Saline-enhanced radio-frequency tissue ablation in the treatment of liver metastases.
OBJECTIVE
To assess the effect of intraparenchymal saline injection on the results of radio-frequency (RF) tissue ablation.


METHODS
Ex vivo and in vivo animal RF ablation was performed with and without intraparenchymal saline injection. Initially, saline was injected as a bolus (1-20 mL) before RF application. For subsequent in vivo studies, saline was injected as a bolus before RF application or continuously (1 mL/min) during RF application. Finally, 14 patients with liver metastases and one patient with primary cholangiocarcinoma were treated with the continuous infusion technique. A single RF electrode (tip exposure, 1-3 cm) was used with various ablation parameters.


RESULTS
With pretreatment bolus injection of saline, lesions measured 1.4 cm +/- 0.1, 1.6 cm +/- 0.2, and 1.2 cm +/- 0.1 in ex vivo liver, in vivo animal muscle, and in vivo animal liver, respectively. Without saline enhancement, lesion sizes were 1.0 +/- 0.2, 1.2 +/- 0.2, and 0.8 +/- 0.1 cm, respectively. With continuous saline injection in in vivo pig liver, lesion size was 1.8 - 4.1 cm in diameter. In human tumors, necrosis volume was variable, but complete necrosis was seen in 13 of 25 lesions (diameter, 1.2-3.9 cm). Partial necrosis greater than 50% was seen in 12 lesions (diameter, 1.5-4.5 cm).


CONCLUSIONS
Saline-enhanced RF ablation might permit percutaneous destruction of large liver lesions.
Livraghi
T
T
Department of Radiology, Ospedale Civile, Vimercate (Milan), Italy.
Goldberg
S N
SN
Monti
F
F
Bizzini
A
A
Lazzaroni
S
S
Meloni
F
F
Pellicanò
S
S
Solbiati
L
L
Gazelle
G S
GS
D000328:Adult; D000368:Aged; D000818:Animals; D017115:Catheter Ablation; D002417:Cattle; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007267:Injections; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012965:Sodium Chloride / Q000008:administration & dosage*; D013552:Swine; D014057:Tomography, X-Ray Computed
D012965:Sodium Chloride