• 제목/요약/키워드: Radiofrequency (RF) ablation

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Radiofrequency Thermal Ablation of Hepatocellular Carcinomas

  • Hyo Keun Lim
    • Korean Journal of Radiology
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    • 제1권4호
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    • pp.175-184
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    • 2000
  • Although surgical resection remains the best option as potentially curative therapy for hepatocellular carcinoma, radiofrequency thermal ablation has begun to receive much attention as an effective minimally invasive technique for the local control of unresectable malignant hepatic tumors. Most recent radiofrequency devices equipped with a powerful generator and larger needle electrode permit larger thermal lesions, up to 5 cm in diameter, with a single ablation. In this article, the author reviews the technical developments and early clinical results obtained with radiofrequency ablation techniques.

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The Effect of using Gamma Titanium RF Electrodes on the Ablation Volume during the Radiofrequency Ablation Process

  • Mohammed S. Ahmed;Mohamed Tarek El-Wakad;Mohammed A. Hassan
    • International Journal of Computer Science & Network Security
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    • 제23권2호
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    • pp.183-192
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    • 2023
  • Radiofrequency ablation (RFA) is an alternative treatment for liver cancer to the surgical intervention preferred by surgeons. However, the main challenge remains the use of RF for the ablation of large tumours (i.e., tumours with a diameter of >3 cm). For large tumours, RFA takes a large duration in the ablation process compared with surgery, which increases patient pain. Therefore, RFA for large tumours is not preferred by surgeons. The currently materials used in RF electrodes, such as the nickeltitanium alloy (nitinol), are characterized by low thermal and electrical conductivities. On the other hand, the use of materials that have high thermal and electrical conductivities, such as titanium aluminide alloy (gamma titanium), produces more thermal energy for tumours. In this paper, we developed a cool-tip RF electrode model that uses nickel-titanium alloy and replaced it with titanium aluminide alloy by using the finite element model (FEM). The aim of this paper is to study the effect of the thermal and electrical conductivities of gamma titanium on the ablation volume. Results showed that the proposed design of the electrode increased the ablation rate by 1 cm3 /minute and 6.3 cm3/10 minutes, with a decrease in the required time ablation. Finally, the proposed model reduces the ablation time and damages healthy tissue while increasing the ablation volume from 22.5% cm3 to 62.5% cm3 in ten minutes compared to recent studies.

고주파 열치료(Rodiofrequency ablotion)에 이용되는 내부 냉각 전극(Internally cooled needle electrodes)를 이용한 간 소작법의 유용성 실험 (An Experimental Study on Hepatic Ablation using an Internally Cooled Needle Electrodes in Radiofrequency Ablation)

  • 한정환;안정현;박원식
    • 대한방사선협회지
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    • 제30권1호
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    • pp.58-62
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    • 2004
  • The purpose of this study was to determine the factors influencing on the size of Radiofrequency ablation using an internally cooled needle electrodes in cattle liver. Ablation procedures involved the use of cool-tip RF system generator and internally coo

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Radiofrequency Thermal Ablation in Painful Myeloma of the Clavicle

  • Gharaei, Helen;Imani, Farnad;Vakily, Masoud
    • The Korean Journal of Pain
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    • 제27권1호
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    • pp.72-76
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    • 2014
  • A 57-year-old male patient had myeloma. He had severe pain in the left clavicle that did not respond to radiotherapy; therefore, it was treated with radiofrequency thermal ablation (RFTA). Under fluoroscopic guidance, two RF needles at a distance of 1.5 cm from each other were inserted into the mass and conventional radiofrequency ($90^{\circ}C$ and 60 seconds) at two different depths (1 cm apart) was applied. Then, 2 ml of 0.5% ropivacaine along with triamcinolone 40 mg was injected in each needle. The visual analogue pain score (VAS from 0 to 10) was decreased from 8 to 0. In the next 3 months of follow-up, the patient was very satisfied with the procedure and the mass gradually became smaller. There were no complications. This study shows that RFTA could be a useful method for pain management in painful osteolytic myeloma lesions in the clavicle

Impact of Energy and Access Methods on Extrahepatic Tumor Spreading and the Ablation Zone: An Ex vivo Experiment Using a Subcapsular Tumor Model

  • Jin Sil Kim;Youngsun Ko;Hyeyoung Kwon;Minjeong Kim;Jeong Kyong Lee
    • Korean Journal of Radiology
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    • 제20권4호
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    • pp.580-588
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    • 2019
  • Objective: To evaluate the impact of energy and access methods on extrahepatic tumor spreading and the ablation zone in an ex vivo subcapsular tumor mimic model with a risk of extrahepatic tumor spreading. Materials and Methods: Forty-two tumor-mimics were created in bovine liver blocks by injecting a mixture of iodine contrast material just below the liver capsule. Radiofrequency (RF) ablations were performed using an electrode placed parallel or perpendicular to hepatic surface through the tumor mimic with low- and high-power protocols (groups 1 and 2, respectively). Computed tomography (CT) scans were performed before and after ablation. The presence of contrast leak on the hepatic surface on CT, size of ablation zone, and timing of the first roll-off and popping sound were compared between the groups. Results: With parallel access, one contrast leak in group 1 (1/10, 10%) and nine in group 2 (9/10, 90%) (p < 0.001) were identified on post-ablation CT. With perpendicular access, six contrast leaks were identified in each group (6/11, 54.5%). The first roll-off and popping sound were significantly delayed in group 1 irrespective of the access method (p = 0.002). No statistical difference in the size of the ablation zone of the liver specimen was observed between the two groups (p = 0.247). Conclusion: Low-power RF ablation with parallel access is proposed to be effective and safe from extrahepatic tumor spreading in RF ablation of a solid hepatic tumor in the subcapsular location. Perpendicular placement of an electrode to the capsule is associated with a risk of extrahepatic tumor spreading regardless of the power applied.

