A review of radiofrequency ablation: Large target tissue necrosis and mathematical modelling.

Radiofrequency ablation (RFA) is an effective clinical method for tumour ablation with minimum intrusiveness. However, the use of RFA is mostly restricted to small tumours, especially those <3cm in diameter. This paper discusses the state-of-the-art of RFA, drawn from experimental and clinical results, for large tumours (i.e. ⩾3cm in diameter). In particular, the paper analyses clinical results related to target tissue necrosis (TTN) and mathematical modelling of the RFA procedure to understand the mechanism whereby the TTN is limited to under 3cm with RFA. This paper also discusses a strategy of controlling of the temperature of target tissue in the RFA procedure with the state-of-art device, which has the potential to increase the size of TTN. This paper ends with a discussion of some future ideas to solve the so-called 3-cm problem with RFA.

[1]  J. Leyendecker,et al.  Long-term outcomes after percutaneous radiofrequency ablation for renal cell carcinoma. , 2011, Urology.

[2]  C Gabriel,et al.  The dielectric properties of biological tissues: I. Literature survey. , 1996, Physics in medicine and biology.

[3]  Dieter Haemmerich,et al.  Automatic control of finite element models for temperature-controlled radiofrequency ablation , 2005, Biomedical engineering online.

[4]  Chris J. Diederich,et al.  Considerations for theoretical modelling of thermal ablation with catheter-based ultrasonic sources: Implications for treatment planning, monitoring and control , 2012, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[5]  D. Haemmerich,et al.  Cytotoxicity of hepatocellular carcinoma cells to hyperthermic and ablative temperature exposures: In vitro studies and mathematical modelling , 2013, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[6]  G. Gazelle,et al.  Microsimulation model predicts survival benefit of radiofrequency ablation and stereotactic body radiotherapy versus radiotherapy for treating inoperable stage I non-small cell lung cancer. , 2013, AJR. American journal of roentgenology.

[7]  Theodoros Samaras,et al.  Parametric study of radiofrequency ablation in the clinical practice with the use of two-compartment numerical models , 2013, Electromagnetic biology and medicine.

[8]  Punit Prakash,et al.  Modelling of endoluminal and interstitial ultrasound hyperthermia and thermal ablation: Applications for device design, feedback control and treatment planning , 2013, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[9]  W. Mitzner,et al.  A theoretical model of the application of RF energy to the airway wall and its experimental validation , 2010, Biomedical engineering online.

[10]  Jae Young Lee,et al.  Radiofrequency ablation of hepatocellular carcinoma as first-line treatment: long-term results and prognostic factors in 162 patients with cirrhosis. , 2014, Radiology.

[11]  Christopher L Brace,et al.  Principles of and advances in percutaneous ablation. , 2011, Radiology.

[12]  N. Enomoto,et al.  Risk factors for exceeding the Milan criteria after successful radiofrequency ablation in patients with early‐stage hepatocellular carcinoma , 2014, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[13]  S. Morita,et al.  Midterm outcomes in patients with intermediate‐sized hepatocellular carcinoma , 2010, Cancer.

[14]  Dohyung Lim,et al.  Effect of input waveform pattern and large blood vessel existence on destruction of liver tumor using radiofrequency ablation: finite element analysis. , 2010, Journal of biomechanical engineering.

[15]  Dieter Haemmerich,et al.  In vivo electrical conductivity of hepatic tumours. , 2003, Physiological measurement.

[16]  J. Kettenbach,et al.  Percutaneous saline-enhanced radiofrequency ablation of unresectable hepatic tumors: initial experience in 26 patients. , 2003, AJR. American journal of roentgenology.

[17]  D. Schutt,et al.  Effects of variation in perfusion rates and of perfusion models in computational models of radio frequency tumor ablation. , 2008, Medical physics.

[18]  Hong Cao,et al.  Three-dimensional finite-element analyses for radio-frequency hepatic tumor ablation , 2002, IEEE Trans. Biomed. Eng..

[19]  F. Duck.  Physical properties of tissue , 1990 .

[20]  Enrique J Berjano,et al.  Theoretical modeling for radiofrequency ablation: state-of-the-art and challenges for the future , 2006, Biomedical engineering online.

