Liver cirrhosis and tumor location can affect the range of intrahepatic microwave ablation zone

Figures & data

Figure 1. Study flow chart. MWA:microwave ablation; AZ: ablation zone.

Figure 2. Postoperative MRI image processing. (a) Selecting MRI sequence; (b) Using the threshold function that comes with 3Dslicer to delineate AZ; (c) Correcting the outline of AZ manually; (d) Generating the 3D-shape of AZ automatically; (e) Rotating and projecting the 3D-shape to find the section with the largest area as the standard section of AZ; (f) Calculating the AZ length width and area. AZ: ablation zone.

Table 1. Baseline of all cases.

Parameter	n = 290
Demographic factors
Gender
Male	225 (77.59%)
Female	65 (22.41%)
Age (year)	57.89 ± 12.27
Tumor type
HCC	197 (67.93%)
Metastatic cancer	93 (32.07%)
Serological factors
ALT (U/L)	24.49 ± 18.15
AST (U/L)	26.13 ± 21.68
TP (g/L)	66.04 ± 5.94
ALB (g/L)	39.78 ± 4.04
TB (μmol/L)	13.85 ± 7.91
DB (μmol/L)	4.98 ± 3.55
PTL	136.2 ± 55.02
Disease-related
Liver parenchyma
Cirrhosis	201 (69.31%)
Non-cirrhosis	89 (30.69%)
Tumor location
Periphery	39 (13.45%)
Intermediate	130 (44.83%)
Near hepatic hilar	121 (41.72%)
Tumor size (cm)	1.31 ± 0.23
MWA parameters
Ablation power
50w	218 (75.17%)
60w	72 (24.83%)
Ablation time
240s	49 (16.9%)
300s	161 (55.52%)
360s	80 (27.59%)
MW antenna
11mm-type	96 (33.1%)
05mm-type	194 (66.9%)

Values are mean ± standard deviation or number (%).

HCC: hepatocellular carcinoma; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase: TP: Total Protein; ALB: Serum albumin, TB: Total bilirubin; DB: Direct Bilirubin; PTL: Platelets.

Figure 3. CV of multiple MRI sequences for AZ length (a); width (b); area (c). CV: coefficient of variation; AZ: ablation zone.

Table 2. Linear Regression for AZ in all cases.

	AZ length						AZ width						AZ area
	Multiple Linear Regression			Stepwise Linear Regression			Multiple Linear Regression			Stepwise Linear Regression			Multiple Linear Regression			Stepwise Linear Regression
	Beta	p value	VIF	Beta	p value	VIF	Beta	p value	VIF	Beta	p value	VIF	Beta	p value	VIF	Beta	p value	VIF
Gender	−0.011	0.805	1.089				0.065	0.146	1.089				0.036	0.376	1.089
Age	0.086	0.065	1.101				0.011	0.797	1.101				0.048	0.232	1.101
Liver parenchyma	0.082	0.038	1.527	0.107	0.02	1.061	0.242	<0.001	1.527	0.23	<0.001	1.028	0.186	<0.001	1.527	0.184	<0.001	1.028
Tumor location	−0.455	<0.001	1.031	−0.452	<0.001	1.009	−0.357	<0.001	1.031	−0.365	<0.001	1.007	−0.46	<0.001	1.031	−0.466	<0.001	1.007
ALT (U/L)	−0.151	0.052	3.013				0.115	0.119	3.013				−0.011	0.873	3.013
AST (U/L)	0.071	0.136	3.405				−0.099	0.207	3.405				0.029	0.684	3.405
TP (g/L)	−0.056	0.331	1.651				−0.027	0.621	1.651				−0.045	0.363	1.651
ALB (g/L)	0.078	0.197	1.832				−0.013	0.826	1.832				0.036	0.493	1.832
TB (μmol/L)	−0.052	0.538	3.62				0.117	0.15	3.62				0.038	0.601	3.62
DB (μmol/L)	0.037	0.676	3.877				−0.1	0.232	3.877				−0.045	0.549	3.877
PTL	0.028	0.592	1.395				0.01	0.838	1.395				0.017	0.71	1.395
Ablation power	0.12	0.01	1.095	0.122	0.007	1.047	0.235	<0.001	1.095	0.239	<0.001	1.044	0.207	<0.001	1.095	0.209	<0.001	1.044
Ablation time	0.447	<0.001	1.108	0.448	<0.001	1.028	0.508	<0.001	1.108	0.512	<0.001	1.028	0.544	<0.001	1.108	0.546	<0.001	1.028
MW antenna	−0.158	0.001	1.082	−0.144	0.001	1.015	−0.103	0.02	1.082	−0.102	0.017	1.013	−0.152	<0.001	1.082	−0.146	<0.001	1.013

