Maximizing parameters for tissue ablation by using an internally cooled electrode.
OBJECTIVE
To compare an algorithm of gradually ramped-up power to a full-power-level technique to determine which technical parameters maximized tissue coagulation by using a saline-perfused electrode.


METHODS
Institutional review board approval was not necessary and animal committee approval was unnecessary because an ex vivo bovine liver model was used and the animals were not specifically killed for this study. This four-part experiment utilized multiple ablations of ex vivo bovine liver with a standard radiofrequency (RF) generator and an internally cooled needle. First, 10 RF ablations were performed at 20-60 W for 12 minutes. Second, ablation volumes obtained from an algorithm of eight ablations performed at 50 W were compared with those obtained from an algorithm of eight ablations that were gradually ramped-up to 50 W, until full impedance. Third, volumes obtained from 10 ablations performed at impedance control power levels were compared with those obtained from 10 ablations performed with a gradual ramp-up of power that started at 50 W, terminating at full impedance. Last, the third part was repeated, but with 11 ablations continuing past full impedance for 12 minutes each.


RESULTS
In the first part, maximum measurements of tissue coagulation seemed to plateau from 40 to 60 W. The second part produced significantly larger measurements of tissue coagulation than did the use of a constant power level of 50 W. The third and final parts produced larger measurements of tissue coagulation than did utilizing full power for 12 minutes. Larger measurements and volumes were obtained from repeat ablations after the generator reached impedance level than were obtained from ablations stopped at maximum impedance.


CONCLUSIONS
A gradual ramp-up of power and repeating ablations after power impedance level is reached are the two methods that increased tissue ablation in this ex vivo experiment.
Department of Radiology, University of California, Davis Medical Center, 4860 Y St, Suite 3100, Sacramento, CA 95817, USA. john.mcgahan@ucdmc.ucdavis.edu
John P
JP
McGahan
Shaun
S
Loh
Fernando J
FJ
Boschini
Eric E
EE
Paoli
John M
JM
Brock
Wayne L
WL
Monsky
Chin-Shang
CS
Li
D000818:Animals; D001831:Body Temperature; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D002417:Cattle; D003080:Cold Temperature; D004566:Electrodes; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods*; D066298:In Vitro Techniques; D008099:Liver / Q000502:physiology* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*