[21]  W. Lees,et al.  Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation , 2009, European Radiology.

[22]  Joon Koo Han,et al.  Monopolar Radiofrequency Ablation Using a Dual-Switching System and a Separable Clustered Electrode: Evaluation of the In Vivo Efficiency , 2014, Korean journal of radiology.

[23]  Yuman Fong,et al.  Image-Guided Cancer Therapy , 2013, Springer New York.

[24]  D. Panescu,et al.  Three-dimensional finite element analysis of current density and temperature distributions during radio-frequency ablation , 1995, IEEE Transactions on Biomedical Engineering.

[25]  Albert J. Shih,et al.  Thermal-Electric Finite Element Analysis and Experimental Validation of Bipolar Electrosurgical Cautery , 2008 .

[26]  C. Christophi,et al.  Mechanisms of focal heat destruction of liver tumors. , 2005, The Journal of surgical research.

[27]  Muhammad Jamil,et al.  Quantification of the effect of electrical and thermal parameters on radiofrequency ablation for concentric tumour model of different sizes. , 2015, Journal of thermal biology.

[28]  M. D’Onofrio,et al.  Radiofrequency Ablation Versus Surgical Resection for the Treatment of Hepatocellular Carcinoma in Cirrhosis , 2007, Journal of Gastrointestinal Surgery.

[29]  Huang‐Wen Huang,et al.  Influence of blood vessel on the thermal lesion formation during radiofrequency ablation for liver tumors. , 2013, Medical physics.

[30]  J. Webster,et al.  Large-volume radiofrequency ablation of ex vivo bovine liver with multiple cooled cluster electrodes. , 2005, Radiology.

[31]  H. Takaki,et al.  Radiofrequency Ablation After Arterial Injection of Miriplatin–Iodized Oil Suspension Into Swine Liver: Ablative Zone Size and Tissue Platinum Concentration , 2014, CardioVascular and Interventional Radiology.

[32]  R. Schmitt,et al.  Acute Safety and Efficacy of a Novel Multipolar Irrigated Radiofrequency Ablation Catheter for Pulmonary Vein Isolation , 2014, Journal of cardiovascular electrophysiology.

[33]  Mehdi Ghommem,et al.  Real-time tumor ablation simulation based on the dynamic mode decomposition method. , 2014, Medical physics.

[34]  N. Horiike,et al.  Efficacy of radiofrequency ablation therapy compared to surgical resection in 164 patients in Japan with single hepatocellular carcinoma smaller than 3 cm, along with report of complications. , 2008, Hepato-gastroenterology.

[35]  M. Moser,et al.  Radiofrequency ablation technique in the treatment of liver tumours: review and future issues , 2013, Journal of medical engineering & technology.

[36]  Uyen D. Nguyen,et al.  Thermal modeling of lesion growth with radiofrequency ablation devices , 2004, Biomedical engineering online.

[37]  L. Xu,et al.  Numerical study of the influence of water evaporation on radiofrequency ablation , 2013, Biomedical engineering online.

[38]  R. Blasco-Gimenez,et al.  Could it be advantageous to tune the temperature controller during radiofrequency ablation? A feasibility study using theoretical models , 2011, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[39]  Y. Melamed,et al.  Hyperbaric Oxygen and Radiotherapy , 2005, Strahlentherapie und Onkologie.

[40]  Riccardo Sartoris,et al.  Percutaneous radiofrequency ablation of benign thyroid nodules assisted by a virtual needle tracking system. , 2014, Ultrasound in medicine & biology.

[41]  Theodoros Samaras,et al.  Simulation of radiofrequency ablation in real human anatomy , 2014, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[42]  W. Willis,et al.  Hyperthermia impairs liver mitochondrial function in vitro. , 2000, American journal of physiology. Regulatory, integrative and comparative physiology.

[43]  Ryosuke Tateishi,et al.  nature publishing group ORIGINAL CONTRIBUTIONS 569 CME Radiofrequency Ablation for Hepatocellular Carcinoma: 10-Year Outcome and Prognostic Factors LIVER , 2022 .

[44]  W. Lees,et al.  Survival after Radiofrequency Ablation in 122 Patients with Inoperable Colorectal Lung Metastases , 2013, CardioVascular and Interventional Radiology.

