To combine arterial embolization with different embolic agents, followed by microwave ablation (MWA) in a porcine renal tumor (RT) to evaluate the ideal setting to produce the largest change in the size of the ablation zones (AZ).
In a transgenic porcine kidney, 32 sites were inoculation with 28 orthotopic RT produced. Experimental groups (23 tumors) underwent angiography with intra-arterial embolization utilizing various embolic materials (calibrated particles from 40 to 1200 μm and ethiodized oil) to complete vascular stasis of the RT. MWA using a standard protocol (3 minutes at 65 watts) was subsequently performed for all tumors. Next, a gross and histologic ex vivo analysis of the AZ was performed.
Control group AZ volume without prior embolization was 5.24 cm3 ± 0.55 cm3. AZ after embolization with 40 μm, 100 μm, 300-500 μm, 900-1200 μm particles were significantly larger than MWA alone (mean ± standard deviation: 15.39 cm3 ± 4.54, p =0.002; 11.07 cm3 ± 1.39 cm3, p= 0.001; 8.68 cm3 ± 0.77 cm3, p=0.001; 900-1200 μm: 9.90 cm3 ± 1.62 cm3, p=0.002 respectively). Liquid embolic, ethiodized oil emulsion did not create a significant increase in the AZ (5.92 cm3 ± 1.43 cm3 p=0.492).
Pre-MWA arterial embolization in a porcine RT model produced a statistically significant increase in the AZ when compared to MWA alone. Using smaller particle size embolic material with distal embolization at the tumor arterioles (50-150 μm) produced the largest, almost 3-fold increase in AZ volume.
Journal of vascular and interventional radiology : JVIR. 2024 Oct 09 [Epub ahead of print]
Samuel L Rice, Sagine Berry-Tony, Jamaal Benjamin, Payal Kapur, Mhd Wisam Alnablsi, Daniel Lamus, Regina Beets-Tan, Anil Pillai
Netherlands Cancer Institute- Antoni van Leeuwenhoekziekenhuis. Department of Radiology Plesmanlaan 121, 1066 CX, Amsterdam, Netherlands; UT Southwestern Medical Center. Department of Radiology, Interventional Radiology Section 5959 Harry Hines Blvd., Dallas, Texas 75390-9061 Professional Office Building I (HP6.600) Mail Code 8834. Electronic address: ., Washington University Mallinckrodt Institute of Radiology at Barnes-Jewish Hospital 510 S Kingshighway Blvd, St. Louis, MO 63110., UT Southwestern Medical Center. Department of Radiology, Interventional Radiology Section 5959 Harry Hines Blvd., Dallas, Texas 75390-9061 Professional Office Building I (HP6.600) Mail Code 8834., UT Southwestern Medical Center. Department of Pathology, 5323 Harry Hines Blvd., Dallas, Texas 75390-9061., Netherlands Cancer Institute- Antoni van Leeuwenhoekziekenhuis. Department of Radiology Plesmanlaan 121, 1066 CX, Amsterdam, Netherlands.