[논문]Optimization of Wet Radiofrequency Ablation Using a Perfused-Cooled Electrode: A Comparative Study in Ex Vivo Bovine Livers

Lee, Jeong Min; Han, Joon Koo; Kim, Se Hyung; Lee, Jae Young; Shin, Kyung Sook; Han, Chang Jin; Lee, Min Woo; Choi, Jun Il; Choi, Byung Ihn

doi:10.3348/kjr.2004.5.4.250

Optimization of Wet Radiofrequency Ablation Using a Perfused-Cooled Electrode: A Comparative Study in Ex Vivo Bovine Livers 원문보기

Korean journal of radiology : official journal of the Korean Radiological Society, v.5 no.4, 2004년, pp.250 - 257

Lee, Jeong Min (Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Korea.) , Han, Joon Koo (Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Korea.) , Kim, Se Hyung (Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Korea.) , Lee, Jae Young (Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Korea.) , Shin, Kyung Sook (Department of Radiology, Chungnam National University College of Medicine, Korea.) , Han, Chang Jin (Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Korea.) , Lee, Min Woo (Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Korea.) , Choi, Jun Il (Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Korea.) , Choi, Byung Ihn (Department of Radiology, and Institute of Radiation Medicine, Seoul National University Co)

Abstract ▼ AI-Helper

ObjectiveTo determine the optimized protocol for wet monopolar radiofrequency ablation (RFA) using a perfused-cooled electrode to induce coagulation necrosis in the ex vivo bovine liver.Materials and MethodsRadiofrequency was applied to excised bovine livers in a monopolar mode using a 200W generator with an internally cooled electrode (groups A and B) or a perfused-cooled electrode (groups C, D, E, and F) at maximum power (150-200 W) for 10 minutes. A total of 60 ablation zones were created with six different regimens: group A - dry RFA using intra-electrode cooling; group B - dry RFA using intra-electrode cooling and a pulsing algorithm; group C - wet RFA using only interstitial hypertonic saline (HS) infusion; group D - wet RFA using interstitial HS infusion and a pulsing algorithm; group E - wet RFA using interstitial HS infusion and intra-electrode cooling; and group F - wet RFA using interstitial HS infusion, intra-electrode cooling and a pulsing algorithm. In groups C, D, E, and F, RFA was performed with the infusion of 6% HS through the perfused cooled electrode at a rate of 2 mL/minute. During RFA, we measured the tissue temperature at a distance of 15 mm from the electrode. The dimensions of the ablation zones and the changes in impedance, currents, and liver temperature during RFA were compared between these six groups.ResultsDuring RFA, the mean tissue impedances in groups A (243 ± 88 Ω) and C (252.5 ± 108 Ω) were significantly higher than those in groups B (85 ± 18.7 Ω), D (108.2 ± 85 Ω), E (70.0 ± 16.3 Ω), and F (66.5 ± 7 Ω) (p < 0.05). The mean currents in groups E and F were significantly higher than those in groups B and D, which were significantly higher than those in groups A and C (p < 0.05): 520 ± 425 mA in group A, 1163 ± 34 mA in group B, 652.5 ± 418 mA in group C, 842.5 ± 773 mA in group D, 1665 ± 295 mA in group E, and 1830 ± 109 mA in group F. The mean volumes of the ablation regions in groups E and F were significantly larger than those in the other groups (p < 0.05): 17.7 ± 5.6 cm3 in group A, 34.5 ± 3.0 cm3 in group B, 20.2 ± 15.6 cm3 in group C, 36.1 ± 19.5 cm3 in group D, 68.1 ± 12.4 cm3 in group E, and 79.5 ± 31 cm3 in group F. The final tissue temperatures at a distance of 15 mm from the electrode were higher in groups E and F than those in groups A, C, and D (p < 0.05): 50 ± 7.5℃ in group A, 66 ± 13.6℃ in group B, 60 ± 13.4℃ in group C, 61 ±12.7℃ in group D, 78 ± 14.2℃ in group E, and 79 ± 12.0℃ in group F.ConclusionWet monopolar RFA, using intra-electrode cooling and interstitial saline infusion, showed better performance in creating a large ablation zone than either dry RFA or wet RFA without intra-electrode cooling.

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참고문헌 (37)

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Optimization of Wet Radiofrequency Ablation Using a Perfused-Cooled Electrode: A Comparative Study in Ex Vivo Bovine Livers 원문보기

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