Ex vivo experiment on radiofrequency liver ablation with saline infusion through a screw-tip cannulated electrode.

PURPOSE To investigate whether radiofrequency (RF) therapy with hypertonic saline infusion through a hollow screw-tip electrode can cause a lesion size suitable for liver tumor ablation. MATERIALS AND METHODS RF tissue ablation of 180 sites was performed by using a hollow screw-tip electrode in 40 freshly excised swine livers. Under both power and temperature control modes, the ablation effects with and without various regimes of 5% hypertonic saline (1 ml/min) prior to and/or during the procedure were compared by measuring the size of lesions at dissection and confirmed by T1 and T2 weighted magnetic resonance (MR) imaging. RESULTS The maximal lesion diameter of 5.5 cm was reached at 30 W with saline infusion 1 min prior to and during 12 min of ablation. The smaller sizes (P < 0.01) between 0.3 and 2.5 cm in diameter were met with noninfusion or preinfusion-only groups. The RF ablation lesions appeared as hyper- and hypointense areas on T1 and T2 MR images, respectively. CONCLUSIONS RF ablation in combination with present hollow screw-tip electrode and saline infusion allows for necrotic development of suitable size for liver tumor ablation. Such ablated lesions can be visualized with MR imaging.

[1]  A. Graham,et al.  Determinants of Impedance Rise During Catheter Ablation of Bovine Myocardium with Radiofrequency Energy , 1989, Pacing and clinical electrophysiology : PACE.

[2]  S. Rossi,et al.  Laparoscopic ablation of liver adenoma by radiofrequency electrocauthery. , 1995, Gastrointestinal endoscopy.

[3]  J. MacFall,et al.  Non-invasive thermometry using magnetic resonance diffusion imaging: potential for application in hyperthermic oncology. , 1992, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[4]  K. Kuroda,et al.  A precise and fast temperature mapping using water proton chemical shift , 1995, Magnetic resonance in medicine.

[5]  K. Kopecky,et al.  Sonographic and computed tomography characteristics of liver ablation lesions induced by high-intensity focussed ultrasound , 1993 .

[6]  S. Huang Advances in Applications of Radiofrequency Current to Catheter Ablation Therapy , 1991, Pacing and clinical electrophysiology : PACE.

[7]  Y. Fong,et al.  A technique for the use of cryosurgery to assist hepatic resection. , 1995, Journal of the American College of Surgeons.

[8]  R Lazzara,et al.  Comparison of in vivo tissue temperature profile and lesion geometry for radiofrequency ablation with a saline-irrigated electrode versus temperature control in a canine thigh muscle preparation. , 1995, Circulation.

[9]  Katherine S. Virgo,et al.  Outcomes after detection of metastatic carcinoma of the colon and rectum in a national hospital system. , 1996, Journal of the American College of Surgeons.

[10]  M Takahashi,et al.  Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation. , 1995, AJR. American journal of roentgenology.

[11]  D. Haines,et al.  The Biophysics of Radiofrequency Catheter Ablation in the Heart: The Importance of Temperature Monitoring , 1993, Pacing and clinical electrophysiology : PACE.

[12]  R. Leveillee,et al.  Enhanced radiofrequency ablation of canine prostate utilizing a liquid conductor: the virtual electrode. , 1996, Journal of endourology.

[13]  D I Rosenthal,et al.  Radiofrequency tissue ablation: importance of local temperature along the electrode tip exposure in determining lesion shape and size. , 1996, Academic radiology.

[14]  L. Pires,et al.  Use of the Saline Infusion Electrode Catheter for Improved Energy Delivery and Increased Lesion Size in Radiofrequency Catheter Ablation , 1995, Pacing and clinical electrophysiology : PACE.

[15]  J. Langberg,et al.  Electrogram Criteria for Identification of Appropriate Target Sites for Radiofrequency Catheter Ablation of Accessory Atrioventricular Connections , 1992, Circulation.

[16]  G. Steinbeck,et al.  Temperature-controlled radiofrequency catheter ablation of AV conduction: first clinical experience. , 1993, European heart journal.

[17]  G. K. Malik,et al.  Hepatocellular carcinoma and cirrhosis of liver , 1986, Indian journal of pediatrics.

[18]  K. Kopecky,et al.  Sonographic and Computed Tomography Characteristics of Liver Ablation Lesions Induced by High‐Intensity Focussed Ultrasound , 1993, Investigative radiology.

[19]  T. Lorentzen,et al.  A cooled needle electrode for radiofrequency tissue ablation: thermodynamic aspects of improved performance compared with conventional needle design. , 1996, Academic radiology.

[20]  G. Gazelle,et al.  Radiofrequency tissue ablation: increased lesion diameter with a perfusion electrode. , 1996, Academic radiology.

[21]  D. Haines,et al.  Observations on electrode-tissue interface temperature and effect on electrical impedance during radiofrequency ablation of ventricular myocardium. , 1990, Circulation.

[22]  J. Bruix,et al.  Hepatocellular carcinoma and cirrhosis. Results of surgical treatment in a European series. , 1996, Annals of surgery.

[23]  R. Lazzara,et al.  Catheter ablation of accessory atrioventricular pathways (Wolff-Parkinson-White syndrome) by radiofrequency current. , 1991, The New England journal of medicine.

[24]  M. Niebauer,et al.  Relation between impedance and temperature during radiofrequency ablation of accessory pathways. , 1995, American heart journal.

[25]  Sandro Rossi,et al.  Percutaneous ultrasound-guided radiofrequency electrocautery for the treatment of small hepatocellular carcinoma , 1993 .

[26]  J S Child,et al.  Transesophageal echocardiography during radiofrequency catheter ablation of ventricular tachycardia. , 1993, The American journal of cardiology.