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Radio-frequency Tumor Ablation: Internally Cooled Electrode versus Saline-enhanced Technique in an Aggressive Rabbit Tumor Model¹

¹ From the Department of Diagnostic Radiology, Universitätsspital Zürich, Rämistrasse 100, CH-8091 Zürich, Switzerland (T.B.); Department of Diagnostic and Interventional Radiology, Friedrich-Schiller-Universität Jena, Germany (A.M., J.R.R., I.H., M.F., W.A.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (S.N.G.); and Schering AG, Research Laboratories, Berlin, Germany (P.H., M.R.). Received March 7, 2001; revision requested April 9; revision received June 18; accepted July 24. Address correspondence to T.B. (e-mail: thomas_boehm@gmx.net).

View larger version (24K): [in a new window]   Figure 1. Schematic illustrates the positioning of the ablation electrode into the center of the tumor (left) and the oval zone of necrosis around the exposed needle tip after ablation (right), which under ideal conditions should fully envelop the implanted tumor.

View larger version (65K): [in a new window]   Figure 2. Ablation electrodes for internally cooled (left) and saline-enhanced (right) techniques. On the right, the cutouts (arrowheads) in the tip serve for saline infusion through the needle into the surrounding tissue.

View larger version (167K): [in a new window]   Figure 3a. US images (US probe oriented parallel to the long axis of the kidney) obtained during a retroperitoneal tumor ablation show a small conic hyperechoic thermal lesion (arrows) around the needle tip at (a) 1 minute, (b) 5 minutes, and (c) 10 minutes of ablation. The poorly defined lesion in b and c prevents visual control of the ablation procedure.

View larger version (156K): [in a new window]   Figure 3b. US images (US probe oriented parallel to the long axis of the kidney) obtained during a retroperitoneal tumor ablation show a small conic hyperechoic thermal lesion (arrows) around the needle tip at (a) 1 minute, (b) 5 minutes, and (c) 10 minutes of ablation. The poorly defined lesion in b and c prevents visual control of the ablation procedure.

View larger version (162K): [in a new window]   Figure 3c. US images (US probe oriented parallel to the long axis of the kidney) obtained during a retroperitoneal tumor ablation show a small conic hyperechoic thermal lesion (arrows) around the needle tip at (a) 1 minute, (b) 5 minutes, and (c) 10 minutes of ablation. The poorly defined lesion in b and c prevents visual control of the ablation procedure.

View larger version (158K): [in a new window]   Figure 4. US images (US probe orientation parallel to the long axis of the kidney) obtained after RF ablation show free retroperitoneal fluid (arrows). Upper left: Fluid delineates the fascia perirenalis. Upper right: Fluid in the vicinity of an ablated tumor. Lower right and left: Two cases of fluid adjacent to the kidney.

View larger version (140K): [in a new window]   Figure 5a. Induced thermal lesion in the left lower pole of the kidney despite a distance of 3 cm between the ablation needle and the kidney. (a) US image shows a hyperechogenic thermal lesion (arrow) with fluid (arrowheads) around the lower pole of the kidney (US probe orientation parallel to the long axis of the kidney). (b) Contrast-enhanced harmonic US scan obtained 10 minutes after ablation shows a perfusion deficit in the cortex of the kidney (arrow). (c) Photomicrograph shows a bandlike thermal lesion in the lower pole kidney parenchyma (*), with neutrophil and macrophage infiltration toward the normal parenchyma (arrow). (Hematoxylin-eosin stain; original magnification, x40.)

View larger version (118K): [in a new window]   Figure 5b. Induced thermal lesion in the left lower pole of the kidney despite a distance of 3 cm between the ablation needle and the kidney. (a) US image shows a hyperechogenic thermal lesion (arrow) with fluid (arrowheads) around the lower pole of the kidney (US probe orientation parallel to the long axis of the kidney). (b) Contrast-enhanced harmonic US scan obtained 10 minutes after ablation shows a perfusion deficit in the cortex of the kidney (arrow). (c) Photomicrograph shows a bandlike thermal lesion in the lower pole kidney parenchyma (*), with neutrophil and macrophage infiltration toward the normal parenchyma (arrow). (Hematoxylin-eosin stain; original magnification, x40.)

View larger version (153K): [in a new window]   Figure 5c. Induced thermal lesion in the left lower pole of the kidney despite a distance of 3 cm between the ablation needle and the kidney. (a) US image shows a hyperechogenic thermal lesion (arrow) with fluid (arrowheads) around the lower pole of the kidney (US probe orientation parallel to the long axis of the kidney). (b) Contrast-enhanced harmonic US scan obtained 10 minutes after ablation shows a perfusion deficit in the cortex of the kidney (arrow). (c) Photomicrograph shows a bandlike thermal lesion in the lower pole kidney parenchyma (*), with neutrophil and macrophage infiltration toward the normal parenchyma (arrow). (Hematoxylin-eosin stain; original magnification, x40.)