Key result
Creating small ablation zones prior to saline infusion significantly increased the coagulation volume during perfused RF ablation compared to bipolar ablation alone (100.26 vs 79.56 cm3).
Why the study?
Does the creation of a small coagulation zone prior to perfused RF ablation enlarge the coagulation zone in excised bovine livers?
Does the creation of a small coagulation zone prior to perfused RF ablation enlarge the coagulation zone in excised bovine livers?
Absolute Event Rate: 100.26% vs 79.56%
Creating small ablation zones prior to saline infusion during RF ablation improves energy delivery efficacy and increases total coagulation volume in an ex vivo liver model.
May enlarge ablation zones in perfused models; leaves open clinical translation of pre-ablation strategy.
One of the strategies for enlarging coagulation zone dimensions during RF ablation of liver tumours is to infuse saline solutions into the tissue during ablation. The aim of this study was to evaluate experimentally whether the creation of a small coagulation adjacent to a bipolar RF applicator and prior to perfused RF ablation would allow enlargement of the coagulation zone. Thirty bipolar RF ablations (group A, n = 15; group B, n = 15) were performed in excised bovine livers. Additionally, in group B a monopolar RF application (60 W, 20 s) was performed before bipolar ablation using three small additional electrodes. Electrical parameters and dimensions of the ablation zone were compared between groups. Despite the fact that all three ablation zone diameters were greater in group B, only one of the minor diameters was significantly longer (5.52 +/- 0.66 cm versus 4.87 +/- 0.47 cm). Likewise, volume was significantly bigger in group B (100.26 +/- 24.10 cm(3) versus 79.56 +/- 15.59 cm(3)). There were no differences in the impedance evolution, allowing a relatively high constant power in both groups (around 90 W). The efficacy of delivering energy (expressed as the delivered energy per coagulation volume) was significantly better in group B, showing a lower value (578 J cm(-3) versus 752 J cm(-3)). These results suggest that the creation of small ablation zones prior to saline infusion improves the performance of this perfusion system, and hence the total volume.
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Navarro et al. (2007) studied liver tumours (ex vivo model) (n=30). Creation of small coagulation zones prior to perfused bipolar RF ablation vs. Perfused bipolar RF ablation alone was evaluated on coagulation volume. Creating small ablation zones prior to saline infusion significantly increased the coagulation volume during perfused RF ablation compared to bipolar ablation alone (100.26 vs 79.56 cm3).
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