For categorical variables: Male set to 1, Female set to 2; Cirrhosis set to 1, Non-cirrhosis set to 2; Periphery zone set to 1, Intermediate zone set to 2, Near hepatic hilar zone set to 3; 11 mm-type needle set to 1; 05 mm-type needle set to 2. The significance of bold values are p value.

ALT:Alanine aminotransferase; AST:Aspartate aminotransferase; TP:Total Protein; ALB:Serum albumin; TB:Total bilirubin, DB:Direct Bilirubin, PTL:Platelets; AZ:ablation zone.

Table 3. Linear Regression for AZ in hepatitis patients.

	AZ length						AZ width						AZ area
	Multiple Linear Regression			Stepwise Linear Regression			Multiple Linear Regression			Stepwise Linear Regression			Multiple Linear Regression			Stepwise Linear Regression
	Beta	p value	VIF	Beta	p value	VIF	Beta	p value	VIF	Beta	p value	VIF	Beta	p value	VIF	Beta	p value	VIF
Gender	−0.05	0.3488	1.047				0.0133	0.7983	1.047				−0.017	0.7165	1.047
Tumor location	−0.405	<0.001	1.126	−0.393	<0.001	1.088	−0.296	<0.001	1.126	−0.31	<0.001	1.088	−0.381	<0.001	1.126	−0.383	<0.001	1.088
TP (g/L)	−0.055	0.3007	1.051				−0.033	0.5249	1.051				−0.05	0.2892	1.051
ALB (g/L)	−0.01	0.8418	1.03				−0.036	0.4838	1.03				−0.024	0.6009	1.03
TB (μmol/L)	−0.071	0.457	3.444				0.1759	0.0633	3.444				0.0611	0.4744	3.444
DB (μmol/L)	0.0454	0.641	3.547				−0.218	0.0235	3.547				−0.109	0.2084	3.547
FIB4	−0.168	0.0028	1.163	−0.171	0.0022	1.153	−0.189	0.0007	1.163	−0.179	0.0012	1.153	−0.195	<0.001	1.163	−0.19	<0.001	1.153
Ablation power	0.1121	0.0388	1.089	0.1053	0.0472	1.055	0.1922	<0.001	1.089	0.2107	<0.001	1.055	0.1789	<0.001	1.089	0.1868	<0.001	1.055
Ablation time	0.4054	<0.001	1.081	0.3991	<0.001	1.061	0.4315	<0.001	1.081	0.4272	<0.001	1.061	0.4687	<0.001	1.081	0.4617	<0.001	1.061
MW antenna	−0.144	0.0079	1.078	−0.131	0.012	1.009	−0.125	0.0188	1.078	−0.107	0.0382	1.009	−0.154	0.0015	1.078	−0.135	0.0038	1.009

For categorical variables: Male set to 1, Female set to 2; Cirrhosis set to 1, Non-cirrhosis set to 2; Periphery zone set to 1, Intermediate zone set to 2, Near hepatic hilar zone set to 3; 11 mm-type needle set to 1; 05 mm-type needle set to 2. The significance of bold values are p value.

ALT:Alanine aminotransferase; AST:Aspartate aminotransferase; TP:Total Protein, ALB:Serum albumin; TB:Total bilirubin, DB:Direct Bilirubin; PTL:Platelets; AZ:ablation zone.