Ep. 158 Microwave Ablation for Liver Lesions with Dr. Driss Raissi

Dr. Christopher Beck talks with Dr. Driss Raissi about his approach to Microwave Ablation of Liver Lesions, including workup, technique, and tips and tricks for a successful ablation treatment.

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SHOW NOTES

In this episode, Dr. Driss Raissi and our host Dr. Chris Beck discuss the planning, technique, and follow-up considerations for microwave ablation of liver lesions.

First, they talk through the process of mapping out the tumor. Dr. Raissi often attends tumor boards to contribute to the variety of treatment perspectives and gain consensus for microwave ablation from colleagues in different specialties. He also discusses the differences between cirrhotic and steatotic livers because the latter can limit the efficiency of microwave energy delivery.

During the procedure, Dr. Raissi appreciates the simplicity of a one-needle device. He offers advice for maneuvering near critical organs: direct the tip of the needle towards the critical structure to gain control. Additionally, he prefers to align the long axis of the needle with the long axis of the tumor and to minimize the number of new liver punctured by overlapping ablation zones.

The doctors also discuss the need to balance clean margins with preservation of liver tissue, noting that lesions in different lobes can be treated in different sessions. Finally, they cover telehealth follow-ups and MRI follow-up during the subsequent month.

Throughout this episode, we refer to findings about microwave ablation from previous publications, which are linked below.

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RESOURCES

Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/30676100/

Liver microwave ablation: a systematic review of various FDA-approved systems:

https://pubmed.ncbi.nlm.nih.gov/30506218/

Early Outcomes with Single-antenna High-powered Percutaneous Microwave Ablation for Primary and Secondary Hepatic Malignancies: Safety, Effectiveness, and Predictors of Ablative Failure:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110402/