Purpose: To determine the impact of including dynamic changes in tissue physical properties during heating on feedback controlled thermal ablation with catheter-based ultrasound. Additionally, we compared the impact of several indicators of thermal damage on predicted extents of ablation zones for planning and monitoring ablations with this modality. Methods: A 3D model of ultrasound ablation with interstitial and transurethral applicators incorporating temperature-based feedback control was used to simulate thermal ablations in prostate and liver tissue. We investigated five coupled models of heat dependent changes in tissue acoustic attenuation/absorption and blood perfusion of varying degrees of complexity. Dimensions of the ablation zone were computed using temperature, thermal dose, and Arrhenius thermal damage indicators of coagulative necrosis. A comparison of the predictions by each of these models was illustrated on a patient-specific anatomy in the treatment planning setting. Results: Models including dynamic changes in blood perfusion and acoustic attenuation as a function of thermal dose/damage predicted near-identical ablation zone volumes (maximum variation < 2.5%). Accounting for dynamic acoustic attenuation appeared to play a critical role in estimating ablation zone size, as models using constant values for acoustic attenuation predicted ablation zone volumes up to 50% larger or 47% smaller in liver and prostate tissue, respectively. Thermal dose (t₄₃ ≥ 240 min) and thermal damage (Ω ≥ 4.6) thresholds for coagulative necrosis are in good agreement for all heating durations, temperature thresholds in the range of 54°C for short (<5 min) duration ablations and 50°C for long (15 min) ablations may serve as surrogates for determination of the outer treatment boundary. Conclusions: Accounting for dynamic changes in acoustic attenuation/absorption appeared to play a critical role in predicted extents of ablation zones. For typical 5–15 min ablations with this modality, thermal dose and Arrhenius damage measures of ablation zone dimensions are in good agreement, while appropriately selected temperature thresholds provide a computationally cheaper surrogate.

Microwave (MW) ablation has emerged as a minimally invasive therapeutic modality and is in clinical use for treatment of unresectable tumors and cardiac arrhythmias, neuromodulation, endometrial ablation, and other applications. Components of image-guided MW ablation systems include high-power MW sources, ablation applicators that deliver power from the generator to the target tissue, cooling systems, energy-delivery control algorithms, and imaging guidance systems tailored to specific clinical indications. The applicator incorporates a MW antenna that radiates MW power into the surrounding tissue. A variety of antenna designs have been developed for MW ablation with the objective of efficiently transferring MW power to tissue, with a radiation pattern well matched to the size and shape of the targeted tissue. Here, we survey advances in percutaneous, endocavitary, and endoscopic antenna designs as an integral element of MW ablation applicators for a diverse set of clinical applications.

Microwave ablation (MWA) is a minimally invasive thermal therapy modality increasingly employed for the treatment of tumors and benign disease. For successful treatment, complete thermal coverage of the tumor and margin of surrounding healthy tissue must be achieved. Currently available interstitial antennas for MWA have cylindrically symmetric radiation patterns. Thus, when treating targets in proximity to critical structures, caution must be taken to prevent unintended thermal damage. A novel coaxial antenna design for MWA with an asymmetrical cylindrical heating pattern is presented in this paper. This radiation pattern is achieved by employing a hemicylindrical reflector positioned at a critical distance from a conventional coaxial monopole antenna. Finite-element method simulations were employed to optimize the geometric dimensions of the antenna with the objective of minimizing the antenna reflection coefficient at the 2.45-GHz operating frequency, and maximizing volume of the ablation zone. Prototype antennas were fabricated and experimentally evaluated. Simulations indicated an optimal S ₁₁ of -32 dB at 2.45 GHz in close agreement with experimental measurements of -29 dB. Ex vivo experiments were performed to validate simulations and observe effects to the antennas' heating pattern with the varying input power and geometry of the reflector. Ablation zones up to 20 mm radially were observed in the forward direction, with minimal heating (less than 4 mm) behind the reflector.

Microwave ablation (MWA) is a minimally invasive technique increasingly used for thermal therapy of liver tumors. Effective MWA requires efficient interstitial antennas that destroy tumors and a margin of healthy tissue, in situ, while minimizing damage to the rest of the organ. Previously, we presented a method for optimizing MWA antenna designs by coupling finite element method models of antennas with a real-coded, multiobjective genetic algorithm. We utilized this procedure to optimize the design of a minimally invasive choke antenna that can be used to create near-spherical ablation zones of adjustable size (radius 1-2 cm) by adjusting treatment durations and a sliding structure of the antenna. Computational results were validated with experiments in ex vivo bovine liver. The optimization procedure yielded antennas with reflection coefficients below -30 dB, which were capable of creating spherical ablation zones up to 2 cm in radius using 100 W input power at 2.45 GHz with treatment durations under 2 min.