Radiofrequency ablation with a high-power generator: device efficacy in an in vivo porcine liver model.

PURPOSE: The purpose of this study was to test the feasibility and efficacy of using a high-power generator with nondeployable electrodes to create large zones of coagulation in an in vivo porcine liver model. METHODS: With approval from our institution's research animal care and use committee, 12 female swine (mean weight = 55 kg) were anesthetized and received RF ablation at laparotomy. Twenty-nine ablations were performed in four groups using: (i) a conventional 200-W generator and cluster electrode (n = 4), or an experimental prototype 250-W generator and (ii) a single, 17-gauge electrode (n = 9), (iii) a cluster electrode (n = 8) or (iv) three electrodes spaced 2.0 cm apart in a triangular configuration (n = 8). In the three-electrode group, power was applied by switching between electrodes using a prototype switching device. All electrodes were internally cooled. Ablation zone size, shape and generator data from each group were compared using a mixed-linear model with animals modeled as random effects. RESULTS: The high-power generator was able to increase significantly the zone of coagulation. Mean (+/-SD) ablation diameter was largest in the switched group (4.31 +/- 0.7 cm) followed by the cluster (3.98 +/- 0.5 cm) and single-electrode (3.26 +/- 0.5 cm) groups. Mean diameter in the high-power single-electrode group was no different than the low-power cluster group (3.25 +/- 0.4 cm, p = 0.98). Circularity measures were high (>0.75) in all groups. CONCLUSIONS: Coupling a high-power generator and switching device is feasible. At higher powers, the switching device creates larger zones of ablation than cluster or single electrodes. Single-electrode ablations created with the prototype high-power generator were equivalent to those produced with the cluster electrode at conventional lower powers.

Thermal tumour ablation: devices, clinical applications and future directions.

Tumour ablation is clinically applied mainly for non-operable liver tumours, with increasing application to other organ sites like kidney, lung, adrenal gland and bone. Most current devices use radiofrequency (RF) current to heat tumour tissue surrounding the applicator, which is introduced into the tumour under imaging guidance. Tissue temperatures in excess of 100 degrees C are achieved, with cell death due to coagulative necrosis occurring above 50 degrees C. Limitations of current ablation devices include inadequate imaging, limited size of coagulation zone and reduced performance next to large vessels. This paper reviews current interstitial RF and microwave devices, clinical applications and future research directions in the field of high-temperature tumour ablation.