Radiofrequency Tissue Ablation with Cooled-Tip Electrodes:An Experimental Study in a Bovine Liver Model on Variables Influencing Lesion Size

Abstract

Purpose: The purpose of this study was to determine the influence of various factors on the extent of thermal coagulation necrosis after radiofrequency (RF) tissue ablation using a cooled-tip electrode in bovine liver.Materials and Methods: RF ablation was induced by a monopolar 500 KHz-RF generator (CC-1; Radionics,Burlington, Mass., U.S.A.) and an 18-G cooled-tip with single or clustered electrodes. The ablation protocol involveda combination of varying current, ablation time, power output, gradual or abrupt increase of this out-put, and pulsed radiofrequency techniques. The maximum diameter of all thermal lesions which showed a color change was measured perpendicular to the electrode axis by two observers who reached their decisions by consensus. Twenty representative lesions were pathologically examined.Results: With increasing current lesion diameter also increased, but above 1500 mA no further increase was induced. Extending the ablation time to 9 minutes for a single electrode and 15 minutes for a clustered electrode increased lesion diameter until a steady state was reached. Higher power levels caused larger lesions, but above 100 W no increase was observed. Ample exposure time coupled with a stepwise increase in power level induced a lesion larger than that resulting from an abrupt increase. Continuous pulsed RF with a high current led to increased coagulation necrosis diameter.Conclusion: These experimental findings may be useful thermotherapy. The data suggest that all involved factors significantly affect lesion size: if the factors are better understood, cancer thermotherapy can be better controlled.