Ferromagnetic self-regulating reheatable thermal rod implants for in situ tissue ablation.
OBJECTIVE
Ferromagnetic compounds, when placed in a radiofrequency magnetic field, develop an electrical current. When placed in tissue, resistance to the transmission of the electrical current leads to heating of the tissues next to the ferromagnetic compound. The Curie temperature is a transition point at which the development of a particular temperature within the material results in loss of its magnetic properties; as such, when this temperature is reached, there is cessation of current, and thus heat production stops. Our goal was to examine the ablative impact of permanently implanted palladium and cobalt self-regulating temperature rods on solid abdominal and pelvic organs. These rods were designed to develop a maximum temperature of 70 degrees C.


METHODS
In 16 pigs, renal, hepatic, uterine, and pancreatic ferromagnetic rods were placed using a template. The rods were delivered in 1-cm parallel rows of two rods each in order to ablate 7 g of tissue. The animals were subsequently treated in an extracorporeal magnetic field of 50 gauss rms at a frequency of 50 kHz. The position of the rods was confirmed by fluoroscopy before the animal was put in the magnetic field. The animals received one or two treatment sessions. Intralesional and extralesional temperatures were measured continuously. Serum chemistry was analyzed before surgery, after each treatment, and at the time of harvest. Two weeks following therapy, the treated tissues were harvested and examined histopathologically.


RESULTS
In all tissues with properly aligned rods, the temperature of the tissue surrounding the rods exceeded 50 degrees C. Histologic review showed confluent tissue necrosis in 7 of 9 kidneys (78%), 6 of 9 livers (67%), 1 of 3 pancreases (33%), and 1 of 3 uterine specimens (33%). Necrosis extended for 2 mm beyond the periphery of the rods. All failures were secondary to technical misalignment of the rods, which occurred because of our attempt to treat more than one organ in each animal.


CONCLUSIONS
Ferromagnetic rods, when properly aligned in a magnetic field, create well-defined areas of necrosis. There are no skip areas of viable tissue within the treated area, and there is a precipitous fall-off of injury just outside the area of treatment. Also, because the rods can be reactivated at any time, recurrent lesions within the same site can be treated. This form of minimally invasive in situ ablative therapy appears promising. Clinical trials in the kidney and in other abdominal and pelvic organs are pending.
Rehman
Jamil
J
Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Landman
Jaime
J
Tucker
Robert D
RD
Bostwick
David G
DG
Sundaram
Chandru P
CP
Clayman
Ralph V
RV
D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use; D002151:Calorimetry; D004574:Electromagnetic Fields; D005260:Female; D005290:Ferric Compounds; D006358:Hot Temperature / Q000627:therapeutic use*; D006979:Hyperthermia, Induced / Q000295:instrumentation* / Q000379:methods*; D007668:Kidney / Q000473:pathology / Q000528:radiation effects; D008099:Liver / Q000473:pathology; D008422:Materials Testing; D009336:Necrosis; D009369:Neoplasms / Q000628:therapy; D010179:Pancreas / Q000473:pathology; D019736:Prostheses and Implants; D000078702:Radiofrequency Therapy; D013552:Swine; D014599:Uterus / Q000473:pathology
D001672:Biocompatible Materials; D005290:Ferric Compounds; C001215:ferrite