Perfused hypertonic-saline-augmented needle enlarges ablation zones in ex vivo porcine livers

摘要

There is a great clinical requirement to improve radio frequency ablation (RFA) efficacy and create larger coagulation necrotic areas. The aim of the present study was to assess the ability of a hypertonic-saline (HS)-enhanced multipolar RFA technique using a perfused electrode to increase RF-created coagulation necrosis, and to compare that technique with natural saline-augmented needle and conventional multipolar RFA. A total of 18 ablations were performed in explanted porcine livers. A total of 6 thermal ablation zones were created in each of 3 groups treated with the conventional multipolar mode, the multipolar mode with 0.9% NaCl and the multipolar mode with 6% NaCl, respectively. During RFA, the dimensions and volumes of the ablation zones were compared, and gross and microscopic pathological evaluations were performed. Multipolar RFA with 6% NaCl created the largest short-axis diameters and volumes of coagulation necrosis (3.89 +/- 0.09 mm and 40.01 +/- 2.86 mm(3), respectively) among the three groups (conventional group: 2.31 +/- 0.04 mm and 8.99 0.52 mm(3), respectively; 0.9% NaCl solution group: 3.17 +/- 0.05 mm and 21.79 +/- 1.05 mm(3), respectively). Overall, multipolar RFA with the instillation of 6% NaCI solution through an open perfusion system created a larger ablation zone compared with the conventional and 0.9% NaCI modes. Therefore, HS-enhanced multipolar RFA may be a promising approach for treating large liver tumors. Introduction Radiofrequency ablation (RFA) has been validated as a safe and efficient treatment for hepatocellular carcinoma (HCC) and focal metastatic liver tumors in patients who are not candidates for hepatic resection or who refuse surgery (1). However, clinical studies have identified a high rate of unsuccessful RFA treatment for large tumors.