Depending on the location of the tumor and the patient's condition, either general anesthesia or conscious sedation is given while the patient is positioned. To precisely detect the tumor, imaging guidance, typically an ultrasound or CT scan is put up.
To ensure precise implantation, a narrow microwave antenna probe is gently inserted into the skin and moved into the tumor's center while being guided by real-time imaging.
When the microwave generator is turned on, electromagnetic energy is produced, quickly heating the tumor tissue. Coagulative necrosis is brought on by temperatures above 60°C, which effectively kills tumor cells in a matter of minutes.
Imaging tracks the expanding necrotic zone surrounding the probe during ablation. To obtain full coverage, including a margin of surrounding healthy tissue to lower the chance of recurrence, energy supply and antenna position can be changed.
The antenna is removed and the microwave energy is cut off once a sufficient ablation zone has been established. To reduce bleeding and tumor seeding, certain systems execute tract ablation during needle removal.
To confirm the degree of tumor elimination and look for problems, contrast-enhanced imaging (CT or ultrasonography) is usually done right away or soon after.
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According to Milan criteria, MWA is appropriate for patients with tiny liver tumors, usually a single tumor ≤5 cm or up to three nodules each <3 cm.
those who refuse surgery, have limited liver reserve, or have comorbidities that make them unsuitable for liver resection.
tumors that are easily accessible and visible under CT or ultrasound guidance for accurate probe placement.
For MWA treatment to be safe, patients typically need to have Child-Pugh class A or B liver function.
For patients to tolerate the surgery, their ECOG performance level should be between 0 and 1.
Patients with portal vein thrombosis, extrahepatic metastases, significant tumor burden (>5-6 cm tumor), or severe liver decompensation are typically not candidates for MWA.
By doing MWA through a tiny skin puncture rather than open surgery, there is less stress, a lower chance of infection, and less pain following the procedure.
Compared to previous ablation methods, MWA produces greater temperatures quickly (over 100°C), allowing for bigger and more reliable ablation zones in less time.
Larger tumors (up to 5 cm or more) and several lesions at once can be safely treated with MWA, which is frequently difficult with other modalities.
With shorter hospital stays, less suffering, and a quicker return to regular activities, patients usually heal more quickly.
MWA can minimize intraoperative bleeding by closing blood arteries when administered in conjunction with liver resection.
MWA is a versatile method for managing cancer since it can be repeated if tumors relapse or new lesions appear.
Research shows that MWA offers patients improved quality of life and strong tumor control with promising survival rates.
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