Saline-enhanced hepatic radiofrequency ablation using a perfused-cooled electrode: comparison of dual probe bipolar mode with monopolar and single probe bipolar modes.
OBJECTIVE
To determine whether saline-enhanced dual probe bipolar radiofrequency ablation (RFA) using perfused-cooled electrodes shows better in-vitro efficiency than monopolar or single probe bipolar RFA in creating larger coagulation necrosis.


METHODS
RF was applied to excised bovine livers in both bipolar and monopolar modes using a 200 W generator (CC-3; Radionics) and the perfused-cooled electrodes for 10 mins. After placing single or double perfused-cooled electrodes in the explanted liver, 30 ablation zones were created at three different regimens: group A; saline-enhanced monopolar RFA, group B; saline-enhanced single probe bipolar RFA, and group C; saline-enhanced dual probe bipolar RFA. During RFA, we measured the tissue temperature at 15 mm from the electrode. The dimensions of the ablation zones and changes in the impedance currents and liver temperature during RFA were then compared between the groups.


RESULTS
The mean current values were higher for monopolar mode (group A) than for the bipolar modes (groups B and C): 1550+/-25 mA in group A, 764+/-189 mA in group B and 819+/-98 mA in group C (p < 0.05). The volume of RF-induced coagulation necrosis was greater in group C than in the other groups: 27.6+/-2.9 cm(3) in group A, 23.7+/-3.8 cm(3) in group B, and 34.2+/-5.1 cm(3) in group C (p < 0.05). However, there was no significant difference between the short-axis diameter of the coagulation necrosis in the three groups: 3.1+/-0.8 cm, 2.9+/-1.2 cm and 4.0+/-1.3 cm in groups A, B and C, respectively (p > 0.05). The temperature at 15 mm from the electrode was higher in group C than in the other groups: 70+/- 18 degrees C in group A, 59+/-23 degrees C in group B and 96+/-16 degrees C in group C (p > 0.05).


CONCLUSIONS
Saline-enhanced bipolar RFA using dual perfused-cooled electrodes increases the dimension of the ablation zone more efficiently than monopolar RFA or single probe bipolar RFA.
Lee
Jeong Min
JM
Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.
Han
Joon Koo
JK
Kim
Se Hyung
SH
Lee
Jae Young
JY
Kim
Dae Jin
DJ
Lee
Min Woo
MW
Cho
Gyung Goo
GG
Han
Chang Jin
CJ
Choi
Byung Ihn
BI
D000818:Animals; D017115:Catheter Ablation / Q000295:instrumentation*; D002417:Cattle; D004564:Electrocoagulation; D066298:In Vitro Techniques; D008099:Liver / Q000473:pathology / Q000601:surgery*; D009336:Necrosis; D012965:Sodium Chloride
D012965:Sodium Chloride