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Purpose <p>We aim to assess whether high-power microwave ablation (MWA) in combination with preablation transarterial chemoembolization (TACE) is associated with greater ablation&#xa0;zone stability in patients diagnosed with hepatocellular carcinoma (HCC) or liver metastases. The primary endpoint was the percentage change in ablation zone area from baseline to late follow-up (T1–T3).</p> Methods <p>In this retrospective, non-randomized, single-center study, 45 patients with HCC and 32 patients with liver metastases were analyzed. All patients underwent computed tomography&#xa0;(CT)-guided percutaneous MWA following TACE.</p> <p>Protocols were stratified into a low-power protocol group (initiated at 60 W and limited to ≤ 100 W) and a high-power protocol group (initiated at 80 W and escalated to ≥ 120–150 W).</p> <p>MRI&#xa0;(magnetic resonance imaging) follow-up was performed at 24&#xa0;h (T1), 3&#xa0;months (T2) and 6&#xa0;months (T3), with manual measurement of the ablation zone area at each time&#xa0;point.</p> Results <p>In the HCC cohort, high-power MWA was associated with significantly greater ablation&#xa0;zone stability (%ΔT1–T3 = − 32.95 ± 5.82%) compared to low-power protocols (%ΔT1–T3 = − 49.72 ± 6.91%;<i> p</i> &lt; 0.001; Cohen’s <i>d</i> = 1.12). In the metastases cohort, high-power MWA also outperformed the low-power group (− 28.4% vs. − 42.1%; <i>p</i> &lt; 0.001, RBC = 0.87; with consistent effect sizes).</p> Conclusion <p>This retrospective single-center cohort study provides exploratory imaging evidence that higher power settings are associated with greater ablation&#xa0;zone stability following TACE, warranting prospective validation.</p>

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High-power microwave ablation with preablation transarterial chemoembolization enhances ablation zone stability in patients with liver malignancies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月5日

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  • Thomas J. Vogl,
  • Daniel M. Dahm,
  • Leon V. Stein,
  • Fabian Finkelmeier,
  • Hamzah Adwan

摘要

Purpose

We aim to assess whether high-power microwave ablation (MWA) in combination with preablation transarterial chemoembolization (TACE) is associated with greater ablation zone stability in patients diagnosed with hepatocellular carcinoma (HCC) or liver metastases. The primary endpoint was the percentage change in ablation zone area from baseline to late follow-up (T1–T3).

Methods

In this retrospective, non-randomized, single-center study, 45 patients with HCC and 32 patients with liver metastases were analyzed. All patients underwent computed tomography (CT)-guided percutaneous MWA following TACE.

Protocols were stratified into a low-power protocol group (initiated at 60 W and limited to ≤ 100 W) and a high-power protocol group (initiated at 80 W and escalated to ≥ 120–150 W).

MRI (magnetic resonance imaging) follow-up was performed at 24 h (T1), 3 months (T2) and 6 months (T3), with manual measurement of the ablation zone area at each time point.

Results

In the HCC cohort, high-power MWA was associated with significantly greater ablation zone stability (%ΔT1–T3 = − 32.95 ± 5.82%) compared to low-power protocols (%ΔT1–T3 = − 49.72 ± 6.91%; p < 0.001; Cohen’s d = 1.12). In the metastases cohort, high-power MWA also outperformed the low-power group (− 28.4% vs. − 42.1%; p < 0.001, RBC = 0.87; with consistent effect sizes).

Conclusion

This retrospective single-center cohort study provides exploratory imaging evidence that higher power settings are associated with greater ablation zone stability following TACE, warranting prospective validation.