01.Patient Positioning & Preparation
Patient in supine position with neck extended (thyroid) or supine with arm abducted (breast). Sterile preparation and local anesthesia.
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Our first batch of DNB Radiology students in Meenakshi hospital, TanjoreMinimally Invasive Image Guided Precise Effective
Microwave ablation uses electromagnetic waves to generate heat and induce coagulative necrosis of target tissue.
What is MWA?
Microwave ablation is a minimally invasive thermal procedure that uses high frequency microwaves to heat and ablate target tissue under ultrasound guidance, with real-time monitoring.
Targeted Applications
Thyroid Nodules
- Benign thyroid nodules (to reduce size & symptoms)
- Recurrent thyroid nodules
Breast Lesions
- Fibroadenoma
- Benign breast lesions
- -Small breast cancers (in selected cases)
Procedure Technique: Step By Step
MWA
Jan
02.Ultrasound Evaluation
Identify and evaluate the lesion; plan the safest needle trajectory avoiding vessels and critical structures.
03.Antenna Insertion
Insert microwave antenna under real-time US guidance to the center or accessible part of the lesion.
04.Position Confirmation
Confirm the tip position within the target lesion in multiple planes.
05.Ablation
Microwave energy is delivered (60–100 °C), causing coagulative necrosis of the tissue.
06.Post-Ablation Assessment
Evaluate the ablation zone (should cover the entire lesion with an adequate safety margin).
07.Antenna Removal & Compression
Remove the antenna and apply compression. Observe for a short duration and discharge if stable.
Indications
Thyroid
- Benign thyroid nodules causing compressive symptoms
- Cosmetic concerns
- Functioning nodules
- Recurrent nodules after surgery
- Patients unfit for surgery
Breast
- Fibroadenoma
- Phyllodes tumor (benign)
- Radial scar
- Papilloma
- Small invasive carcinoma (s2 cm) in selected patients
Contraindications
Absolute
- Pregnancy
- Pacemaker (relative; caution near device-consult cardiology)
- Uncorrected coagulopathy ( 1NR > 1.5 , Platelets < 50,000/μL)
- Severe active infection
Relative
- Lesion adjacent to critical structures (recurrent laryngeal nerve, trachea, esophagus, major vessels)
- Large cystic lesions
- Poorly controlled diabetes
- Patient refusal
Other Possible Applications
- Liver tumors (primary & metastatic)
- Lung tumors
- Kidney tumors
- Bone tumors
- Adrenal tumors
- Soft tissue tumors
"This poster focuses on Thyroid & Breast lesions"
ADVANTAGES
Minimally invasive (no surgery)
Performed under local anesthesia
Real-time USG guidance
Precise targeting of the lesion
Preserves surrounding normal tissue
Short procedure time
Day care procedure
Minimal discomfort & quick recovery
Reduced hospital stay
Can be repeated if needed
Excellent cosmetic outcomes (breast)
Cost-effective compared to surgery
Types of Microwave Antennas
- Straight Shaft Antenna (various lengths & gauges)
- Deployable/Expandable Antenna (larger ablation zone)
- Multiple Antenna Technique (for larger lesions)
Usg Guided Mwa - Thyroid Nodule
Breast Lesion
Potential Complications
Absolute
- Pain / discomfort
- Bleeding / hematoma
- Skin burn (rare)
- Infection (rare)
- Voice change (thyroid – RLN injury, rare)
- Hypothyroidism (rare, after extensive ablation)
- Seroma (breast)
- Fat necrosis (breast, rare)
Key Points
- Careful patient selection is essential.
- Use real-time US guidance throughout.
- Ablation zone should completely cover the lesion with adequate margin.
- Avoid critical structures.
- Follow up with USG (1, 3, 6 months) to assess volume reduction.
- MWA is a safe, effective and repeatable option for selected thyroid and breast lesions.
Important Advice
- Microwave Ablation-Safe, Precise, Effective A promising alternative to surgery for benign thyroid and breast lesions with excellent patient outcomes
