Skip to main content
SpringerLink
Log in

Combined treatment of radiofrequency ablation and acetic acid injection: an in vivo feasibility study in rabbit liver

  • Experimental
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The aim of this study was to compare the effects of percutaneous radiofrequency ablation (RFA) combined with percutaneous acetic acid injection (PAI) and either therapy alone for their effects on in vivo rabbit liver tissue. Thirty New Zealand white rabbits were included in this study and were allocated to three groups: group A, conventional RFA (n=10); group B, PAI (n=10); and group C, combined RFA and PAI (n=10). Under US guidance, 1 ml of 50% acetic acid was injected into the target area of the liver parenchyma through a 21-G Chiba needle before performing RFA. The RFA was then performed using a 17-G internally cooled electrode with 1-cm active tip, and RF energy (30 W) was applied for 3 min with or without acetic acid injection. After RFA or PAI, contrast-enhanced CT and CT pathologic correlation were performed. The maximum diameters of the thermal lesions in each group were compared. All procedures were technically successful, and a total of 30 lesions (10 lesions for each group) were produced. The mean maximum diameter of the coagulation necrosis in the rabbits of group C (25±9 mm) was significantly larger than the diameters of the other groups: 12.2±1 mm (group A) and 14.3±3 mm (group B; p=0.001). On contrast-enhanced CT scanning, the lesions of group B (7 of 10, 70%) appeared frequently irregular compared with those of groups A (2 of 10, 20%) and C (4 of 10, 40%; p=0.08). There were seven complications (23.3%): a localized hematoma in a group-A rabbit; two hematomas and one chemical peritonitis in group-B rabbits; and a hematoma, a chemical peritonitis, and a burn injury to the stomach in group-C rabbits. Compared with the group-A rabbits (1 of 10, 10%), the group-B (3 of 10, 30%) and group-C rabbits (3 of 10, 30%) showed a tendency toward complications, but the difference was not significant (p=0.48). Under the present experimental condition, combined RFA and PAI was able to increase the diameter of coagulation necrosis up to 2.5 cm without significantly increasing complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1a–d
Fig. 2a–e

Similar content being viewed by others

References

  1. Gazelle GS, Goldberg SN, Solbiati L, Livraghi T (2000) Tumor ablation with radio-frequency energy. Radiology 217:633–646

    CAS  PubMed  Google Scholar 

  2. Lim HK (2000) Radiofrequency thermal ablation of hepatocellular carcinomas. Korean J Radiol 1:175–184

    CAS  PubMed  Google Scholar 

  3. McGahan JP, Dodd GD III (2001) Radiofrequency ablation of the liver: current status. Am J Roentgenol 176:3–16

    Google Scholar 

  4. Solbiati L, Livraghi T, Ierace T, Meloni F, Goldberg SN (2000) Local control of focal liver malignancies treated with RF ablation: initial report of the Italian Multicenter Cooled-tip RF Study Group (Abstract). Radiology 217 (Suppl):27

    Google Scholar 

  5. Ahmed M, Goldberg SN (2002) Thermal ablation therapy for hepatocellular carcinoma. J Vasc Interv Radiol 13:S231–S243

    PubMed  Google Scholar 

  6. Dupuy DE, Goldberg SN (2001) Image-guided radiofrequency tumor ablation: challenges and opportunities—part II. J Vasc Interv Radiol 12:1135–1148

    CAS  PubMed  Google Scholar 

  7. Rossi S, Stasi M di, Buscarini E, Quaretti P, Garbagnati F, Squassante L, Paties CT, Silverman DE, Buscarini L (1996) Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. Am J Roentgenol 167:759–768

    CAS  Google Scholar 

  8. Livraghi T, Goldberg SN, Meloni F, Solbiati L, Gazelle GS (1999) Hepatocellular carcinoma: comparison of efficacy between percutaneous ethanol instillation and radiofrequency. Radiology 210:655–663

    CAS  PubMed  Google Scholar 

  9. Livraghi T, Goldberg SN, Lazzaroni S, Meloni F, Ierace T, Solbiati L, Gazelle GS (2000) Hepatocellular carcinoma: radiofrequency ablation of medium and large lesions. Radiology 214:761–768

    PubMed  Google Scholar 

  10. Ni Y, Miao S, Mulier S, Yu J, Baert AL, Marchal G (2000) A novel “cooled-wet’’ electrode for radiofrequency ablation. Eur Radiol 10:852–854

    Article  CAS  PubMed  Google Scholar 

  11. Miao Y, Ni Y, Yu J, Zhang H, Baert A, Marchal G (2001) An ex vivo study on radiofrequency tissue ablation: increased lesion size by using an “expandable-wet” electrode. Eur Radiol 11:1841–1847

    Article  CAS  PubMed  Google Scholar 

  12. Miao Y, Ni Y, Yu J, Marchal G (2000) A comparative study on validation of a novel cooled-wet electrode for radiofrequency liver ablation. Invest Radiol 35:438–444

    Google Scholar 

  13. Lee JM, Youk JH, Kim YK, Han YM, Chung GH, Lee SY, Kim CS (2003) Radiofrequency thermal ablation with hypertonic saline solution injection of the lung: ex vivo and in vivo feasibility studies. Eur Radiol 13:2540–2547

    Google Scholar 

  14. Rossi S, Garbagnati F, Lencioni R, Allgaier HP, Marchiano A, Fornari F, Quaretti P, Tolla GD, Ambrosi C, Mazzaferro V, Blum HE, Bartolozzi C (2000) Percutaneous radiofrequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply. Radiology 217:119–126

