Influence of electrical and thermal properties on RF ablation of breast cancer: is the tumour preferentially heated?
BACKGROUND
Techniques based on radio frequency (RF) energy have many applications in medicine, in particular tumour ablation. Today, mammography screening detects many breast cancers at an early stage, facilitating treatment by minimally invasive techniques such as radio frequency ablation (RFA). The breast cancer is mostly surrounded by fat, which during RFA-treatment could result in preferential heating of the tumour due to the substantial differences in electrical parameters. The object of this study was to investigate if this preferential heating existed during experimental in vitro protocols and during computer simulations.


METHODS
Excised breast material from four patients with morphologically diagnosed breast cancers were treated with our newly developed RFA equipment. Subsequently, two finite element method (FEM) models were developed; one with only fat and one with fat and an incorporated breast cancer of varying size. The FEM models were solved using temperature dependent electrical conductivity versus constant conductivity, and transient versus steady-state analyses.


RESULTS
Our experimental study performed on excised breast tissue showed a preferential heating of the tumour, even if associated with long tumour strands. The fat between these tumour strands was surprisingly unaffected. Furthermore, the computer simulations demonstrated that the difference in electrical and thermal parameters between fat and tumour tissue can cause preferential heating of the tumour. The specific absorption rate (SAR) distribution changed significantly when a tumour was present in fatty tissue. The degree of preferential heating depended on tissue properties, tumour shape, and placement relative to the electrode. Temperature dependent electrical conductivity increased the thermal lesion volume, but did not change the preferential heating. Transient solutions decreased the thermal lesion volume but increased the preferential heating of the tumour.


CONCLUSIONS
Both the computer model and the in vitro study confirmed that preferential heating of the tumour during RFA exists in breast tissue. However, the observed preferential heating in the in vitro studies were more pronounced, indicating that additional effects other than the difference in tissue parameters might be involved. The existing septa layers between the cancer tissue and the fatty tissue could have an additional electrical or thermal insulating effect, explaining the discrepancy between the in vitro study and the computer model.
Ekstrand
Vilhelm
V
Department of Surgical Sciences, Karolinska Institutet, Stockholm, Sweden. vilhelm.ekstrand@comair.se
Wiksell
Hans
H
Schultz
Inkeri
I
Sandstedt
Bengt
B
Rotstein
Samuel
S
Eriksson
Anders
A
D000273:Adipose Tissue / Q000503:physiopathology* / Q000528:radiation effects; D001940:Breast / Q000503:physiopathology* / Q000528:radiation effects / Q000601:surgery*; D001943:Breast Neoplasms / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D003198:Computer Simulation; D004307:Dose-Response Relationship, Radiation; D004574:Electromagnetic Fields; D006358:Hot Temperature; D006801:Humans; D066298:In Vitro Techniques; D008954:Models, Biological; D011829:Radiation Dosage; D025321:Surgery, Computer-Assisted / Q000379:methods*