J Korean Soc Radiol.  2012 Apr;66(4):363-369. 10.3348/jksr.2012.66.4.363.

Comparison of Radiofrequency Ablation with Saturated Saline Preinjection and Renal Artery Occlusion: In Vivo Study in Canine Kidneys

• Shin BS
• Ahn M
• Park MH
• Jeon GS
• Lee BM
• Lee K
• Kim HJ
• Ohm JY

• KMID: 2208850
• DOI: http://doi.org/10.3348/jksr.2012.66.4.363

Abstract

PURPOSE
To compare the ablation zone after radiofrequency ablation (RFA) with saturated saline preinjection and renal artery occlusion in canine kidneys.
MATERIALS AND METHODS
RFA was induced in the kidneys of six mongrel dogs. A total of 24 ablation zones were induced using a 1-cm tip internally cooled needle electrode in three groups: RFA (Control group), RFA with 0.5 mL saturated saline preinjection (SS group), and RFA with renal artery occlusion by atraumatic vascular clamp (Occlusion group). Ablation zone diameters were measured along transverse and longitudinal sections of the needle axis, and volumes were calculated. Temperature, applied voltage, current, and impedance during RFA were recorded automatically.
RESULTS
The RFA zone volume was the largest in the SS group (1.33 +/- 0.34 cm3), followed by the Occlusion group (1.07 +/- 0.38 cm3) and then the Control group (0.62 +/- 0.09 cm3). Volumes for the SS and Occlusion groups were significantly larger than those for the Control group (p = 0.001, p = 0.012). There was no significant difference in volumes between the SS and Occlusion groups (p = 0.178).
CONCLUSION
Saturated saline preinjection is as effective as renal arterial occlusion for expanding the ablation zone. RFA with saturated saline preinjection could help to treat large renal tumors.

MeSH Terms

Animals
Axis, Cervical Vertebra
Dogs
Electric Impedance
Electrodes
Kidney
Needles
Renal Artery

Reference

1. Hui GC, Tuncali K, Tatli S, Morrison PR, Silverman SG. Comparison of percutaneous and surgical approaches to renal tumor ablation: metaanalysis of effectiveness and complication rates. J Vasc Interv Radiol. 2008. 19:1311–1320.

2. Breen DJ, Railton NJ. Minimally invasive treatment of small renal tumors: trends in renal cancer diagnosis and management. Cardiovasc Intervent Radiol. 2010. 33:896–908.

3. Gervais DA, McGovern FJ, Arellano RS, McDougal WS, Mueller PR. Radiofrequency ablation of renal cell carcinoma: part 1, Indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR Am J Roentgenol. 2005. 185:64–71.

4. Varkarakis IM, Allaf ME, Inagaki T, Bhayani SB, Chan DY, Su LM, et al. Percutaneous radio frequency ablation of renal masses: results at a 2-year mean followup. J Urol. 2005. 174:456–460. discussion 460.

5. Zagoria RJ, Traver MA, Werle DM, Perini M, Hayasaka S, Clark PE. Oncologic efficacy of CT-guided percutaneous radiofrequency ablation of renal cell carcinomas. AJR Am J Roentgenol. 2007. 189:429–436.

6. Breen DJ, Rutherford EE, Stedman B, Roy-Choudhury SH, Cast JE, Hayes MC, et al. Management of renal tumors by image-guided radiofrequency ablation: experience in 105 tumors. Cardiovasc Intervent Radiol. 2007. 30:936–942.

7. Goldberg SN, Grassi CJ, Cardella JF, Charboneau JW, Dodd GD 3rd, Dupuy DE, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol. 2009. 20:7 Suppl. S377–S390.

8. Dodd GD 3rd, Frank MS, Aribandi M, Chopra S, Chintapalli KN. Radiofrequency thermal ablation: computer analysis of the size of the thermal injury created by overlapping ablations. AJR Am J Roentgenol. 2001. 177:777–782.

9. Goldberg SN, Gazelle GS. Radiofrequency tissue ablation: physical principles and techniques for increasing coagulation necrosis. Hepatogastroenterology. 2001. 48:359–367.

