Personalized antenna pathways for enhancing safety and efficacy: optimizing microwave ablation outcomes in hepatic tumor treatments

Microwave ablation (MWA) is a minimally invasive technique for treating malignant liver tumors. Achieving an adequate minimal ablative margin (MAM) of at least 5 mm prevents tumor progression and recurrence. However, challenges in consistently achieving adequate MAM due to factors such as tumor morphology and location, antenna placement, and procedural complications highlight the opportunity for optimized insertion pathway techniques to improve outcomes. Image data from 10 patients were used to create patient-specific 3D finite element models, including liver, tumor, and vasculature. Simulations were conducted based on a triaxial antenna at 2.45 GHz for an ablation time of 10 minutes and mimicked clinical procedure parameters. The investigation of two clinically feasible antenna pathways was guided using incremental probe rotations and collision detection algorithms to evaluate potential pathways. These pathways were selected based on their ability to minimize collisions with critical structures, including liver vasculature, lung, heart, rib cage, pancreas, gallbladder, and bowels. The chosen pathways were analyzed for their potential to reduce ablated tissue effectively, achieving reductions between 4.5% and 44% while maintaining adequate MAM without compromising the effectiveness of MWA. This study emphasizes the potential clinical impact of optimizing antenna insertion pathways and the critical role of personalized treatment planning in improving the safety and effectiveness of MWA for liver cancer, suggesting the potential for patient-specific 3D simulations to improve clinical outcomes.