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Percutaneous US-guided Radiofrequency Ablation with Perfused Needle Applicators: Improved Survival with the VX2 Tumor Model in Rabbits¹

¹ From the Department of Medicine I (J.H., M.W., T.B., T.S., M.F., S.S., E.G.H., D.S.), Institute of Pathology (D.N.), and Institute of Diagnostic Radiology (R.J.), Friedrich-Alexander-University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany; Institute of Biomedical Engineering, University Furthwangen, Germany (W.M.); and Department of Medicine, Hospital of Eckernfoerde, Germany (D.B.). Received September 3, 2002; revision requested November 18; final revision received April 15, 2003; accepted April 30. Supported by grants from the Bavarian Economics Ministry (High-Tech Projekt: Leitprojekte Medizintechnik) and the Hans-Löwel-Foundation, Bamberg. Address correspondence to J.H. (e-mail: johannes.haensler@med1.med.uni-erlangen.de).

View larger version (19K): [in a new window]   Figure 1. Graph of Kaplan-Meier survival analysis shows significant survival benefit for the animals treated with RF ablation (T, blue curve) compared with survival in the control group (C, red curve). Subgroup analysis shows that not only are animals in complete remission after RF ablation (group T1), but animals with metastatic disease (group T2) had significant survival benefit.

View larger version (134K): [in a new window]   Figure 2. Images show typical changes in liver parenchyma after RF ablation. A, Contrast-enhanced US image of untreated tumor with typical peripheral contrast enhancement (arrow) in the early arterial phase. B, Contrast-enhanced US image obtained 1 day after RF ablation. Small arrow indicates tumor margin. Large arrow indicates safety margin with typical speckles after RF ablation. C, CT scan obtained before RF ablation shows typical peripheral contrast enhancement (oval). D, CT scan obtained 1 day after treatment shows absence of contrast enhancement (coagulation zone) (box). E, Microscopic image of residual tumor in an animal that died before the study end point shows the tumor completely embedded in coagulation necrosis (arrows); the proliferation rate of residual tumor (insert E1) is much lower than that in the control group (insert E2). (Immunostaining for PCNA: original magnification for E, x4; inserts E1 and E2, x40.) F, Microscopic image in an animal with complete remission shows circumscribed scarring and chronic inflammation with iron-loaded macrophages (insert F2, Prussian blue stain; original magnification, x40) and giant cells (arrows), as well as small bile duct proliferations (insert F1) that indicate focal liver regeneration. (Hematoxylin-eosin stain; original magnification of F, x4; insert F1, x40.)