The arXiv preprint introduces a finite-element digital twin that couples microwave propagation and bioheat equations using patient-specific dielectric properties extracted from preoperative CT and MRI. In three in-vivo swine ablations performed near large vessels, the simulator matched observed necrosis zones with Dice scores of 0.79-0.82. When the optimizer adjusted power, duration, and antenna depth to compensate for deliberate misplacement, Dice improved 20-48% without re-insertion. This directly addresses the clinical reality that even millimeter-scale antenna deviations can leave tumor margins untreated or risk seeding. Yet the work remains a 2026 preprint, not peer-reviewed, and relies on only three animal livers whose vascular patterns differ from cirrhotic human tissue. Earlier MWA modeling studies (e.g., 2022 IEEE TBME finite-element validation in ex-vivo porcine liver) already showed similar vessel-heat-sink effects; the novelty here is the closed-loop replanning optimizer. A 2024 Lancet Oncology review of 1,200 MWA cases reported 15-25% incomplete ablation rates attributable to placement error, underscoring why intra-operative correction could matter within months once integrated into existing navigation platforms. Limitations include absence of respiratory motion, real-time imaging feedback, and regulatory validation pathways for model-driven parameter changes. If these gaps close, the approach could shift decision-making from reactive re-ablation to predictive parameter tweaking, raising 5-year local control rates while reducing needle passes.