유한 요소 해석을 이용한 고주파 간 종양 절제술의 입력 파형 최적화를 위한 연구 (A Study For Optimizing Input Waveforms In Radiofrequency Liver Tumor Ablation Using Finite Element Analysis)

  • 임도형;남궁범석;이태우;최진승;탁계래;김한성
    • 대한의용생체공학회:의공학회지
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    • 제28권2호
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    • pp.235-243
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    • 2007
  • Hepatocellular carcinoma is significant worldwide public health problem with an estimated annually mortality of 1,000,000 people. Radiofrequency (RF) ablation is an interventional technique that in recent years has come to be used for treatment of the hepatocellualr carcinoma, by destructing tumor tissues in high temperatures. Numerous studies have been attempted to prove excellence of RF ablation and to improve its efficiency by various methods. However, the attempts are sometimes paradox to advantages of a minimum invasive characteristic and an operative simplicity in RF ablation. The aim of the current study is, therefore, to suggest an improved RF ablation technique by identifying an optimum RF pattern, which is one of important factors capable of controlling the extent of high temperature region in lossless of the advantages of RF ablation. Three-dimensional finite element (FE) model was developed and validated comparing with the results reported by literature. Four representative Rf patterns (sine, square, exponential, and simulated RF waves), which were corresponding to currents fed during simulated RF ablation, were investigated. Following parameters for each RF pattern were analyzed to identify which is the most optimum in eliminating effectively tumor tissues. 1) maximum temperature, 2) a degree of alteration of maximum temperature in a constant time range (30-40 second), 3) a domain of temperature over $47^{\circ}C$ isothermal temperature (IT), and 4) a domain inducing over 63% cell damage. Here, heat transfer characteristics within the tissues were determined by Bioheat Governing Equation. Developed FE model showed 90-95% accuracy approximately in prediction of maximum temperature and domain of interests achieved during RF ablation. Maximum temperatures for sine, square, exponential, and simulated RF waves were $69.0^{\circ}C,\;66.9^{\circ}C,\;65.4^{\circ}C,\;and\;51.8^{\circ}C$, respectively. While the maximum temperatures were decreased in the constant time range, average time intervals for sine, square, exponential, and simulated RE waves were $0.49{\pm}0.14,\;1.00{\pm}0.00,\;1.65{\pm}0.02,\;and\;1.66{\pm}0.02$ seconds, respectively. Average magnitudes of the decreased maximum temperatures in the time range were $0.45{\pm}0.15^{\circ}C$ for sine wave, $1.93{\pm}0.02^{\circ}C$ for square wave, $2.94{\pm}0.05^{\circ}C$ for exponential wave, and $1.53{\pm}0.06^{\circ}C$ for simulated RF wave. Volumes of temperature domain over $47^{\circ}C$ IT for sine, square, exponential, and simulated RF waves were 1480mm3, 1440mm3, 1380mm3, and 395mm3, respectively. Volumes inducing over 63% cell damage for sine, square, exponential, and simulated RF waves were 114mm3, 62mm3, 17mm3, and 0mm3, respectively. These results support that applying sine wave during RF ablation may be generally the most optimum in destructing effectively tumor tissues, compared with other RF patterns.

MR Imaging-Histopathologic Correlation of Radiofrequency Thermal Ablation Lesion in a Rabbit Liver Model: Observation during Acute and Chronic Stages

  • Jong Deok Lee;Jeong Min Lee;Sang Won Kim;Chong Soo Kim;Woo Sung Mun
    • Korean Journal of Radiology
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    • 제2권3호
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    • pp.151-158
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    • 2001
  • Objective: To determine the ability of MR imaging to detect the pathological changes occurring in radiofrequency (RF) thermal lesions and to assess its accuracy in revealing the extent of tissue necrosis. Materials and Methods: Using an RF electrode, thermal lesions were created in the livers of 18 rabbits. The procedure involved three phases. In the acute phase, six animals were killed the day after performing thermal ablation with RF energy, and two on day 3. In the subacute and chronic phases, eight rabbits underwent percutaneous hepatic RF ablation. After performing MR imaging, two animals were sacrificed at 1, 2, 4, and 7 weeks after the procedure, and MRpathologic correlation was performed. Results: In the acute phase, the thermal ablation lesions appeared at gross examination as well-circumscribed, necrotic areas, representing early change in the coagulative necrosis seen at microscopic examination. They were hypointense on T2-weighted images, and hyperintense on T1-weighted images. Gadolinium-enhanced MR imaging showed that a thin hyperemic rim surrounded the central coagulative necrosis. In the subacute phase, ablated lesions also showed extensive coagulative necrosis and marked inflammation at microscopic examination. Beyond two weeks, the lesions showed gradual resorption of the necrotic area, with a peripheral fibrovascular rim. The size of lesions measured by MR imaging correlated well with the findings at gross pathologic examination. Conclusion: MR imaging effectively demonstrates the histopathological tissue change occurring after thermal ablation, and accurately determines the extent of the target area.

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Predictive factors associated with successful response to utrasound guided genicular radiofrequency ablation

  • Kose, Selin Guven;Kose, Halil Cihan;Celikel, Feyza;Akkaya, Omer Taylan
    • The Korean Journal of Pain
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    • 제35권4호
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    • pp.447-457
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    • 2022
  • Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291-16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038-4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405-5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124-0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.