[45]  S. Goldberg,et al.  Reduced tumor growth with combined radiofrequency ablation and radiation therapy in a rat breast tumor model. , 2005, Radiology.

[46]  D. Haemmerich,et al.  Increased Duration of Heating Boosts Local Drug Deposition during Radiofrequency Ablation in Combination with Thermally Sensitive Liposomes (ThermoDox) in a Porcine Model , 2015, PloS one.

[47]  Electrical-thermal performance of a cooled RF applicator for hepatic ablation with additional distant infusion of hypertonic saline: In vivo study and preliminary computer modeling , 2012, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[48]  J. Haaga,et al.  Radiofrequency ablation: effect of tumor- and organ-specific pharmacologic modulation of arterial and portal venous blood flow on coagulation diameter in an N1-S1 tumor model. , 2012, Journal of vascular and interventional radiology : JVIR.

[49]  M. Bloomston,et al.  Ex vivo electrical impedance measurements on excised hepatic tissue from human patients with metastatic colorectal cancer , 2015, Physiological measurement.

[50]  Juan J. Pérez,et al.  Computer modeling of electrical and thermal performance during bipolar pulsed radiofrequency for pain relief. , 2014, Medical physics.

[51]  Macarena Trujillo,et al.  Review of the mathematical functions used to model the temperature dependence of electrical and thermal conductivities of biological tissue in radiofrequency ablation , 2013, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[52]  Enrique J Berjano,et al.  RF tumor ablation with internally cooled electrodes and saline infusion: what is the optimal location of the saline infusion? , 2007, Biomedical engineering online.

[53]  S. Goldberg,et al.  Tumor Ablation: An Evolving Technology , 2013 .

[54]  P R Mueller,et al.  Benign prostatic hyperplasia: US-guided transrectal urethral enlargement with radio frequency--initial results in a canine model. , 1998, Radiology.

[55]  J. Bruix,et al.  Novel advancements in the management of hepatocellular carcinoma in 2008. , 2008, Journal of hepatology.

[56]  J. Soh,et al.  Radiofrequency Ablation of Lung Tumors Using a Multitined Expandable Electrode: Impact of the Electrode Array Diameter on Local Tumor Progression. , 2016, Journal of vascular and interventional radiology : JVIR.

[57]  E. J. Woo,et al.  Thermal—electrical finite element modelling for radio frequency cardiac ablation: Effects of changes in myocardial properties , 2000, Medical and Biological Engineering and Computing.

[58]  Bin Li,et al.  Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma , 2010, BMC gastroenterology.

[59]  Javier Saiz,et al.  Modeling for radio-frequency conductive keratoplasty: implications for the maximum temperature reached in the cornea , 2005, Physiological measurement.

[60]  Luigi Solbiati,et al.  Small liver colorectal metastases treated with percutaneous radiofrequency ablation: local response rate and long-term survival with up to 10-year follow-up. , 2012, Radiology.

[61]  Sheldon K Hall,et al.  Cell death, perfusion and electrical parameters are critical in models of hepatic radiofrequency ablation , 2015, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[62]  Juan J. Pérez,et al.  Computer modeling and ex vivo experiments with a (saline-linked) irrigated electrode for RF-assisted heating , 2014, Biomedical engineering online.

[63]  Alptekin Aksan,et al.  Prediction of the extent of thermal damage in the cornea during conductive keratoplasty , 2010 .

[64]  S. Goldberg,et al.  Liposomal doxorubicin increases radiofrequency ablation-induced tumor destruction by increasing cellular oxidative and nitrative stress and accelerating apoptotic pathways. , 2010, Radiology.

[66]  Y. Chou,et al.  Survival rates are comparable after radiofrequency ablation or surgery in patients with small hepatocellular carcinomas. , 2011, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[67]  Xiaoming He,et al.  Thermostability of Biological Systems: Fundamentals, Challenges, and Quantification , 2011, The open biomedical engineering journal.

[68]  John A. Pearce,et al.  Comparative analysis of mathematical models of cell death and thermal damage processes , 2013, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[69]  D. Dupuy,et al.  Thermal ablation of tumours: biological mechanisms and advances in therapy , 2014, Nature Reviews Cancer.