    CAS  PubMed  Google Scholar 

  15. Goldberg SN, Kruskal JB, Oliver BS, Clouse ME, Gazelle GS (2000) Percutaneous tumor ablation: increased coagulation by combining radiofrequency ablation and ethanol instillation in a rat breast tumor model. Radiology 217:827–831

    CAS  PubMed  Google Scholar 

  16. Ohnishi K, Ohyama N, Ito S, Fujiwara K (1994) Small hepatocellular carcinoma: treatment with US-guided intratumoral injection of acetic acid. Radiology 190:53–57

    PubMed  Google Scholar 

  17. Haaga JR (1994) Interventional CT-guided procedures. In: Haaga JR, Lanzieri CF (eds) Computed tomography and magnetic resonance imaging of the whole body, 3rd edn. Mosby Year-Book, St. Louis, pp 1572–1693

  18. Goldberg SN, Gazelle GS, Comptom CC, Mueller PR, Tanabe KK (2000) Treatment of intrahepatic malignancy with radiofrequency ablation. Cancer 88:2452–2463

    Article  CAS  PubMed  Google Scholar 

  19. Lee JD, Lee JM, Kim SW, Kim CS, Mun WS (2001) MR imaging—histopathologic correlation of radiofrequency thermal ablation lesion in a rabbit liver model: observation during acute and chronic stages. Korean J Radiol 2:151–158

    CAS  PubMed  Google Scholar 

  20. Char CH, Lee FT, Gurney JM, Markhardt BK, Warner TF, Kelcz F, Mahvi DM (2000) CT vs sonography for monitoring radiofrequency ablation in a porcine liver. AJR 175:705–711

    Google Scholar 

  21. Shiina S, Tagawa K, Niwa Y, Unuma T, Komatsu Y, Yoshiura K, Hamada E, Takahashi M, Shiratori Y, Terano A (1993) Percutaneous ethanol injection therapy for hepatocellular carcinoma: results in 146 patients. Am J Roentgenol 160:1023–1028

    CAS  Google Scholar 

  22. Livraghi T, Giorgio A, Martin G, Salmi A, Sio I de, Bolondi L, Pompili M, Brunello F, Lazzaroni S, Torzilli G (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. Radiology 197:101–108

    CAS  PubMed  Google Scholar 

  23. Buscarini L, Buscarini E, Stasi M di, Vallisa D, Quaretti P, Rocca A (2001) Percutaneous radiofrequency ablation of small hepatocellular carcinoma: long-term results. Eur Radiol 11:914–921

    PubMed  Google Scholar 

  24. Goldberg SN, Gazelle GS (2001). Radiofrequency tissue ablation: physical principles and techniques for increasing coagulation necrosis. Hepatogastroenterology 48:359–367

    Google Scholar 

  25. Lencioni R, Cioni D, Donati F, Bartolozzi C (2001) Combination of interventional therapies in hepatocellular carcinoma. Hepatogastroenterology 48:8–14

    CAS  PubMed  Google Scholar 

  26. Goldberg SN, Saldinger PF, Gazelle GS, Huertas JC, Stuart KE, Jacobs T, Kruskal JB (2001) Percutaneous tumor ablation: increased coagulation necrosis with combined radiofrequency and percutaneous doxorubicin injection. Radiology 220:420–427

    CAS  PubMed  Google Scholar 

  27. Patterson EJ, Scudamore CH, Owen DA, Nagy AG, Buczkowski AK (1998) Radiofrequency ablation of porcine liver in vivo: effects of blood flow and treatment time on lesion size. Ann Surg 227:559–566

    CAS  PubMed  Google Scholar 

  28. Goldberg SN, Hahn PF, Halpern E, Fogle R, Gazelle GS (1998) Radiofrequency thermal ablation: effect of pharmacologic modulation of blood flow on coagulation diameter. Radiology 209:761–769

    CAS  PubMed  Google Scholar 

  29. Ohnishi K, Yoshioka H, Ito S, Fujiwara K (1998) Prospective randomized controlled trial comparing percutaneous acetic acid injection and percutaneous ethanol injection for small hepatocellular carcinoma. Hepatology 27:67–72

    CAS  PubMed  Google Scholar 

  30. Dodd GD, Frank MS, Aribandi M, Chopra S, Chintapalli KN (2002) Radiofrequency thermal ablation: computer analysis created by overlapping ablations. Am J Roentgenol 177:777–782

    Google Scholar 

Download references

Acknowledgements

The authors thank L. So for her assistance in animal observation and anesthesia, and for her outstanding support in obtaining the CT images. We also thank B. Hami for her editorial assistance and manuscript preparation.

Author information

Authors and Affiliations

  1. Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, 28, Yongon-Dong, Chongno-Gu, 110-744, Seoul, South Korea

    Jeong Min Lee, Se Hyung Kim, Joon Koo Han & Byung Ihn Choi

  2. Department of Diagnostic Radiology, Wonkwang University Hospital, Iksan, South Korea

    Young Hwan Lee

  3. Department of Diagnostic Radiology, Chonbuk National University Hospital, Chonju, South Korea

    Young Kon Kim & Sang Won Kim

Authors
  1. Jeong Min Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Young Hwan Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Young Kon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sang Won Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Se Hyung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Joon Koo Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Byung Ihn Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeong Min Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, J.M., Lee, Y.H., Kim, Y.K. et al. Combined treatment of radiofrequency ablation and acetic acid injection: an in vivo feasibility study in rabbit liver. Eur Radiol 14, 1303–1310 (2004). https://doi.org/10.1007/s00330-003-2140-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-003-2140-0

Keywords

Search

Navigation