Comparison of Wet Radiofrequency Ablation with Dry Radiofrequency Ablation and Radiofrequency Ablation Using Hypertonic Saline Preinjection: Ex Vivo Bovine Liver.
- Author:
Jeong Min LEE
1
;
Joon Koo HAN
;
Se Hyung KIM
;
Kyung Sook SHIN
;
Jae Young LEE
;
Hee Sun PARK
;
Hurn HUR
;
Byung Ihn CHOI
Author Information
- Publication Type:Original Article ; Comparative Study ; Research Support, Non-U.S. Gov't
- Keywords: Experimental study; Interventional procedures; Liver; Radiofrequency ablation
- MeSH: Animals; Body Temperature; Catheter Ablation/*methods; Cattle; Disease Models, Animal; Electric Impedance; Electrodes, Implanted; Equipment Design; Injections; Liver/pathology/*surgery; Necrosis; Perfusion; Saline Solution, Hypertonic/*administration & dosage
- From:Korean Journal of Radiology 2004;5(4):258-265
- CountryRepublic of Korea
- Language:English
- 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. MATER 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 omega) than for group A (80 omega) (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 omega 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 cm3 in group A; 12.4+/-3.8 cm3 in group B; 80.9+/-9.9 cm3 in group C; 45.3+/-11.3 cm3 in group D and 81.6+/-8.6 cm3 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 degreesC in group A, 42+/-2degreesC in group B, 93+/-8 degreesC in group C; 79+/-12 degreesC in group D and 83+/-8 degreesC 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.