10. Aschoff AJ, Sulman A, Martinez M, Duerk JL, Resnick MI, MacLennan GT, et al. Perfusion-modulated MR imaging-guided radiofrequency ablation of the kidney in a porcine model. AJR Am J Roentgenol. 2001. 177:151–158.

11. Corwin TS, Lindberg G, Traxer O, Gettman MT, Smith TG, Pearle MS, et al. Laparoscopic radiofrequency thermal ablation of renal tissue with and without hilar occlusion. J Urol. 2001. 166:281–284.

12. Kariya Z, Yamakado K, Nakatuka A, Onoda M, Kobayasi S, Takeda K. Radiofrequency ablation with and without balloon occlusion of the renal artery: an experimental study in porcine kidneys. J Vasc Interv Radiol. 2003. 14(2 Pt 1):241–245.

13. Chang I, Mikityansky I, Wray-Cahen D, Pritchard WF, Karanian JW, Wood BJ. Effects of perfusion on radiofrequency ablation in swine kidneys. Radiology. 2004. 231:500–505.

14. Yamakado K, Nakatsuka A, Kobayashi S, Akeboshi M, Takaki H, Kariya Z, et al. Radiofrequency ablation combined with renal arterial embolization for the treatment of unresectable renal cell carcinoma larger than 3.5 cm: initial experience. Cardiovasc Intervent Radiol. 2006. 29:389–394.

15. Goldberg SN, Ahmed M, Gazelle GS, Kruskal JB, Huertas JC, Halpern EF, et al. Radio-frequency thermal ablation with NaCl solution injection: effect of electrical conductivity on tissue heating and coagulation-phantom and porcine liver study. Radiology. 2001. 219:157–165.

16. Lobo SM, Afzal KS, Ahmed M, Kruskal JB, Lenkinski RE, Goldberg SN. Radiofrequency ablation: modeling the enhanced temperature response to adjuvant NaCl pretreatment. Radiology. 2004. 230:175–182.

17. Hänsler J, Frieser M, Schaber S, Kutschall C, Bernatik T, Müller W, et al. Radiofrequency ablation of hepatocellular carcinoma with a saline solution perfusion device: a pilot study. J Vasc Interv Radiol. 2003. 14:575–580.

18. Kettenbach J, Köstler W, Rücklinger E, Gustorff B, Hüpfl M, Wolf F, et al. Percutaneous saline-enhanced radiofrequency ablation of unresectable hepatic tumors: initial experience in 26 patients. AJR Am J Roentgenol. 2003. 180:1537–1545.

19. Leveillee RJ, Hoey MF. Radiofrequency interstitial tissue ablation: wet electrode. J Endourol. 2003. 17:563–577.

20. Patel VR, Leveillee RJ, Hoey MF, Herron AJ, Zaias J, Hulbert JC. Radiofrequency ablation of rabbit kidney using liquid electrode: acute and chronic observations. J Endourol. 2000. 14:155–159.

21. Munver R, Threatt CB, Delvecchio FC, Preminger GM, Polascik TJ. Hypertonic saline-augmented radiofrequency ablation of the VX-2 tumor implanted in the rabbit kidney: a short-term survival pilot study. Urology. 2002. 60:170–175.

22. Polascik TJ, Hamper U, Lee BR, Dai Y, Hilton J, Magee CA, et al. Ablation of renal tumors in a rabbit model with interstitial saline-augmented radiofrequency energy: preliminary report of a new technology. Urology. 1999. 53:465–472. discussion 470-472.

23. Collyer WC, Landman J, Olweny EO, Andreoni C, Kerbl K, Bostwick DG, et al. Comparison of renal ablation with cryotherapy, dry radiofrequency, and saline augmented radiofrequency in a porcine model. J Am Coll Surg. 2001. 193:505–513.

24. Ahmed M, Lobo SM, Weinstein J, Kruskal JB, Gazelle GS, Halpern EF, et al. Improved coagulation with saline solution pretreatment during radiofrequency tumor ablation in a canine model. J Vasc Interv Radiol. 2002. 13:717–724.

25. Cha J, Choi D, Lee MW, Rhim H, Kim YS, Lim HK, et al. Radiofrequency ablation zones in ex vivo bovine and in vivo porcine livers: comparison of the use of internally cooled electrodes and internally cooled wet electrodes. Cardiovasc Intervent Radiol. 2009. 32:1235–1240.