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Comparison of wet radiofrequency ablation with dry radiofrequency ablation and radiofrequency ablation using hypertonic saline preinjection: ex vivo bovine liver.

Lee JM, Han JK, Kim SH, Shin KS, Lee JY, Park HS, Hur H, Choi BI - Korean J Radiol (2004 Oct-Dec)

Bottom Line: Radiofrequency was applied to excised bovine livers in a monopolar mode for 10 minutes using a 200 W generator and a perfused-cooled electrode with or without injection or slow infusion of NaCl solutions.With injection or infusion of NaCl solutions, the mean initial tissue impedance prior to RF ablation was significantly less in groups B, C, D, and E (43-75 ohm) than for group A (80 ohm) (p < 0.05).In addition, the volumes of RF-induced coagulation necrosis were greater in groups C and E than in group D, which was greater than in groups A and B than in group E (p < 0.05); 14.3+/-3.0 cm(3) in group A; 12.4+/-3.8 cm(3) in group B; 80.9+/-9.9 cm(3) in group C; 45.3+/-11.3 cm(3) in group D and 81.6+/-8.6 cm(3) in group E.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Objective: We wished to compare the in-vitro efficiency of wet radiofrequency(RF) ablation with the efficiency of dry RF ablation and RF ablation with preinjection of NaCl solutions using excised bovine liver.

Materials and methods: Radiofrequency was applied to excised bovine livers in a monopolar mode for 10 minutes using a 200 W generator and a perfused-cooled electrode with or without injection or slow infusion of NaCl solutions. After placing the perfused-cooled electrode in the explanted liver, 50 ablation zones were created with five different regimens: group A; standard dry RF ablation, group B; RF ablation with 11 mL of 5% NaCl solution preinjection, group C; RF ablation with infusion of 11 mL of 5% NaCl solution at a rate of 1 mL/min, group D; RFA with 6 mL of 36% NaCl solution preinjection, group E; RF ablation with infusion of 6 mL of 36% NaCl solution at a rate of 0.5 mL/min. In groups C and E, infusion of the NaCl solutions was started 1 min before RF ablation and then maintained during RF ablation (wet RF ablation). During RF ablation, we measured the tissue temperature at 15 mm from the electrode. The dimensions of the ablation zones and changes in impedance, current and liver temperature during RF ablation were then compared between the groups.

Results: With injection or infusion of NaCl solutions, the mean initial tissue impedance prior to RF ablation was significantly less in groups B, C, D, and E (43-75 ohm) than for group A (80 ohm) (p < 0.05). During RF ablation, the tissue impedance was well controlled in groups C and E, but it was often rapidly increased to more than 200 ohm in groups A and B. In group D, the impedance was well controlled in six of ten trials but it was increased in four trials (40%) 7 min after starting RF ablation. As consequences, the mean current was higher for groups C, D, and E than for the other groups: 401+/-145 mA in group A, 287+/-32 mA in group B, 1907+/-96 mA in group C, 1649+/-514 mA in group D, and 1968+/-108 mA in group E (p< 0.05). In addition, the volumes of RF-induced coagulation necrosis were greater in groups C and E than in group D, which was greater than in groups A and B than in group E (p < 0.05); 14.3+/-3.0 cm(3) in group A; 12.4+/-3.8 cm(3) in group B; 80.9+/-9.9 cm(3) in group C; 45.3+/-11.3 cm(3) in group D and 81.6+/-8.6 cm(3) in group E. The tissue temperature measured at 15 mm from the electrode was higher in groups C, D and E than other groups (p < 0.05): 53+/-12 degrees C in group A, 42+/-2 degrees C in group B, 93+/-8 degrees C in group C; 79+/-12 degrees C in group D and 83+/-8 degrees C in group E.

Conclusion: Wet RF ablation with 5% or 36% NaCl solutions shows better efficiency in creating a large ablation zone than does dry RF ablation or RF ablation with preinjection of NaCl solutions.

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Measurement of the ablated area. Photographs of specimen created by dry RF ablation (group A) in the electrode insertion axis (A) and in the transverse axis perpendicular to the electrode shaft (B). Arrows indicate the three directional diameters of the RF-induced coagulation necrosis: V indicates the vertical diameter; T1, the transverse diameter on the plane along the electrode insertion axis; and T2, the transverse diameter on the plane perpendicular to the electrode shaft.
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Figure 2: Measurement of the ablated area. Photographs of specimen created by dry RF ablation (group A) in the electrode insertion axis (A) and in the transverse axis perpendicular to the electrode shaft (B). Arrows indicate the three directional diameters of the RF-induced coagulation necrosis: V indicates the vertical diameter; T1, the transverse diameter on the plane along the electrode insertion axis; and T2, the transverse diameter on the plane perpendicular to the electrode shaft.

Mentions: Liver blocks containing the RF ablation lesions were dissected along the longitudinal plane passing through the axes of the probe (the L-plane), and then we cut the blocks transversely and perpendicular to the L-plane (the T-plane). As the white central area of the RF induced ablation zone has been previously shown to correspond with the zone of coagulation necrosis (27, 28), two observers measured the vertical diameter (DV) along the probe, and the transverse diameter (DT1) perpendicular to the DV in the L-plane, and the second transverse diameter of the ablation zone (DT2) in the T-plane (Fig. 2). The volumes of ablation zones were evaluated by approximating the lesion to a sphere using: π(DV × DT1 × DT2)/6.


