Initial institutional experience of uncooled single-antenna microwave ablation for large hepatocellular carcinoma

Aim: To evaluate the safety, efficacy, and feasibility of a novel microwave generator, designed to deliver automatically adjusted energy by tissue permittivity feedback control into the tumour via an uncooled antenna, in patients with larger hepatocellular carcinoma (HCC). Materials and methods: Fourteen patients with HCC >5 cm in diameter received surgical or percutaneous microwave ablation with more than 12 months of follow-up. Microwave ablation was performed using a 902–928 MHz generator at 28 W; a single 14 G antenna without water-cooled system was used. The patients were followed up with contrast-enhanced CT and serum alpha-foetoprotein to monitor for tumour recurrence at 1 month and then every 3 months after tumour ablation. Results: The follow-up duration for the 11 male and three female patients (mean tumour size 5.77 cm, range 5–7 cm; mean age 63.8 years) was 15.8 months. The mean ablation time was 2025 s (range 900–3600 s), and the mean ablation session was 2.5 (range 1–4). The complete ablation rate was 85% (17 of 20). Local recurrence rate was 5.8% (1 of 17). All patients survived and the morbidity and mortality rate was 21.4% and 0%, respectively. Conclusions: Microwave tissue ablation using this novel system with tissue permittivity feedback control and a single uncooled antenna has a high complete ablation rate and lower morbidity. It proved to be a fast, easy, and effective option for ablation of large (>5 cm) tumours. - Highlights: • We used a microwave system with tissue permittivity feedback control firstly in Asia. • It can deliver automatic-adjusted energy into tumors quickly via an uncooled antenna. • Tumor ablation using this system has a high complete ablation rate and safety. • It was proved to be a fast and effective option for large (>5 cm) tumor ablation