DOI QR코드

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Moving-Shot versus Fixed Electrode Techniques for Radiofrequency Ablation: Comparison in an Ex-Vivo Bovine Liver Tissue Model

  • Ha, Eun Ju (Department of Radiology and the Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Baek, Jung Hwan (Department of Radiology and the Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jeong Hyun (Department of Radiology and the Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2014.02.05
  • 심사 : 2014.09.09
  • 발행 : 2014.12.01

초록

Objective: To compare the ablation characteristics of the moving-shot technique (MST) and the fixed electrode technique (FET) for radiofrequency (RF) ablation in an ex-vivo bovine liver tissue model. Materials and Methods: We performed RF ablation using FET in 110 bovine liver blocks using 11 different ablation times ranging from 5 seconds to 5 minutes (10 blocks per each time duration). Ten bovine liver blocks at each ablation time of 1- or 2-minute, were ablated with MST, which treated conceptual ablation units by moving the electrode tip. We evaluated the ablation volume obtained with FET across ablation time lengths. The results of FET and MST performed with the same ablation time lengths, i.e., 1- and 2-minute ablation time were also compared. Results: The ablation volume achieved with FET gradually increased with increasing ablation time; however, the pair-wise statistical comparison between 2 neighboring ablation time lengths was not significant after 30 seconds. MST with either 1- or 2-minute ablation time achieved larger ablation volumes ($1.1{\pm}0.2$ mL vs. $2.7{\pm}0.3$ mL, p < 0.001; and $1.4{\pm}0.2$ mL vs. $5.6{\pm}0.4$ mL, p < 0.001, respectively), longer true RF times ($46.7{\pm}4.6$ seconds vs. 60 seconds, p < 0.001; and $64.8{\pm}4.6$ seconds vs. 120 seconds, p < 0.001, respectively), fewer numbers of RF cut-offs ($1.6{\pm}0.5$ vs. 0, p < 0.001; and $5.5{\pm}0.5$ vs. 0, p < 0.001, respectively), and greater energy deposition ($2050.16{\pm}209.2$ J vs. $2677.76{\pm}83.68$ J, p < 0.001; and $2970.64{\pm}376.56$ J vs. $5564.72{\pm}5439.2$ J, p < 0.001, respectively), than FET. Conclusion: The MST can achieve a larger ablation volume by preventing RF cut-off, compared with the FET in an ex-vivo bovine liver model.

