Radiofrequency Liver Ablation
Experimental Comparative Study of Water-Cooled Versus Expandable Systems
Thierry de Baere1,
Alban Denys2,
Bradford Johns Wood3,
Nathalie Lassau1,
Mourad Kardache1,
Valerie Vilgrain2,
Yves Menu2 and
Alain Roche1
1
Service de Radiologie Interventionnelle, Institut Gustave Roussy, 94805
Villejuif Cedex, France.
2
Service d'Imagerie Médicale, Hopital Beaujon,
92110 Clichy, France.
3
Department of Radiology, National Institutes of Health, Bethesda, MD
20892.
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Fig. 1A. —Radiofrequency systems tested. Photograph of tip of 15-gauge
expandable needle shows four hookshaped, expandable electrodes deployed.
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Fig. 1B. —Radiofrequency systems tested. Photograph of cooled-tip
triple-cluster needle with 2.5-cm exposed active parts shows probe-guiding
device and stabilizer threaded onto needle.
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Fig. 1C. —Radiofrequency systems tested. Photograph of two generators
used for experiments. Generator for expandable needle is on left, and
generator for cooled needle is on right.
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Fig. 2. —Diagram shows size of lesions induced by administration of
radiofrequency with cooled-tip needle ([UNK]) and with expandable needle
(x). Longest dimension is x-axis, and shortest dimension is
y-axis. Note that lesions induced with cooled-tip needle electrode
are larger than those produced with expandable needle electrodes. Also, note
that expandable needle electrodes produced lesions that were more spheric than
those produced with the cooled-tip needle.
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Fig. 3A. —Radiofrequency lesions located close to large vessels.
Photograph shows evidence of heat-sink effect. Lesion induced with cooled-tip
needle was partially modified in shape by adjacent large hepatic vein
(arrow).
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Fig. 3B. —Radiofrequency lesions located close to large vessels.
Photograph shows evidence of heat-sink effect. Lesion induced with expandable
needle molded around large vessels (arrows), which are responsible
for its irregular shape.
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Fig. 3C. —Radiofrequency lesions located close to large vessels.
Photograph shows radiofrequency ablation induced only four small areas of
tissue destruction (arrowheads) at periphery of large hepatic vein.
Expandable system failed to induce a large lesion in this case.
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Fig. 4. —Photograph of round lesion, induced with expandable needle
system, in liver parenchyma shows small clotted portal vein branch runs
through lesion and patent larger vessels at periphery.
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Copyright © 2001 by the American Roentgen Ray Society.