[70]  Punit Prakash,et al.  Interstitial ultrasound ablation of vertebral and paraspinal tumours: Parametric and patient-specific simulations , 2014, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[71]  C. Claussen,et al.  Internally gas-cooled radiofrequency applicators as an alternative to conventional radiofrequency and microwave ablation devices: an in vivo comparison. , 2013, European journal of radiology.

[72]  Yigang Luo,et al.  Numerical analysis of the relationship between the area of target tissue necrosis and the size of target tissue in liver tumours with pulsed radiofrequency ablation , 2015, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[73]  E. Berjano,et al.  Could the heat sink effect of blood flow inside large vessels protect the vessel wall from thermal damage during RF-assisted surgical resection? , 2014, Medical physics.

[74]  Juan J. Pérez,et al.  Electrical and Thermal Effects of Esophageal Temperature Probes on Radiofrequency Catheter Ablation of Atrial Fibrillation: Results from a Computational Modeling Study , 2015, Journal of cardiovascular electrophysiology.

[75]  E. Berjano,et al.  Relationship between roll-off occurrence and spatial distribution of dehydrated tissue during RF ablation with cooled electrodes , 2012, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[76]  R. Warters,et al.  Hyperthermia and the cell nucleus. , 1982, Radiation research.

[77]  K. Baldwin,et al.  Bipolar radiofrequency ablation of liver tumors: Technical experience and interval follow‐up in 22 patients with 33 ablations , 2012, Journal of surgical oncology.

[78]  T. Vogl,et al.  Image-guided tumor ablation: standardization of terminology and reporting criteria--a 10-year update. , 2014, Radiology.

[79]  S. Goldberg,et al.  Combination radiofrequency (RF) ablation and IV liposomal heat shock protein suppression: reduced tumor growth and increased animal endpoint survival in a small animal tumor model. , 2012, Journal of controlled release : official journal of the Controlled Release Society.

[80]  Dieter Haemmerich,et al.  RF Ablation at Low Frequencies for Targeted Tumor Heating: In Vitro and Computational Modeling Results , 2011, IEEE Transactions on Biomedical Engineering.

[81]  E. Berjano,et al.  Feasibility study of an internally cooled bipolar applicator for RF coagulation of hepatic tissue: Experimental and computational study , 2012, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[82]  C. V. van Kuijk,et al.  Long-term results of radiofrequency ablation for unresectable colorectal liver metastases: a potentially curative intervention. , 2011, The British journal of radiology.

[83]  N. Samani,et al.  The Impact of Power Output During Percutaneous Catheter Radiofrequency Ablation for Atrial Fibrillation on Efficacy and Safety Outcomes: A Systematic Review , 2013, Journal of cardiovascular electrophysiology.

[84]  P. Gow,et al.  Radiofrequency ablation versus resection for the treatment of early stage hepatocellular carcinoma: a multicenter Australian study , 2015, Scandinavian journal of gastroenterology.

[85]  Renal cell carcinoma: radiofrequency ablation with a multiple-electrode switching system--a phase II clinical study. , 2013, Radiology.

[86]  S. Topp,et al.  Saline-Linked Surface Radiofrequency Ablation: Factors Affecting Steam Popping and Depth of Injury in the Pig Liver , 2004, Annals of surgery.

[87]  Hongzan Sun,et al.  Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: a meta-analysis of randomized-controlled trials , 2013, European journal of gastroenterology & hepatology.

[88]  S. Goldberg,et al.  Computer modeling of the effect of perfusion on heating patterns in radiofrequency tumor ablation , 2007, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[89]  E F Halpern,et al.  Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. , 2001, Radiology.

[90]  John G. Webster,et al.  Hepatic radiofrequency ablation with internally cooled probes: effect of coolant temperature on lesion size , 2003, IEEE Transactions on Biomedical Engineering.

[91]  G. Hahn,et al.  Effects of hyperthermia in a malignant tumor , 1980, Cancer.

[92]  Michael A J Moser,et al.  Study of the relationship between the target tissue necrosis volume and the target tissue size in liver tumours using two-compartment finite element RFA modelling , 2014, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[93]  H. H. Penns.  Analysis of tissue and arterial blood temperatures in the resting human forearm , 1948 .

