ABSTRACT Microwave ablation (MWA) has become an increasingly important minimally invasive treatment option for pulmonary lesions, though its clinical performance remains limited by tissue heterogeneity and inconsistent energy deposition across patients. This study systematically investigates the therapeutic mechanisms of MWA, combining well‐documented thermal coagulation effects with the potential non‐thermal bioelectromagnetic effects discussed in existing preclinical research, through an integrated framework of computational modeling and orthogonal experimental design. Our Multiphysics simulations quantified the differential effects of antenna wavelength ( λ ), geometry (length‐to‐width, l/w ratio), and power ( P ) on specific absorption rate (SAR) distribution across pulmonary parenchyma. Particle swarm optimization (PSO) identified =70 W and λ = 0.1 m as optimal parameters, achieving peak SAR (78.48 W/kg) with statistically significant dominance of power ( p < 0.01) and wavelength effects on necrotic volume ( p = 0.02). Therapeutically, our analysis suggests that MWA's efficacy may derive from synergistic mechanisms: instantaneous thermal necrosis driven by 60°C–70°C protein denaturation, and potential nonthermal bioelectromagnetic effects that could disrupt cellular integrity and enhance anti‐tumor immunity. This combined mechanism may be particularly beneficial for improving ablation completeness in heterogeneous lung tissues, where conventional single‐factor thermal models often struggle to account for variable tissue properties. Our findings establish evidence‐based antenna optimization guidelines, demonstrating that precise modulation of P and λ can standardize ablation zones while minimizing collateral damage. The potential nonthermal effects summarized in this analysis provide new avenues to address persistent challenges in pulmonary MWA applications, which could ultimately help advance toward more predictable clinical outcomes, though further preclinical validation is still needed to confirm these effects.
Li et al. (Fri,) studied this question.