Comparison of Internally Cooled Wet Electrode and Hepatic Vascular Inflow Occlusion Method for Hepatic Radiofrequency Ablation
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Background/Aims: Various strategies to expand the ablation zone have been attempted using hepatic radiofrequency ablation (RFA). The optimal strategy, however, is unknown. We compared hepatic RFA with an internally cooled wet (ICW) electrode and vascular inflow occlusion. Methods: Eight dogs were assigned to one of three groups: only RFA using an internally cooled electrode (group A), RFA using an ICW electrode (group B), and RFA using an internally cooled electrode with the Pringle maneuver (group C). The ablation zone diameters were measured on the gross specimens, and the volume of the ablation zone was calculated. Results: The ablation zone volume was greatest in group B (1.82±1.23 cm3), followed by group C (1.22±0.47 cm3), and then group A (0.48±0.33 cm3). The volumes for group B were significantly larger than the volumes for group A (p=0.030). There was no significant difference in the volumes between groups A and C (p=0.079) and between groups B and C (p=0.827). Conclusions: Both the usage of an ICW electrode and hepatic vascular occlusion effectively expanded the ablation zone. The use of an ICW electrode induced a larger ablation zone with easy handling compared with using hepatic vascular occlusion, although this difference was not statistically significant
Abstract
Background/Aims: Various strategies to expand the ablation zone have been attempted using hepatic radiofrequency ablation (RFA). The optimal strategy, however, is unknown. We compared hepatic RFA with an internally cooled wet (ICW) electrode and vascular inflow occlusion. Methods: Eight dogs were assigned to one of three groups: only RFA using an internally cooled electrode (group A), RFA using an ICW electrode (group B), and RFA using an internally cooled electrode with the Pringle maneuver (group C). The ablation zone diameters were measured on the gross specimens, and the volume of the ablation zone was calculated. Results: The ablation zone volume was greatest in group B (1.82±1.23 cm3), followed by group C (1.22±0.47 cm3), and then group A (0.48±0.33 cm3). The volumes for group B were significantly larger than the volumes for group A (p=0.030). There was no significant difference in the volumes between groups A and C (p=0.079) and between groups B and C (p=0.827). Conclusions: Both the usage of an ICW electrode and hepatic vascular occlusion effectively expanded the ablation zone. The use of an ICW electrode induced a larger ablation zone with easy handling compared with using hepatic vascular occlusion, although this difference was not statistically significant
참고문헌 (36)
- Poon RT, "Locoregional therapies for hepatocellular carcinoma: a critical review from the surgeon’s perspective", Ann Surg, 235, pp.466~486 (2002)
- Tateishi R, "Percutaneous radiofrequency ablation for hepatocellular carcinoma. An analysis of 1000 cases", Cancer, 103, pp.1201~1209 (2005)
- Solbiati L, "Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes", Radiology, 205, pp.367~373 (1997)
- Livraghi T, "Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions", Radiology, 214, pp.761~768 (2000)
- de Baere T, "Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than 1 year", AJR Am J Roentgenol, 175, pp.1619~1625 (2000)
- Dodd GD 3rd, "Radiofrequency thermal ablation: computer analysis of the size of the thermal injury created by overlapping ablations", AJR Am J Roentgenol, 177, pp.777~782 (2001)
- Goldberg SN, "Radiofrequency tissue ablation: physical principles and techniques for increasing coagulation necrosis", Hepatogastroenterology, 48, pp.359~367 (2001)
- Haemmerich D, "Large-volume radiofrequency ablation of ex vivo bovine liver with multiple cooled cluster electrodes", Radiology, 234, pp.563~568 (2005)
- Lee FT Jr, "Multiple probe radiofrequency ablation: pilot study in an animal model", J Vasc Interv Radiol, 14, pp.1437~1442 (2003)
- Laeseke PF, "Multiple-electrode radiofrequency ablation creates confluent areas of necrosis: in vivo porcine liver results", Radiology, 241, pp.116~124 (2006)
- Strickland AD, "Experimental study of large-volume microwave ablation in the liver", Br J Surg, 89, pp.1003~1007 (2002)
