Saline-enhanced hepatic radiofrequency ablation using a perfused-cooled electrode: comparison of dual probe bipolar mode with monopolar and single probe bipolar modes.

Abstract

ObjectiveTo determine whether saline-enhanced dual probe bipolar radiofrequency ablation (RFA) using perfused-cooled electrodes shows better in-vitro efficiency than monopolar or single probe bipolar RFA in creating larger coagulation necrosis.Materials and MethodsRF was applied to excised bovine livers in both bipolar and monopolar modes using a 200W generator (CC-3; Radionics) and the perfused-cooled electrodes for 10 mins. After placing single or double perfused-cooled electrodes in the explanted liver, 30 ablation zones were created at three different regimens: group A; saline-enhanced monopolar RFA, group B; saline-enhanced single probe bipolar RFA, and group C; saline-enhanced dual probe bipolar RFA. During RFA, we measured the tissue temperature at 15mm from the electrode. The dimensions of the ablation zones and changes in the impedance currents and liver temperature during RFA were then compared between the groups.ResultsThe mean current values were higher for monopolar mode (group A) than for the bipolar modes (groups B and C): 1550±25 mA in group A, 764±189 mA in group B and 819±98 mA in group C (p < 0.05). The volume of RF-induced coagulation necrosis was greater in group C than in the other groups: 27.6±2.9 cm3 in group A, 23.7±3.8 cm3 in group B, and 34.2±5.1 cm3 in group C (p < 0.05). However, there was no significant difference between the short-axis diameter of the coagulation necrosis in the three groups: 3.1±0.8 cm, 2.9±1.2 cm and 4.0±1.3 cm in groups A, B and C, respectively (p > 0.05). The temperature at 15 mm from the electrode was higher in group C than in the other groups: 70±18℃ in group A, 59±23℃ in group B and 96±16℃ in group C (p < 0.05).ConclusionSaline-enhanced bipolar RFA using dual perfused-cooled electrodes increases the dimension of the ablation zone more efficiently than monopolar RFA or single probe bipolar RFA.