Microwave Ablation versus Radiofrequency Ablation in the Kidney: High-power Triaxial Antennas Create Larger Ablation Zones than Similarly Sized Internally Cooled Electrodes

Purpose

To determine whether microwave ablation with high-power triaxial antennas creates significantly larger ablation zones than radiofrequency (RF) ablation with similarly sized internally cooled electrodes.

Materials and Methods

Twenty-eight 12-minute ablations were performed in an in vivo porcine kidney model. RF ablations were performed with a 200-W pulsed generator and either a single 17-gauge cooled electrode (n = 9) or three switched electrodes spaced 1.5 cm apart (n = 7). Microwave ablations were performed with one (n = 7), two (n = 3), or three (n = 2) 17-gauge triaxial antennas to deliver 90 W continuous power per antenna. Multiple antennas were powered simultaneously. Temperatures 1 cm from the applicator were measured during two RF and microwave ablations each. Animals were euthanized after ablation and ablation zone diameter, cross-sectional area, and circularity were measured. Comparisons between groups were performed with use of a mixed-effects model with P values less than .05 indicating statistical significance.

Results

No adverse events occurred during the procedures. Three-electrode RF (mean area, 14.7 cm²) and single-antenna microwave (mean area, 10.9 cm²) ablation zones were significantly larger than single-electrode RF zones (mean area, 5.6 cm²; P = .001 and P = .0355, respectively). No significant differences were detected between single-antenna microwave and multiple-electrode RF. Ablation zone circularity was similar across groups (P > .05). Tissue temperatures were higher during microwave ablation (maximum temperature of 123°C vs 100°C for RF).

Conclusions

Microwave ablation with high-power triaxial antennas created larger ablation zones in normal porcine kidneys than RF ablation with similarly sized applicators.

Abbreviations: RCC, renal cell carcinoma, RF, radiofrequency