- Wright AS, "Hepatic microwave ablation with multiple antennae results in synergistically larger zones of coagulation necrosis", Ann Surg Oncol, 10, pp.275~283 (2003)
- Aramaki M, "Microwave coagulation therapy for unresectable hepatocellular carcinoma", Hepatogastroenterology, 51, pp.1784~1787 (2004)
- Goldberg SN, "Radio-frequency thermal ablation with NaCl solution injection: effect of electrical conductivity on tissue heating and coagulation-phantom and porcine liver study", Radiology, 219, pp.157~165 (2001)
- Ahmed M, "Improved coagulation with saline solution pretreatment during radiofrequency tumor ablation in a canine model", J Vasc Interv Radiol, 13, pp.717~724 (2002)
- JeongMinLee, "Percutaneous Radiofrequency Thermal Ablation with Hypertonic Saline Injection: In Vivo Study in a Rabbit Liver Model", Korean Journal of Radiology, 4(1), pp.27~34 (2003), 대한영상의학회
- Schmidt D, "Automated saline-enhanced radiofrequency thermal ablation: initial results in ex vivo bovine livers", AJR Am J Roentgenol, 180, pp.163~165 (2003)
- Hänsler J, "Radiofrequency ablation of hepatocellular carcinoma with a saline solution perfusion device: a pilot study", J Vasc Interv Radiol, 14, pp.575~580 (2003)
- Kettenbach J, "Percutaneous saline-enhanced radiofrequency ablation of unresectable hepatic tumors: initial experience in 26 patients", AJR Am J Roentgenol, 180, pp.1537~1545 (2003)
- Jeong Min Lee, "Comparison of Wet Radiofrequency Ablation with Dry Radiofrequency Ablation and Radiofrequency Ablation Using Hypertonic Saline Preinjection: Ex Vivo Bovine Liver", Korean Journal of Radiology, 5(4), pp.258~265 (2004), 대한영상의학회
- Lobo SM, "Radiofrequency ablation: modeling the enhanced temperature response to adjuvant NaCl pretreatment", Radiology, 230, pp.175~182 (2004)
- Lee JM, "Radiofrequency ablation of the porcine liver in vivo: increased coagulation with an internally cooled perfusion electrode", Acad Radiol, 13, pp.343~352 (2006)
- Kim SK, "CT findings after radiofrequency ablation in rabbit livers: comparison of internally cooled electrodes, perfusion electrodes, and internally cooled perfusion electrodes", J Vasc Interv Radiol, 18, pp.1417~1427 (2007)
- Ni Y, "A novel “cooled-wet” electrode for radiofrequency ablation", Eur Radiol, 10, pp.852~854 (2000)
- Miao Y, "A comparative study on validation of a novel cooled-wet electrode for radiofrequency liver ablation", Invest Radiol, 35, pp.438~444 (2000)
- Cha J, "Radiofrequency ablation zones in ex vivo bovine and in vivo porcine livers: comparison of the use of internally cooled electrodes and internally cooled wet electrodes", Cardiovasc Intervent Radiol, 32, pp.1235~1240 (2009)
- Chinn SB, "Effect of vascular occlusion on radiofrequency ablation of the liver: results in a porcine model", AJR Am J Roentgenol, 176, pp.789~795 (2001)
- Patterson EJ, "Radiofrequency ablation of porcine liver in vivo: effects of blood flow and treatment time on lesion size", Ann Surg, 227, pp.559~565 (1998)
- Curley SA, "Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients", Ann Surg, 230, pp.1~8 (1999)
- Wiersinga WJ, "Lesion progression with time and the effect of vascular occlusion following radiofrequency ablation of the liver", Br J Surg, 90, pp.306~312 (2003)
- Denys AL, "Radio-frequency tissue ablation of the liver: effects of vascular occlusion on lesion diameter and biliary and portal damages in a pig model", Eur Radiol, 11, pp.2102~2108 (2001)
- de Baère T, "Adverse events during radiofrequency treatment of 582 hepatic tumors", AJR Am J Roentgenol, 181, pp.695~700 (2003)
- Seung Kwon Kim, "Radiofrequency Ablation of Rabbit Liver In Vivo: Effect of the Pringle Maneuver on Pathologic Changes in Liver Surrounding the Ablation Zone", Korean Journal of Radiology, 5(4), pp.240~249 (2004), 대한영상의학회
- Ng KK, "Delayed portal vein thrombosis after experimental radiofrequency ablation near the main portal vein", Br J Surg, 91, pp.632~639 (2004)
- Sugimori K, "Extension of radiofrequency ablation of the liver by transcatheter arterial embolization with iodized oil and gelatin sponge: results in a pig model", J Vasc Interv Radiol, 16, pp.849~856 (2005)
- Iwamoto T, "Effectiveness of hepatic arterial embolization on radiofrequency ablation volume in a swine model: relationship to portal venous flow and liver parenchymal pressure", J Vasc Interv Radiol, 19, pp.1646~1651 (2008)
