Experimental and Clinical Radiofrequency Ablation: Proposal for Standardized Description of Coagulation Size and Geometry

Mulier, Stefaan; Ni, Yicheng; Frich, Lars; Burdı́o, Fernando; Denys, Alban; Wispelaere, J F De; Dupas, B.; Habib, Nagy; Hoey, Michael F.; Jansen, Matthijs; Lacrosse, M.; Leveillee, Raymond J.; Miao, Yi; Mulier, Peter; Mutter, Didier; Ng, Kelvin K. C.; Santambrogio, Roberto; Stippel, Dirk L.; Tamaki, Katsuyoshi; Gulik, Thomas M. van; Marchal, Guy; Michel, Luc

doi:10.1245/s10434-006-9033-9

Cited by 63 publications

(44 citation statements)

References 93 publications

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“…In the authors’ view, the very recent arrival of data on long-term survival after RFA [18,23,24,25,26, 28, 30, 45, 193], data on factors influencing local recurrence [79] and data on size and geometry of the ablation zone [176, 182] have paved the way for a more scientifically founded, more refined and more generally acceptable trial.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation versus Resection for Resectable Colorectal Liver Metastases: Time for a Randomized Trial?

et al. 2008

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Background: A recent proposal of a randomized trial comparing resection and radiofrequency ablation (RFA) in a selected subgroup of patients with small resectable colorectal liver metastases (CRLM) has initiated a debate on this issue. Meanwhile, new data have been published. The aim of the study was to update and critically review the oncological evidence in favor of and against the use of RFA for resectable CRLM in general and in favor of and against conducting a randomized trial in a selected subgroup of patients. Methods: An exhaustive review was carried out of papers and abstracts on RFA of colorectal metastases published before July 15, 2008. Results: Local recurrence rate after resection of CRLM is 1.2–10.4%. Local recurrence rate after RFA of CRLM is between 1.7 and 66.7%. For tumors <3 cm, local control after open RFA is equivalent to resection. Local recurrence rates, however, are higher for larger tumors and for the percutaneous and laparoscopic route. Accumulating evidence suggests that RFA and resection induce profoundly different biological effects, which may influence survival. Conclusions: Local recurrence rate after open RFA for CRLM <3 cm seems to be equivalent to resection. A randomized trial under strict conditions would be justified in this subgroup of patients. A randomized trial is currently not justified for larger tumors or for percutaneous or laparoscopic RFA, since local recurrence rates in these groups are too high to be acceptable for resectable tumors.

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Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation versus Resection for Resectable Colorectal Liver Metastases: Time for a Randomized Trial?

et al. 2008

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“…In SB mode, RF current flowed from one electrode to the other, and RF energy was applied alternately to the pair of electrodes. 24 The applied current, power output and impedance were continuously monitored by the generator during RFA and were recorded automatically using a computer program.…”

Section: Radiofrequency Ablation Protocolmentioning

confidence: 99%

“…[17][18][19] Recently, multiple-electrode RFA approaches, including the switching monopolar (SM) mode, bipolar mode and multipolar mode, have been attempted with each demonstrating efficiency in creating a larger ablation zone in liver tissue than in the standard monopolar RF technique. 2,[20][21][22][23][24][25][26] Theoretically, RFA in switching bipolar (SB) mode using multiple electrodes should further improve the thermal and electronic efficiency of RFA devices compared to conventional monopolar modes. However, until now, the efficacy of SB-RFA with internally cooled wet (ICW) electrodes, which allow simultaneous internal cooling and saline infusion, in creating 3-to 5-cm coagulation areas, have not been tested in previous in vivo studies.…”

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Switching bipolar hepatic radiofrequency ablation using internally cooled wet electrodes: comparison with consecutive monopolar and switching monopolar modes

Yoon

Lee²,

Woo

et al. 2015

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Objective: To evaluate whether switching bipolar radiofrequency ablation (SB-RFA) using three internally cooled wet (ICW) electrodes can induce coagulations .5 cm in porcine livers with better efficiency than consecutive monopolar (CM) or switching monopolar (SM) modes. The mean D min of coagulations was significantly larger in Group C than in Groups A and B (5.1 6 0.9, 3.9 6 1.2 and 4.4 6 1.0 cm, respectively, p 5 0.002) at a lower delivered RF energy level (76.8 6 14.3, 120.9 6 24.5 and 114.2 6 18.3 kJ, respectively, p , 0.001). Conclusion: SB-RFA using three ICW electrodes can create coagulations .5 cm in diameter with better efficiency than do SM-or CM-RFA. Advances in knowledge: SB-RFA can create large, regular ablation zones with better time-energy efficiency than do CM-or SM-RFA.