키워드

참고문헌

  1. Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WW, Kavanagh PV, Safran H. Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 2000;174:57-59 https://doi.org/10.2214/ajr.174.1.1740057
  2. Dupuy DE, Goldberg SN. Image-guided radiofrequency tumor ablation: challenges and opportunities--part II. J Vasc Interv Radiol 2001;12:1135-1148 https://doi.org/10.1016/S1051-0443(07)61670-4
  3. Gazelle GS, Goldberg SN, Solbiati L, Livraghi T. Tumor ablation with radio-frequency energy. Radiology 2000;217:633-646 https://doi.org/10.1148/radiology.217.3.r00dc26633
  4. Kang TW, Rhim H, Kim EY, Kim YS, Choi D, Lee WJ, et al. Percutaneous radiofrequency ablation for the hepatocellular carcinoma abutting the diaphragm: assessment of safety and therapeutic efficacy. Korean J Radiol 2009;10:34-42 https://doi.org/10.3348/kjr.2009.10.1.34
  5. Goldberg SN. Radiofrequency tumor ablation: principles and techniques. Eur J Ultrasound 2001;13:129-147 https://doi.org/10.1016/S0929-8266(01)00126-4
  6. Goldberg SN, Gazelle GS, Mueller PR. Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 2000;174:323-331 https://doi.org/10.2214/ajr.174.2.1740323
  7. Rhim H, Goldberg SN, Dodd GD 3rd, Solbiati L, Lim HK, Tonolini M, et al. Essential techniques for successful radio-frequency thermal ablation of malignant hepatic tumors. Radiographics 2001;21 Spec No:S17-S35; discussion S36-S39 https://doi.org/10.1148/radiographics.21.suppl_1.g01oc11s17
  8. Baek JH, Kim YS, Lee D, Huh JY, Lee JH. Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control condition. AJR Am J Roentgenol 2010;194:1137-1142 https://doi.org/10.2214/AJR.09.3372
  9. Baek JH, Kim YS, Sung JY, Choi H, Lee JH. Locoregional control of metastatic well-differentiated thyroid cancer by ultrasound-guided radiofrequency ablation. AJR Am J Roentgenol 2011;197:W331-W336 https://doi.org/10.2214/AJR.10.5345
  10. Baek JH, Moon WJ, Kim YS, Lee JH, Lee D. Radiofrequency ablation for the treatment of autonomously functioning thyroid nodules. World J Surg 2009;33:1971-1977 https://doi.org/10.1007/s00268-009-0130-3
  11. Jeong WK, Baek JH, Rhim H, Kim YS, Kwak MS, Jeong HJ, et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol 2008;18:1244-1250 https://doi.org/10.1007/s00330-008-0880-6
  12. Lee JH, Kim YS, Lee D, Choi H, Yoo H, Baek JH. Radiofrequency ablation (RFA) of benign thyroid nodules in patients with incompletely resolved clinical problems after ethanol ablation (EA). World J Surg 2010;34:1488-1493 https://doi.org/10.1007/s00268-010-0565-6
  13. Sung JY, Kim YS, Choi H, Lee JH, Baek JH. Optimum first-line treatment technique for benign cystic thyroid nodules: ethanol ablation or radiofrequency ablation? AJR Am J Roentgenol 2011;196:W210-W214 https://doi.org/10.2214/AJR.10.5172
  14. Baek JH, Lee JH, Valcavi R, Pacella CM, Rhim H, Na DG. Thermal ablation for benign thyroid nodules: radiofrequency and laser. Korean J Radiol 2011;12:525-540 https://doi.org/10.3348/kjr.2011.12.5.525
  15. Ha EJ, Baek JH, Lee JH. The efficacy and complications of radiofrequency ablation of thyroid nodules. Curr Opin Endocrinol Diabetes Obes 2011;18:310-314 https://doi.org/10.1097/MED.0b013e32834a9168
  16. Baek JH, Jeong HJ, Kim YS, Kwak MS, Lee D. Radiofrequency ablation for an autonomously functioning thyroid nodule. Thyroid 2008;18:675-676 https://doi.org/10.1089/thy.2007.0274
  17. Baek JH, Lee JH, Sung JY, Bae JI, Kim KT, Sim J, et al. Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study. Radiology 2012;262:335-342 https://doi.org/10.1148/radiol.11110416
  18. Spiezia S, Garberoglio R, Milone F, Ramundo V, Caiazzo C, Assanti AP, et al. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid 2009;19:219-225 https://doi.org/10.1089/thy.2008.0202
  19. Ha EJ, Baek JH, Lee JH, Kim JK, Shong YK. Clinical significance of vagus nerve variation in radiofrequency ablation of thyroid nodules. Eur Radiol 2011;21:2151-2157 https://doi.org/10.1007/s00330-011-2167-6
