Early Preclinical Experience with a Novel Endobronchial Radiofrequency Ablation System for Lung Cancer Treatment

Yoneda, Ken Y.; Li, S.; Herth, Felix J.F.; Spangler, Taylor; Gelfand, Michael J.; Raina, Sameer; Panescu, Dorin

doi:10.1109/embc.2019.8857593

Cited by 5 publications

(13 citation statements)

References 7 publications

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“…The late CT follow-up (3 months) showed shrinkage of the lesions (Fig. 4a,4b and 7b), as in other studies 20,21 . Histopathological examination revealed coagulation necrosis in the affected areas surrounded by brosed interlobular septa (Fig.…”

Section: Resultssupporting

confidence: 83%

A novel bronchoscopic guided non-invasive treatment for lung nodule

Kim

Shah²,

Seol³

et al. 2023

Preprint

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Radiofrequencyablation (RFA) is one of the treatment options for lung nodules; however, the need for exact delivery of the rigid metal electrode into the center of the target mass often leads to complications or suboptimal results. To overcome these limitations, we report a novel bronchoscopy-guided atraumatic no-touch RFA procedure that uses a specially designed radiofrequency (RF) conductor balloon catheter (CAROL catheter) and an injectable bronchial electrode based on a medical grade liquid metal (E-GaIn) in porcine lungs. The bronchial electrode injected from the CAROL catheter was able to turn the target-site bronchial air pipe into a temporally multi-tined RF electrode. The mean volume of E-GaIn (bronchial electrode) for each effective CAROL was 0.46 ± 0.47 ml. The ablation results showed highly efficacious and consistent results especially in the peripheral lung. Most bronchial electrodes were also retrieved by either bronchoscopic suction immediately after the procedure or by natural expectoration thereafter. The residual bronchial electrode did not cause any significant safety issues. Our computer simulation model also supported preclinical data.

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Section: Resultssupporting

confidence: 83%

A novel bronchoscopic guided non-invasive treatment for lung nodule

Kim

Shah²,

Seol³

et al. 2023

Preprint

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“…72 A novel externally cooled RFA probe (Fig. 2) has demonstrated efficacy in animal models 71 and is being examined in clinical trials (Table 2).…”

Section: Bronchoscopic Rfamentioning

confidence: 99%

Bronchoscopic treatments for early‐stage peripheral lung cancer: Are we ready for prime time?

Steinfort

Herth

2020

Respirology

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Lung cancer is the leading cause of cancer-related death worldwide and surgical lobectomy remains the preferred therapy for patients with early-stage NSCLC. Medical comorbidities and advanced age preclude resection in many patients and minimally invasive ablative therapies are needed for treatment. Stereotactic ablative radiation is established as an effective modality in this patient group, although may be contraindicated in some patients with prior radiation exposure, comorbidities or centrally positioned tumours. Percutaneous ablative methods are available, although are frequently associated with significant complications. Numerous endoscopic ablative techniques are under evaluation. With a more favourable safety profile and the ability to provide diagnosis and staging information potentially within a single procedure, there is a strong rationale for development of bronchoscopic ablative modalities. In the following article, the authors aim to explore the role bronchoscopic ablation may play in treatment of peripheral lung tumours, and to describe a pathway to establishing these modalities as part of routine care. The current status of several bronchoscopic ablative options is discussed in detail.

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“…Although we have previously described our novel RFA system, we will provide another summary of its features [9]. As shown in Fig.…”

Section: A Rfa Systemmentioning

confidence: 99%

“…In other words, attention was paid to the clearance of the RF electrode with respect to the pleura and the diaphragm so that the expected ablation volumes would have inconsequential involvement of the pleura or of the diaphragm. A disposable 5-mm outer diameter bronchoscope (Ambu, Copenhagen, Denmark) with a 2.2 mm working channel was used to gain access to the target bronchi [9]. The catheter was tracked through the working channel and placed so that the ablation electrode reached the intended target location.…”

Section: B Study Proceduresmentioning

confidence: 99%

“…Radiofrequency Ablation (RFA) is one such therapy that uses oscillating electrical fields to heat up the site of the tumor and cause necrosis of the tumor cells [4 -8]. We have previously presented early preclinical data with a novel endobronchial RFA system designed for treatment of lung cancer [9]. Our present goal was to follow up on our previous experience and report the findings of a 12-week survival healthy-swine study.…”

Section: Introductionmentioning

confidence: 99%

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Long-term Survival Results following Endobronchial RF Ablation in a Healthy-Porcine Model

Yoneda

Herth

Spangler³

et al. 2020

2020 42nd Annual International Conference of the IEEE Engineering in Medicine &Amp; Biology Society (EMBC)

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This paper presents results from long-term survival study where healthy swine were ablated with a novel technology designed for treating early-stage non-small cell lung cancer using an endobronchial flexible catheter. Methods-The radiofrequency ablation (RFA) system has been presented previously and consisted of an ablation catheter, radiofrequency generator, irrigation pump for infusion of hypertonic saline (HS) and a laptop. The catheter carried an occlusion balloon, a 5 mm long RF electrode, with irrigation holes, and a 1 mm long electrode for bipolar impedance measurements. The outer diameter (OD) was 1.4 mm for compatibility with current bronchoscopes, navigation systems and radial EBUS. Nine swine were treated in this study with survival times of 1, 4 and 12 weeks (N=3 at each time point). In all animals, the treatment sites consisted of one location in the upper right lung (RUL) and another one in the lower right lung (RLL). CTs were taken pre-op, immediately post-op and at every 2 weeks post treatment. Ablation times ranged from 6 to 8 min and average applied power was 68 W (range 63-72 W). Results-At 1-week survival, large zones of necrotic tissue were observed in all respective 6 ablations. Ablation volumes had an average diameter of 3.2 cm at RUL locations and 3.8 cm in RLLs (likely due to longer RLL ablation durations). As time progressed, the necrotic tissue was gradually replaced with fibrotic tissue. At 4-week survival, the replacement was almost complete in all respective 3 animals. As a result, ablation volumes decreased to an average diameter of 1.3 cm at RUL locations and 2.3 cm in RLLs (likely due to longer RLL ablation durations). At 12-week survival, as the replacement process continued, histopathology revealed zones of residual necrotic tissue that were further reduced in size. Ablation zones had been resorbed and contracted by fibrous scar tissue. The average volume of the treatment effect decreased to 1.1 cm (RUL) and to 1.6 cm (RLL) in equivalent diameter. There were no complications in any of the nine animals. Conclusion-In healthy swine lungs, RFA with a 1.4-mm OD, radial-EBUS-sheath-compatible, endobronchial catheter was effective and safe. This system and therapeutic approach may be considered for further evaluation in minimally invasive treatment of tumorous lung nodules.

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Early Preclinical Experience with a Novel Endobronchial Radiofrequency Ablation System for Lung Cancer Treatment

Cited by 5 publications

References 7 publications

A novel bronchoscopic guided non-invasive treatment for lung nodule

A novel bronchoscopic guided non-invasive treatment for lung nodule

Bronchoscopic treatments for early‐stage peripheral lung cancer: Are we ready for prime time?

Long-term Survival Results following Endobronchial RF Ablation in a Healthy-Porcine Model

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