Saline-Enhanced Radiofrequency Thermal Ablation of the Lung: A Feasibility Study in Rabbits

Objective To assess the feasibility and safety of CT-guided percutaneous transthoracic radiofrequency ablation (RFA) with saline infusion of pulmonary tissue in rabbits. Materials and Methods Twenty-eight New Zealand White rabbits were divided into two groups: an RFA group (n=10) and a saline-enhanced RFA (SRFA) group (n=18). In the RFA group, percutaneous RFA of the lung was performed under CT guidance and using a 17-gauge internally cooled electrode. In the SRFA group, 1.5 ml of 0.9% saline was infused slowly through a 21-gauge, polyteflon-coated Chiba needle prior to and during RFA. Lesion size and the healing process were studied in rabbits sacrificed at times from the day following treatment to three weeks after, and any complications were noted. Results In the SRFA group, the mean diameter (12.5 ± 1.6 mm) of acute RF lesions was greater than that of RFA lesions (8.5 ± 1.4 mm) (p < .05). The complications arising in 12 cases were pneumothorax (n=8), thermal injury to the chest wall (n=2), hemothorax (n=1), and lung abscess (n=1). Although procedure-related complications tended to occur more frequently in the SRFA group (55.6%) than in the RFA group (20%), the difference was not statistically significant (p = .11). Conclusion Saline-enhanced RFA of pulmonary tissue in rabbits produces more extensive coagulation necrosis than conventional RFA procedures, without adding substantial risk of serious complications.

[1]  A L Baert,et al.  Ex vivo experiment on radiofrequency liver ablation with saline infusion through a screw-tip cannulated electrode. , 1997, The Journal of surgical research.

[2]  F. Garbagnati,et al.  Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. , 1996, AJR. American journal of roentgenology.

[3]  D M Ikeda,et al.  Radiofrequency ablation of breast cancer: first report of an emerging technology. , 1999, Archives of surgery.

[4]  Jeong Min Lee,et al.  MR Imaging-Histopathologic Correlation of Radiofrequency Thermal Ablation Lesion in a Rabbit Liver Model: Observation during Acute and Chronic Stages , 2001, Korean journal of radiology.

[5]  G. Steele,et al.  Cancer: Principles and Practice of Oncology , 1983 .

[6]  V. Devita,et al.  Cancer : Principles and Practice of Oncology , 1982 .

[7]  Y. Ni,et al.  A comparative study on validation of a novel cooled-wet electrode for radiofrequency liver ablation. , 2000, Investigative radiology.

[8]  G. Gazelle,et al.  Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. , 2000, AJR. American journal of roentgenology.

[9]  W. Fry,et al.  Ten‐year survey of lung cancer treatment and survival in hospitals in the United States , 1999, Cancer.

[10]  G S Gazelle,et al.  Percutaneous radiofrequency tissue ablation: optimization of pulsed-radiofrequency technique to increase coagulation necrosis. , 1999, Journal of vascular and interventional radiology : JVIR.

[11]  P R Mueller,et al.  Radio-frequency ablation of renal cell carcinoma: early clinical experience. , 2000, Radiology.

[12]  G. Gazelle,et al.  Tumor ablation with radio-frequency energy. , 2000, Radiology.

[13]  L V Rubinstein,et al.  Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. , 1995, The Annals of thoracic surgery.

[14]  R Fiocca,et al.  Percutaneous US-guided radio-frequency tissue ablation of liver metastases: treatment and follow-up in 16 patients. , 1997, Radiology.

[15]  R. Landreneau,et al.  Video‐Assisted Thoracoscopic Wedge Resection of T1 Lung Cancer in High‐Risk Patients , 1993, Annals of surgery.

[16]  H J Mankin,et al.  Percutaneous Radiofrequency Coagulation of Osteoid Osteoma Compared with Operative Treatment* , 1998, The Journal of bone and joint surgery. American volume.

[17]  Steven A. Curley,et al.  Radiofrequency Ablation of Hepatocellular Cancer in 110 Patients With Cirrhosis , 2000, Annals of surgery.

[18]  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.

[19]  Harvey I. Pass,et al.  Lung cancer : principles and practice , 1996 .

[20]  J. Haaga.  Computed tomography and magnetic resonance imaging of the whole body , 1994 .

[21]  R E Lenkinski,et al.  Radio-frequency thermal ablation with NaCl solution injection: effect of electrical conductivity on tissue heating and coagulation-phantom and porcine liver study. , 2001, Radiology.

[22]  T. Livraghi,et al.  Small hepatocellular carcinoma treated with percutaneous RF ablation: MR imaging follow-up. , 1999, AJR. American journal of roentgenology.

[23]  C. Compton,et al.  Radio-frequency tissue ablation of VX2 tumor nodules in the rabbit lung. , 1996, Academic radiology.

[24]  F. Torti,et al.  Radio frequency ablation of lung metastases from renal cell carcinoma. , 2001, The Journal of urology.

[25]  G. Dodd,et al.  Radiofrequency thermal ablation: computer analysis of the size of the thermal injury created by overlapping ablations. , 2001, AJR. American journal of roentgenology.

[26]  H. Lim.  Radiofrequency Thermal Ablation of Hepatocellular Carcinomas , 2000, Korean journal of radiology.

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

[28]  L. Ellis,et al.  Radiofrequency Ablation of Unresectable Primary and Metastatic Hepatic Malignancies: Results in 123 Patients , 1999 .

[29]  R. Lufkin,et al.  Preliminary experience with MR-guided thermal ablation of brain tumors. , 1995, AJNR. American journal of neuroradiology.

[30]  W. Kaiser,et al.  Radio-frequency tumor ablation: internally cooled electrode versus saline-enhanced technique in an aggressive rabbit tumor model. , 2002, Radiology.

[31]  W W Mayo-Smith,et al.  Percutaneous radiofrequency ablation of malignancies in the lung. , 2000, AJR. American journal of roentgenology.

[32]  G Marchal,et al.  Radiofrequency ablation for eradication of pulmonary tumor in rabbits. , 2001, The Journal of surgical research.

[33]  G S Gazelle,et al.  Radiofrequency tissue ablation in the rabbit lung: efficacy and complications. , 1995, Academic radiology.

[34]  M. Mack,et al.  Wedge resection versus lobectomy for stage I (T1 N0 M0) non-small-cell lung cancer. , 1997, The Journal of thoracic and cardiovascular surgery.

[35]  L Solbiati,et al.  Saline-enhanced radio-frequency tissue ablation in the treatment of liver metastases. , 1997, Radiology.