Combined radiofrequency ablation and hot saline injection in rabbit liver.
OBJECTIVE
To determine whether combining hot saline injection (HSI) and radiofrequency ablation (RFA) can increase the extent of thermally mediated coagulation in in vivo rabbit liver tissue.


METHODS
In 66 rabbits, RF energy and/or hot saline-induced coagulations were produced using a 17-gauge cooled electrode or 21-gauge needle under ultrasound guidance. Rabbits were allocated into 1 of 5 groups: group A, RFA alone (n = 15); group B, HSI (1 mL hot saline infused, n = 10); group C, combined therapy for HSI followed by RFA (n = 21); group D, combined therapy for RFA immediately followed by HSI (n = 10); and group E, 1 mL room temperature saline infusion before RFA (n = 10). RF energy (30 W) was applied for 3 minutes. The changes in tissue impedance, current, power output, and temperature of the electrode tip were automatically measured. Before RFA, precontrast computed tomography was performed, and after RFA, pre- and postcontrast spiral computed tomographic scans were acquired. The maximum diameters of the thermal lesions on the gross specimens and complications of each group were compared.


RESULTS
All procedures were technically successful. There were 9 of 61 procedure-related complications (14.8%) including 6 localized hematomas and 3 thermal injuries to the diaphragm and the stomach. In rabbits in groups C and E, a marked decrease of tissue impedance (43.4 omega, 44.1 omega) and an increase of current (709 mA, 722 mA) occurred with instillation of saline infusion compared with RFA only. Combined therapy for HSI followed by RFA produced a greater short-axis mean diameter of coagulation (14.6 +/- 4.3 mm) than that in rabbits of other groups, for RFA only (10.4 +/- 2.4 mm), HSI only (8.7 +/- 3.3 mm), and combined therapy for RFA immediately followed by HIS (12.0 +/- 1.4 mm; P < 0.05).


CONCLUSIONS
Combined therapy for HSI followed by RFA can increase the volume of RFA-induced coagulation in the liver with a single application, and therefore may improve the results of RFA for the treatment of larger tumors.
Kim
Young Kon
YK
Department of Radiology, Chonbuk National University Medical School, Chonju, Seoul, Korea.
Lee
Jeong Min
JM
Kim
Sang Won
SW
Kim
Chong Soo
CS
D000818:Animals; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D006358:Hot Temperature / Q000627:therapeutic use*; D006979:Hyperthermia, Induced / Q000379:methods*; D015552:Injections, Intralesional; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D009336:Necrosis; D011817:Rabbits; D012965:Sodium Chloride / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed
D012965:Sodium Chloride