microwave ablation and bipolar radiofrequency ablation both with an internally cooled probe: results in ex vivo and in vivo porcine livers. Eur J Radiol 79:124–130CrossRefGoogle Scholar
  23. 23.
    Poulou LS, Botsa E, Thanou I, Ziakas PD, Thanos L (2015) Percutaneous microwave ablation vs radiofrequency ablation in the treatment of hepatocellular carcinoma. World J Hepatol 7(8):1054–1063CrossRefGoogle Scholar
  24. 24.
    Harari CM, Magagna M, Bedoya M, et al. (2016) Microwave ablation: comparison of simultaneous and sequential activation of multiple antennas in liver model systems. Radiology 278:95–103CrossRefGoogle Scholar
  25. 25.
    Laeseke PF, Jr Lee FT, van der Weide DW, Brace CL (2009) Multiple-antenna microwave ablation: spatially distributing power improves thermal profiles and reduces invasiveness. J Interv Oncol 2(2):65–72Google Scholar
  26. 26.
    Thamtorawat S, Hicks RM, Yu J, et al. (2016) Preliminary outcome of microwave ablation of hepatocellular carcinoma: breaking the 3-cm barrier? J Vasc Interv Radiol 27:623–630CrossRefGoogle Scholar
  27. 27.
    Sun Y, Cheng Z, Dong L, et al. (2012) Comparison of temperature curve and ablation zone between 915- and 2450-MHz cooled-shaft microwave antenna: Results in ex vivo porcine livers. Eur J Radiol 81:553–557CrossRefGoogle Scholar
  28. 28.
    Teng W, Liu K-W, Lin C-C, et al. (2015) Insufficient ablative margin determined by early computed tomography may predict the recurrence of hepatocellular carcinoma after radiofrequency ablation. Liver Cancer 4:26–38CrossRefGoogle Scholar
  29. 29.
    Wang X, Sofocleous CT, Erinjeri JP, et al. (2013) Margin size is an independent predictor of local tumor progression after ablation of colon cancer liver metastases. Cardiovasc Intervent Radiol 36(1):166–175CrossRefGoogle Scholar
  30. 30.
    Liu F, Liang P, Xiaoling Yu, et al. (2013) A three-dimensional visualisation preoperative treatment planning system in microwave ablation for liver cancer: a preliminary clinical application. Int J Hyperthermia 29(7):671–677CrossRefGoogle Scholar
  31. 31.
    Liu F, Cheng Z, Han Z, et al. (2017) A three-dimensional visualization preoperative treatment planning system for microwave ablation in liver cancer: a simulated experimental study. Abdom Radiol 42(6):1788–1793CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Li-nan Dong
    • 1
  • Xiao-ling Yu
    • 1
  • Zhi-gang Cheng
    • 1
  • Zhi-yu Han
    • 1
  • Fang-yi Liu
    • 1
  • Gang Chen
    • 1
  • Yan-chun Luo
    • 1
  • Jie Yu
    • 1
    Email author
  • Ping Liang
    • 1
    Email author
  1. 1.Department of Interventional UltrasoundChinese PLA General HospitalBeijingChina

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