[94]  Jeong Min Lee,et al.  Multiple-electrode radiofrequency ablations using Octopus® electrodes in an in vivo porcine liver model. , 2012, The British journal of radiology.

[95]  John G. Webster,et al.  Finite-element analysis of hepatic multiple probe radio-frequency ablation , 2002, IEEE Transactions on Biomedical Engineering.

[96]  T. Kinoshita,et al.  Radiofrequency ablation as local therapy for early breast carcinomas , 2011, Breast cancer.

[97]  G. Francica,et al.  Ultrasound-guided percutaneous treatment of hepatocellular carcinoma by radiofrequency hyperthermia with a 'cooled-tip needle'. A preliminary clinical experience. , 1999, European journal of ultrasound : official journal of the European Federation of Societies for Ultrasound in Medicine and Biology.

[98]  J C Bischof,et al.  Investigation of the thermal and tissue injury behaviour in microwave thermal therapy using a porcine kidney model , 2004, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[99]  E. Vicaut,et al.  Radiofrequency ablation of hepatocellular carcinoma: Long‐term results and prognostic factors in 235 Western patients with cirrhosis , 2009, Hepatology.

[100]  E. Feinstein,et al.  Toll-like receptor 5 agonist protects mice from dermatitis and oral mucositis caused by local radiation: implications for head-and-neck cancer radiotherapy. , 2012, International journal of radiation oncology, biology, physics.

[101]  P. Wolf,et al.  A Three-Dimensional Finite Element Model of Radiofrequency Ablation with Blood Flow and its Experimental Validation , 2000, Annals of Biomedical Engineering.

[102]  L Solbiati,et al.  Large-volume tissue ablation with radio frequency by using a clustered, internally cooled electrode technique: laboratory and clinical experience in liver metastases. , 1998, Radiology.

[103]  P. Wolf,et al.  Temperature-controlled and constant-power radio-frequency ablation: what affects lesion growth? , 1999, IEEE Transactions on Biomedical Engineering.

[104]  Dieter Haemmerich,et al.  Electrical conductivity measurement of excised human metastatic liver tumours before and after thermal ablation , 2009, Physiological measurement.

[105]  W. R. Lees,et al.  Radiofrequency ablation of colorectal liver metastases , 2005, Abdominal Imaging.

[106]  T. Iwamoto.  Clinical application of drug delivery systems in cancer chemotherapy: review of the efficacy and side effects of approved drugs. , 2013, Biological & pharmaceutical bulletin.

[107]  Christopher L Brace,et al.  Radiofrequency and microwave ablation of the liver, lung, kidney, and bone: what are the differences? , 2009, Current problems in diagnostic radiology.

[108]  P. Krysl,et al.  A Theoretical and Experimental Analysis of Radiofrequency Ablation with a Multielectrode, Phased, Duty‐Cycled System , 2010, Pacing and clinical electrophysiology : PACE.

[109]  P. Lambin,et al.  What to choose as radical local treatment for lung metastases from colo-rectal cancer: surgery or radiofrequency ablation? , 2014, Cancer treatment reviews.

[110]  S. Baldwin,et al.  A Heat Transfer Model of Thermal Balloon Endometrial Ablation , 2001, Annals of Biomedical Engineering.

[111]  H-X Xu,et al.  Prognostic factors for long-term outcome after percutaneous thermal ablation for hepatocellular carcinoma: a survival analysis of 137 consecutive patients. , 2005, Clinical radiology.

[112]  S. Psutka,et al.  Long-term oncologic outcomes after radiofrequency ablation for T1 renal cell carcinoma. , 2013, European urology.

[113]  K. Sung,et al.  Medium-Sized (3.1–5.0 cm) Hepatocellular Carcinoma: Transarterial Chemoembolization Plus Radiofrequency Ablation Versus Radiofrequency Ablation Alone , 2011, Annals of Surgical Oncology.

[114]  J. Haaga,et al.  Real-time monitoring of radiofrequency ablation and postablation assessment: accuracy of contrast-enhanced US in experimental rat liver model. , 2013, Radiology.