Improved coagulation with saline solution pretreatment during radiofrequency tumor ablation in a canine model

Muneeb Ahmed, S. Melvyn Lobo, Joseph Weinstein, Jonathan B. Kruskal, G. Scott Gazelle, Elkan F. Halpern, S. Karim Afzal, Robert E. Lenkinski, S. Nahum Goldberg

Research output: Contribution to journalArticle

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Abstract

PURPOSE: To determine whether pretreatment with local NaCl injection can increase radiofrequency (RF)-induced coagulation in a large animal model. MATERIAL AND METHODS: Multiple canine venereal sarcomas (n = 25) were implanted subcutaneously in eight mildly immunosuppressed dogs (25 mg/kg cyclosporin A twice daily). Tumors were incubated for 8-12 weeks to a diameter of 4.2-6.3 cm (5.1 cm ± 0.7). Internally cooled RF ablation (1-cm tip; 12 min; pulsed technique; 2,000-mA maximum) was performed. Tumors were pretreated with 6 mL of 18%, 24%, or 36% NaCl injected intratumorally under direct ultrasound guidance after RF electrode insertion, and this treatment was compared to RF treatment without NaCl injection and to 36% NaCl injection without RF ablation. Impedance measurements and remote thermometry were performed. These measurements and resultant coagulation were compared. RESULTS: Significantly greater RF heating (73°C ± 11°C at 20 mm) was observed when the tumors were treated with 24% or 36% NaCl pretreatment, compared to the 47°C ± 5°C observed when 18% or no NaCl was injected (P < .02). In the 36% NaCl group, the entire tumor (5.2 cm ± 0.8 diameter) was completely ablated in every case, with coagulation extending several centimeters into the surrounding tissues. By comparison, control tumors (without NaCl injection) contained coagulation measuring 3.1 cm ± 0.2, surrounded by viable, well-perfused tumor (P < .01), and 36% NaCl alone produced 2.7 cm ± 0.6 of patchy necrosis. CONCLUSIONS: Pretreatment with intratumoral injection of small volumes of highly concentrated NaCl markedly increases RF heating and coagulation in a large animal tumor model. The complete destruction of tumors 5 cm in diameter or larger suggests that this substantial increase may be achieved for tumor ablation in clinical practice.

Original languageEnglish (US)
Pages (from-to)717-724
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume13
Issue number7
StatePublished - 2002

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Sodium Chloride
Canidae
Neoplasms
Injections
Heating
Animal Models
Thermometry
Electric Impedance
Sarcoma
Cyclosporine
Electrodes
Necrosis
Dogs
Therapeutics

Keywords

  • Neoplasms, therapy
  • Radiofrequency (RF) ablation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Ahmed, M., Lobo, S. M., Weinstein, J., Kruskal, J. B., Gazelle, G. S., Halpern, E. F., ... Goldberg, S. N. (2002). Improved coagulation with saline solution pretreatment during radiofrequency tumor ablation in a canine model. Journal of Vascular and Interventional Radiology, 13(7), 717-724.

Improved coagulation with saline solution pretreatment during radiofrequency tumor ablation in a canine model. / Ahmed, Muneeb; Lobo, S. Melvyn; Weinstein, Joseph; Kruskal, Jonathan B.; Gazelle, G. Scott; Halpern, Elkan F.; Afzal, S. Karim; Lenkinski, Robert E.; Goldberg, S. Nahum.

In: Journal of Vascular and Interventional Radiology, Vol. 13, No. 7, 2002, p. 717-724.

Research output: Contribution to journalArticle

Ahmed, M, Lobo, SM, Weinstein, J, Kruskal, JB, Gazelle, GS, Halpern, EF, Afzal, SK, Lenkinski, RE & Goldberg, SN 2002, 'Improved coagulation with saline solution pretreatment during radiofrequency tumor ablation in a canine model', Journal of Vascular and Interventional Radiology, vol. 13, no. 7, pp. 717-724.
Ahmed, Muneeb ; Lobo, S. Melvyn ; Weinstein, Joseph ; Kruskal, Jonathan B. ; Gazelle, G. Scott ; Halpern, Elkan F. ; Afzal, S. Karim ; Lenkinski, Robert E. ; Goldberg, S. Nahum. / Improved coagulation with saline solution pretreatment during radiofrequency tumor ablation in a canine model. In: Journal of Vascular and Interventional Radiology. 2002 ; Vol. 13, No. 7. pp. 717-724.
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abstract = "PURPOSE: To determine whether pretreatment with local NaCl injection can increase radiofrequency (RF)-induced coagulation in a large animal model. MATERIAL AND METHODS: Multiple canine venereal sarcomas (n = 25) were implanted subcutaneously in eight mildly immunosuppressed dogs (25 mg/kg cyclosporin A twice daily). Tumors were incubated for 8-12 weeks to a diameter of 4.2-6.3 cm (5.1 cm ± 0.7). Internally cooled RF ablation (1-cm tip; 12 min; pulsed technique; 2,000-mA maximum) was performed. Tumors were pretreated with 6 mL of 18{\%}, 24{\%}, or 36{\%} NaCl injected intratumorally under direct ultrasound guidance after RF electrode insertion, and this treatment was compared to RF treatment without NaCl injection and to 36{\%} NaCl injection without RF ablation. Impedance measurements and remote thermometry were performed. These measurements and resultant coagulation were compared. RESULTS: Significantly greater RF heating (73°C ± 11°C at 20 mm) was observed when the tumors were treated with 24{\%} or 36{\%} NaCl pretreatment, compared to the 47°C ± 5°C observed when 18{\%} or no NaCl was injected (P < .02). In the 36{\%} NaCl group, the entire tumor (5.2 cm ± 0.8 diameter) was completely ablated in every case, with coagulation extending several centimeters into the surrounding tissues. By comparison, control tumors (without NaCl injection) contained coagulation measuring 3.1 cm ± 0.2, surrounded by viable, well-perfused tumor (P < .01), and 36{\%} NaCl alone produced 2.7 cm ± 0.6 of patchy necrosis. CONCLUSIONS: Pretreatment with intratumoral injection of small volumes of highly concentrated NaCl markedly increases RF heating and coagulation in a large animal tumor model. The complete destruction of tumors 5 cm in diameter or larger suggests that this substantial increase may be achieved for tumor ablation in clinical practice.",
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T1 - Improved coagulation with saline solution pretreatment during radiofrequency tumor ablation in a canine model