Comparison of wet radiofrequency ablation with dry radiofrequency ablation and radiofrequency ablation using hypertonic saline preinjection: ex vivo bovine liver.

Lee JM, Han JK, Kim SH, Shin KS, Lee JY, Park HS, Hur H, Choi BI - Korean J Radiol (2004 Oct-Dec)

Measurement of the ablated area. Photographs of specimen created by dry RF ablation (group A) in the electrode insertion axis (A) and in the transverse axis perpendicular to the electrode shaft (B). Arrows indicate the three directional diameters of the RF-induced coagulation necrosis: V indicates the vertical diameter; T1, the transverse diameter on the plane along the electrode insertion axis; and T2, the transverse diameter on the plane perpendicular to the electrode shaft.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698170&req=5

Figure 2: Measurement of the ablated area. Photographs of specimen created by dry RF ablation (group A) in the electrode insertion axis (A) and in the transverse axis perpendicular to the electrode shaft (B). Arrows indicate the three directional diameters of the RF-induced coagulation necrosis: V indicates the vertical diameter; T1, the transverse diameter on the plane along the electrode insertion axis; and T2, the transverse diameter on the plane perpendicular to the electrode shaft.
Mentions: Liver blocks containing the RF ablation lesions were dissected along the longitudinal plane passing through the axes of the probe (the L-plane), and then we cut the blocks transversely and perpendicular to the L-plane (the T-plane). As the white central area of the RF induced ablation zone has been previously shown to correspond with the zone of coagulation necrosis (27, 28), two observers measured the vertical diameter (DV) along the probe, and the transverse diameter (DT1) perpendicular to the DV in the L-plane, and the second transverse diameter of the ablation zone (DT2) in the T-plane (Fig. 2). The volumes of ablation zones were evaluated by approximating the lesion to a sphere using: π(DV × DT1 × DT2)/6.

Bottom Line: Radiofrequency was applied to excised bovine livers in a monopolar mode for 10 minutes using a 200 W generator and a perfused-cooled electrode with or without injection or slow infusion of NaCl solutions.With injection or infusion of NaCl solutions, the mean initial tissue impedance prior to RF ablation was significantly less in groups B, C, D, and E (43-75 ohm) than for group A (80 ohm) (p < 0.05).In addition, the volumes of RF-induced coagulation necrosis were greater in groups C and E than in group D, which was greater than in groups A and B than in group E (p < 0.05); 14.3+/-3.0 cm(3) in group A; 12.4+/-3.8 cm(3) in group B; 80.9+/-9.9 cm(3) in group C; 45.3+/-11.3 cm(3) in group D and 81.6+/-8.6 cm(3) in group E.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Objective: We wished to compare the in-vitro efficiency of wet radiofrequency(RF) ablation with the efficiency of dry RF ablation and RF ablation with preinjection of NaCl solutions using excised bovine liver.

Materials and methods: Radiofrequency was applied to excised bovine livers in a monopolar mode for 10 minutes using a 200 W generator and a perfused-cooled electrode with or without injection or slow infusion of NaCl solutions. After placing the perfused-cooled electrode in the explanted liver, 50 ablation zones were created with five different regimens: group A; standard dry RF ablation, group B; RF ablation with 11 mL of 5% NaCl solution preinjection, group C; RF ablation with infusion of 11 mL of 5% NaCl solution at a rate of 1 mL/min, group D; RFA with 6 mL of 36% NaCl solution preinjection, group E; RF ablation with infusion of 6 mL of 36% NaCl solution at a rate of 0.5 mL/min. In groups C and E, infusion of the NaCl solutions was started 1 min before RF ablation and then maintained during RF ablation (wet RF ablation). During RF ablation, we measured the tissue temperature at 15 mm from the electrode. The dimensions of the ablation zones and changes in impedance, current and liver temperature during RF ablation were then compared between the groups.

Results: With injection or infusion of NaCl solutions, the mean initial tissue impedance prior to RF ablation was significantly less in groups B, C, D, and E (43-75 ohm) than for group A (80 ohm) (p < 0.05). During RF ablation, the tissue impedance was well controlled in groups C and E, but it was often rapidly increased to more than 200 ohm in groups A and B. In group D, the impedance was well controlled in six of ten trials but it was increased in four trials (40%) 7 min after starting RF ablation. As consequences, the mean current was higher for groups C, D, and E than for the other groups: 401+/-145 mA in group A, 287+/-32 mA in group B, 1907+/-96 mA in group C, 1649+/-514 mA in group D, and 1968+/-108 mA in group E (p< 0.05). In addition, the volumes of RF-induced coagulation necrosis were greater in groups C and E than in group D, which was greater than in groups A and B than in group E (p < 0.05); 14.3+/-3.0 cm(3) in group A; 12.4+/-3.8 cm(3) in group B; 80.9+/-9.9 cm(3) in group C; 45.3+/-11.3 cm(3) in group D and 81.6+/-8.6 cm(3) in group E. The tissue temperature measured at 15 mm from the electrode was higher in groups C, D and E than other groups (p < 0.05): 53+/-12 degrees C in group A, 42+/-2 degrees C in group B, 93+/-8 degrees C in group C; 79+/-12 degrees C in group D and 83+/-8 degrees C in group E.

Conclusion: Wet RF ablation with 5% or 36% NaCl solutions shows better efficiency in creating a large ablation zone than does dry RF ablation or RF ablation with preinjection of NaCl solutions.

Show MeSH
Related in: MedlinePlus