  20. Na DG, Lee JH, Jung SL, Kim JH, Sung JY, Shin JH, et al. Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: consensus statement and recommendations. Korean J Radiol 2012;13:117-125 https://doi.org/10.3348/kjr.2012.13.2.117
  21. Lee JD, Lee JM, Kim SW, Kim CS, Mun WS. MR imaging-histopathologic correlation of radiofrequency thermal ablation lesion in a rabbit liver model: observation during acute and chronic stages. Korean J Radiol 2001;2:151-158 https://doi.org/10.3348/kjr.2001.2.3.151
  22. Morimoto M, Sugimori K, Shirato K, Kokawa A, Tomita N, Saito T, et al. Treatment of hepatocellular carcinoma with radiofrequency ablation: radiologic-histologic correlation during follow-up periods. Hepatology 2002;35:1467-1475 https://doi.org/10.1053/jhep.2002.33635
  23. Clasen S, Schmidt D, Dietz K, Boss A, Krober SM, Schraml C, et al. Bipolar radiofrequency ablation using internally cooled electrodes in ex vivo bovine liver: prediction of coagulation volume from applied energy. Invest Radiol 2007;42:29-36 https://doi.org/10.1097/01.rli.0000248973.95949.eb
  24. Crocetti L, Lencioni R, Debeni S, See TC, Pina CD, Bartolozzi C. Targeting liver lesions for radiofrequency ablation: an experimental feasibility study using a CT-US fusion imaging system. Invest Radiol 2008;43:33-39 https://doi.org/10.1097/RLI.0b013e31815597dc
  25. Lee JM, Han JK, Kim HC, Choi YH, Kim SH, Choi JY, et al. Switching monopolar radiofrequency ablation technique using multiple, internally cooled electrodes and a multichannel generator: ex vivo and in vivo pilot study. Invest Radiol 2007;42:163-171 https://doi.org/10.1097/01.rli.0000252495.44818.b3
  26. Lee JM, Han JK, Kim HC, Kim SH, Kim KW, Joo SM, et al. Multiple-electrode radiofrequency ablation of in vivo porcine liver: comparative studies of consecutive monopolar, switching monopolar versus multipolar modes. Invest Radiol 2007;42:676-683 https://doi.org/10.1097/RLI.0b013e3180661aad
  27. Lee JM, Han JK, Kim SH, Shin KS, Lee JY, Park HS, et al. Comparison of wet radiofrequency ablation with dry radiofrequency ablation and radiofrequency ablation using hypertonic saline preinjection: ex vivo bovine liver. Korean J Radiol 2004;5:258-265 https://doi.org/10.3348/kjr.2004.5.4.258
  28. Na DG, Lee JH, Kim SM, Lim HK, Baek JH. Unidirectional ablation electrode to minimize thermal injury during radiofrequency ablation: an experimental study in an ex vivo bovine liver model. J Vasc Interv Radiol 2011;22:935-940 https://doi.org/10.1016/j.jvir.2011.02.010
  29. Haemmerich D, Laeseke PF. Thermal tumour ablation: devices, clinical applications and future directions. Int J Hyperthermia 2005;21:755-760 https://doi.org/10.1080/02656730500226423
  30. Jang SW, Baek JH, Kim JK, Sung JY, Choi H, Lim HK, et al. How to manage the patients with unsatisfactory results after ethanol ablation for thyroid nodules: role of radiofrequency ablation. Eur J Radiol 2012;81:905-910 https://doi.org/10.1016/j.ejrad.2011.02.039
  31. Huh JY, Baek JH, Choi H, Kim JK, Lee JH. Symptomatic benign thyroid nodules: efficacy of additional radiofrequency ablation treatment session--prospective randomized study. Radiology 2012;263:909-916 https://doi.org/10.1148/radiol.12111300
  32. Gharib H, Hegedüs L, Pacella CM, Baek JH, Papini E. Clinical review: nonsurgical, image-guided, minimally invasive therapy for thyroid nodules. J Clin Endocrinol Metab 2013;98:3949-3957 https://doi.org/10.1210/jc.2013-1806

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  18. 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology vol.19, pp.4, 2018, https://doi.org/10.3348/kjr.2018.19.4.632
  19. Comparison between ultrasound-guided percutaneous radiofrequency and microwave ablation in benign thyroid nodules vol.15, pp.7, 2014, https://doi.org/10.4103/jcrt.jcrt_322_19
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