Comparison of wet radiofrequency ablation with dry radiofrequency ablation and radiofrequency ablation using hypertonic saline preinjection: ex vivo bovine liver.
OBJECTIVE
We wished to compare the in-vitro efficiency of wet radiofrequency(RF) ablation with the efficiency of dry RF ablation and RF ablation with preinjection of NaCl solutions using excised bovine liver.


METHODS
Radiofrequency was applied to excised bovine livers in a monopolar mode for 10 minutes using a 200 W generator and a perfused-cooled electrode with or without injection or slow infusion of NaCl solutions. After placing the perfused-cooled electrode in the explanted liver, 50 ablation zones were created with five different regimens: group A; standard dry RF ablation, group B; RF ablation with 11 mL of 5% NaCl solution preinjection, group C; RF ablation with infusion of 11 mL of 5% NaCl solution at a rate of 1 mL/min, group D; RFA with 6 mL of 36% NaCl solution preinjection, group E; RF ablation with infusion of 6 mL of 36% NaCl solution at a rate of 0.5 mL/min. In groups C and E, infusion of the NaCl solutions was started 1 min before RF ablation and then maintained during RF ablation (wet RF ablation). During RF ablation, we measured the tissue temperature at 15 mm from the electrode. The dimensions of the ablation zones and changes in impedance, current and liver temperature during RF ablation were then compared between the groups.


RESULTS
With injection or infusion of NaCl solutions, the mean initial tissue impedance prior to RF ablation was significantly less in groups B, C, D, and E (43-75 ohm) than for group A (80 ohm) (p < 0.05). During RF ablation, the tissue impedance was well controlled in groups C and E, but it was often rapidly increased to more than 200 ohm in groups A and B. In group D, the impedance was well controlled in six of ten trials but it was increased in four trials (40%) 7 min after starting RF ablation. As consequences, the mean current was higher for groups C, D, and E than for the other groups: 401+/-145 mA in group A, 287+/-32 mA in group B, 1907+/-96 mA in group C, 1649+/-514 mA in group D, and 1968+/-108 mA in group E (p< 0.05). In addition, the volumes of RF-induced coagulation necrosis were greater in groups C and E than in group D, which was greater than in groups A and B than in group E (p < 0.05); 14.3+/-3.0 cm(3) in group A; 12.4+/-3.8 cm(3) in group B; 80.9+/-9.9 cm(3) in group C; 45.3+/-11.3 cm(3) in group D and 81.6+/-8.6 cm(3) in group E. The tissue temperature measured at 15 mm from the electrode was higher in groups C, D and E than other groups (p < 0.05): 53+/-12 degrees C in group A, 42+/-2 degrees C in group B, 93+/-8 degrees C in group C; 79+/-12 degrees C in group D and 83+/-8 degrees C in group E.


CONCLUSIONS
Wet RF ablation with 5% or 36% NaCl solutions shows better efficiency in creating a large ablation zone than does dry RF ablation or RF ablation with preinjection of NaCl solutions.
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
Shin
Kyung Sook
KS
Lee
Jae Young
JY
Park
Hee Sun
HS
Hur
Hurn
H
Choi
Byung Ihn
BI
D000818:Animals; D001831:Body Temperature; D017115:Catheter Ablation / Q000379:methods*; D002417:Cattle; D004195:Disease Models, Animal; D017097:Electric Impedance; D004567:Electrodes, Implanted; D004867:Equipment Design; D007267:Injections; D008099:Liver / Q000473:pathology / Q000601:surgery*; D009336:Necrosis; D010477:Perfusion; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*
D012462:Saline Solution, Hypertonic