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“…Matavimai atlikti remiantis Mulier ir kt. (26) pasiūlyta eksperimentinės ir klinikinės radijo dažnio abliacijos standartizuota aprašymo bei abliacijos zonos dydžio ir formos vertinimo sistema. Kiekvienos abliacijos atveju išmatuotas išilginis diametras (AD, angl.…”

Section: Darbo Medžiaga Ir Metodikaunclassified

Bipolinės ir multipolinės radijo dažnio bliacijos zonos priklausomybė nuo laiko ir elektrinio lauko parametrų

2012

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ĮVADASOnkologinės ligos yra labai ryški šiuolaikinės visuomenės sveikatos problema, nes Lietuvoje vėžiu serga 1,2% gyventojų ir sergančiųjų skaičius kasmet didėja (1). Dažnai joms gydyti taikoma radijo dažnio abliacija -minimaliai invazyvus audinių suardymo metodas (2-5). Šio gydymo būdo kol kas negalima pritaikyti visų navikų gydymui ir jis dažniausiai apsiriboja kepenyse, inkstuose, plaučiuose bei kauluose esančiais navikais. Kartais radijo dažnio abliacija yra taikoma paliatyviai, siekiant sumažinti skausmą, ir tai duoda gerų ir ilgai trunkančių rezultatų (6). Be to, verta pastebėti, kad radijo dažnio abliacija gali būti ir yra naudojama ne tik navikinių audinių suardymui.Radijo dažnio abliacija yra atliekama aplikatorių pagalba, kurie, stebint echoskopijos, kompiuterinės tomografijos arba magnetinio rezonanso vaizdus, įstumiami į navikinius audinius. Šiuo metu yra gaminama įvairaus dydžio, formos bei veikimo principo aplikatorių, tačiau visų jų paskirtisgreta esančiuose audiniuose sukurti kintamą elektrinį lauką (dažnis: 375 -480 kHz), verčiantį audiniuose esančius jonus judėti ir tarpusavyje sąveikaujant išskirti šilumą, dėl kurios žūva ten esančios ląstelės (4, 7-9). Elektriniame lauke suardytų audinių sritis vadinama abliacijos zona.Kad būtų sunaikintas visas navikas, abliacijos zona turi apimti ne tik matomą naviko dalį, bet ir apgaubti visą naviką papildomu sluoksniu (storis apie 1 cm), vadinamu abliacijos kraštu, nes tyrimais patvirtinta, kad navikinės ląstelės naviko periferijoje dažnai būna nematomos makroskopinių tyrimų vaizduose (10). Siekiant užtikrinti reikiamą abliacijos zoną naudojami įvairūs jos didinimo būdai: manipuliavimas aplikatoriais ir jais tekančia elektros srove, kraujagyslėmis tekančio kraujo įtakos mažinimas, pagalbinių me-

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Experimental and Clinical Radiofrequency Ablation: Proposal for Standardized Description of Coagulation Size and Geometry

Abstract: Adoption of the proposed standardized description method may help to fill in the many gaps in our current knowledge of the size and geometry of RF coagulation zones.

Cited by 63 publications

References 93 publications

Radiofrequency Ablation versus Resection for Resectable Colorectal Liver Metastases: Time for a Randomized Trial?

Radiofrequency Ablation versus Resection for Resectable Colorectal Liver Metastases: Time for a Randomized Trial?

Switching bipolar hepatic radiofrequency ablation using internally cooled wet electrodes: comparison with consecutive monopolar and switching monopolar modes

Bipolinės ir multipolinės radijo dažnio bliacijos zonos priklausomybė nuo laiko ir elektrinio lauko parametrų

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