AU - Ahmed, Muneeb

AU - Lobo, S. Melvyn

AU - Weinstein, Joseph

AU - Kruskal, Jonathan B.

AU - Gazelle, G. Scott

AU - Halpern, Elkan F.

AU - Afzal, S. Karim

AU - Lenkinski, Robert E.

AU - Goldberg, S. Nahum

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N2 - PURPOSE: To determine whether pretreatment with local NaCl injection can increase radiofrequency (RF)-induced coagulation in a large animal model. MATERIAL AND METHODS: Multiple canine venereal sarcomas (n = 25) were implanted subcutaneously in eight mildly immunosuppressed dogs (25 mg/kg cyclosporin A twice daily). Tumors were incubated for 8-12 weeks to a diameter of 4.2-6.3 cm (5.1 cm ± 0.7). Internally cooled RF ablation (1-cm tip; 12 min; pulsed technique; 2,000-mA maximum) was performed. Tumors were pretreated with 6 mL of 18%, 24%, or 36% NaCl injected intratumorally under direct ultrasound guidance after RF electrode insertion, and this treatment was compared to RF treatment without NaCl injection and to 36% NaCl injection without RF ablation. Impedance measurements and remote thermometry were performed. These measurements and resultant coagulation were compared. RESULTS: Significantly greater RF heating (73°C ± 11°C at 20 mm) was observed when the tumors were treated with 24% or 36% NaCl pretreatment, compared to the 47°C ± 5°C observed when 18% or no NaCl was injected (P < .02). In the 36% NaCl group, the entire tumor (5.2 cm ± 0.8 diameter) was completely ablated in every case, with coagulation extending several centimeters into the surrounding tissues. By comparison, control tumors (without NaCl injection) contained coagulation measuring 3.1 cm ± 0.2, surrounded by viable, well-perfused tumor (P < .01), and 36% NaCl alone produced 2.7 cm ± 0.6 of patchy necrosis. CONCLUSIONS: Pretreatment with intratumoral injection of small volumes of highly concentrated NaCl markedly increases RF heating and coagulation in a large animal tumor model. The complete destruction of tumors 5 cm in diameter or larger suggests that this substantial increase may be achieved for tumor ablation in clinical practice.

AB - PURPOSE: To determine whether pretreatment with local NaCl injection can increase radiofrequency (RF)-induced coagulation in a large animal model. MATERIAL AND METHODS: Multiple canine venereal sarcomas (n = 25) were implanted subcutaneously in eight mildly immunosuppressed dogs (25 mg/kg cyclosporin A twice daily). Tumors were incubated for 8-12 weeks to a diameter of 4.2-6.3 cm (5.1 cm ± 0.7). Internally cooled RF ablation (1-cm tip; 12 min; pulsed technique; 2,000-mA maximum) was performed. Tumors were pretreated with 6 mL of 18%, 24%, or 36% NaCl injected intratumorally under direct ultrasound guidance after RF electrode insertion, and this treatment was compared to RF treatment without NaCl injection and to 36% NaCl injection without RF ablation. Impedance measurements and remote thermometry were performed. These measurements and resultant coagulation were compared. RESULTS: Significantly greater RF heating (73°C ± 11°C at 20 mm) was observed when the tumors were treated with 24% or 36% NaCl pretreatment, compared to the 47°C ± 5°C observed when 18% or no NaCl was injected (P < .02). In the 36% NaCl group, the entire tumor (5.2 cm ± 0.8 diameter) was completely ablated in every case, with coagulation extending several centimeters into the surrounding tissues. By comparison, control tumors (without NaCl injection) contained coagulation measuring 3.1 cm ± 0.2, surrounded by viable, well-perfused tumor (P < .01), and 36% NaCl alone produced 2.7 cm ± 0.6 of patchy necrosis. CONCLUSIONS: Pretreatment with intratumoral injection of small volumes of highly concentrated NaCl markedly increases RF heating and coagulation in a large animal tumor model. The complete destruction of tumors 5 cm in diameter or larger suggests that this substantial increase may be achieved for tumor ablation in clinical practice.

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KW - Radiofrequency (RF) ablation

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