In vivo assessment of radio frequency induced thermal damage of kidney using optical spectroscopy.
OBJECTIVE
Radio frequency ablation is a promising modality for treating small renal tumors. Several studies have been published showing its efficacy. A major drawback in the current management of renal tumors with radio frequency ablation is the lack of an effective modality to accurately monitor the progress of the ablation zone in real-time fashion. Previous studies have demonstrated the feasibility of using optical spectroscopy to assess tissue thermal damage, especially in hepatic lesions. We examined the feasibility of this technology in the setting of renal radio frequency ablation.


METHODS
A portable spectroscopic system was used to acquire in vivo fluorescence and diffuse reflectance spectra from porcine renal tissue undergoing radio frequency ablation in real-time fashion with simultaneous temperature recordings. Fluorescence and diffuse reflectance spectral data were then correlated with various degrees of thermal damage and temperature recordings.


RESULTS
The most noticeable change in fluorescence characteristics of renal tissue resulting from thermal coagulation was a strong decrease in fluorescence intensity between 400 and 550 nm. When fully coagulated, a significant increase in diffuse reflectance intensity was observed between 500 and 800 nm.


CONCLUSIONS
Optical spectroscopy, specifically fluorescence and diffuse reflectance spectroscopy, differs significantly in porcine renal tissues with varying degrees of thermal damage from radio frequency ablation in an in vivo setting. Future clinical studies with sufficient sample size are required to validate the potential of these findings. Optical diagnostics may prove to be a rapid, noninvasive, low cost option for monitoring the tumor response to radio frequency based ablative techniques. It may be integrated into future radio frequency ablation probes.
Parekh
Dipen J
DJ
Department of Urologic Surgery and Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA. parekhd@mskcc.org
Chiang
Lin Wei
LW
Herrell
S Duke
SD
D000818:Animals; D004564:Electrocoagulation; D005240:Feasibility Studies; D007668:Kidney / Q000473:pathology / Q000528:radiation effects* / Q000601:surgery; D011833:Radiation Injuries, Experimental / Q000175:diagnosis*; D011846:Radio Waves; D015203:Reproducibility of Results; D013050:Spectrometry, Fluorescence; D013552:Swine