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Evaluation of a Thermoprotective Gel for Hydrodissection During Percutaneous Microwave Ablation: In Vivo Results

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Abstract

Purpose

To evaluate whether thermoreversible poloxamer 407 15.4 % in water (P407) can protect non-target tissues adjacent to microwave (MW) ablation zones in a porcine model.

Materials and Methods

MW ablation antennas were placed percutaneously into peripheral liver, spleen, or kidney (target tissues) under US and CT guidance in five swine such that the expected ablation zones would extend into adjacent diaphragm, body wall, or bowel (non-target tissues). For experimental ablations, P407 (a hydrogel that transitions from liquid at room temperature to semi-solid at body temperature) was injected into the potential space between target and non-target tissues, and the presence of a gel barrier was verified on CT. No barrier was used for controls. MW ablation was performed at 65 W for 5 min. Thermal damage to target and non-target tissues was evaluated at dissection.

Results

Antennas were placed 7 ± 3 mm from the organ surface for both control and gel-protected ablations (p = 0.95). The volume of gel deployed was 49 ± 27 mL, resulting in a barrier thickness of 0.8 ± 0.5 cm. Ablations extended into non-target tissues in 12/14 control ablations (mean surface area = 3.8 cm2) but only 4/14 gel-protected ablations (mean surface area = 0.2 cm2; p = 0.0005). The gel barrier remained stable at the injection site throughout power delivery.

Conclusion

When used as a hydrodissection material, P407 protected non-targeted tissues and was successfully maintained at the injection site for the duration of power application. Continued investigations to aid clinical translation appear warranted.

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Acknowledgments

The authors thank Lisa Sampson, M.S.; Alice Minx, B.Sc.; Thomas Warner, M.D., and Jeffrey Wu for their help with experimental setup.

Conflict of interest

The MW ablation system and P407 gel used in this study incorporate aspects of multiple patents pending. No industrial support was provided for this study. Four authors of this study have affiliations with NeuWave Medical, Inc, all of which are outside the submitted work: Anna J. Moreland is a consultant; J. Louis Hinshaw is a member of the medical advisory board and shareholder; Fred T. Lee Jr. is a patent holder, member of the board of directors, and shareholder; and Christopher L. Brace is a founder, shareholder, and consultant. Meghan G. Lubner, Timothy J. Ziemlewicz, Douglas R. Kitchin, and Alexander D. Johnson have no conflict of interest.

Funding Sources

NIH R01CA142737, R01CA149379; Wisconsin Alumni Research Foundation Technology Development program.

Statement of Animal Rights

All applicable institutional and/or national guidelines for the care and use of animals were followed.

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Authors and Affiliations

  1. Department of Radiology, E3/366 Clinical Science Center, University of Wisconsin – Madison, 600 Highland Avenue, Madison, WI, 53792-3252, USA

    Anna J. Moreland, Meghan G. Lubner, Timothy J. Ziemlewicz, Douglas R. Kitchin, J. Louis Hinshaw, Alexander D. Johnson, Fred T. Lee Jr. & Christopher L. Brace

  2. Department of Biomedical Engineering, University of Wisconsin – Madison, 1111 Highland Ave, WIMR 1141, Madison, WI, 53705, USA

    Alexander D. Johnson, Fred T. Lee Jr. & Christopher L. Brace

  3. Department of Medical Physics, University of Wisconsin – Madison, 1111 Highland Avenue, Room 1005, Madison, WI, 53705-2275, USA

    Christopher L. Brace

Authors
  1. Anna J. Moreland
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  2. Meghan G. Lubner
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  3. Timothy J. Ziemlewicz
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  4. Douglas R. Kitchin
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  5. J. Louis Hinshaw
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  6. Alexander D. Johnson
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  7. Fred T. Lee Jr.
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  8. Christopher L. Brace
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Corresponding author

Correspondence to Christopher L. Brace.

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Moreland, A.J., Lubner, M.G., Ziemlewicz, T.J. et al. Evaluation of a Thermoprotective Gel for Hydrodissection During Percutaneous Microwave Ablation: In Vivo Results. Cardiovasc Intervent Radiol 38, 722–730 (2015). https://doi.org/10.1007/s00270-014-1008-9

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  • DOI: https://doi.org/10.1007/s00270-014-1008-9

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