Bimodal electric tissue ablation – modified radiofrequency ablation with a le veen electrode in a pig model
Dobbins C1, Wemyss-Holden SA, Cockburn J, Maddern GJ
Radiofrequency ablation (RFA) is a method of treating non-resectable liver tumors by use of a high-frequency alternating electrical current. Concerns have been raised as the local recurrence rates following treatment have been reported to be as high as 47%. The size of the ablation is limited by charring of adjacent tissues. It is hypothesized that by hydrating the liver, we can reduce charring, thus producing larger ablations, and that this can be achieved by addition of a direct electrical current to the electrical circuit. Using a pig model, standard RFA control ablations were created in the left lobe of the liver. Ablations using the modified circuit were created in the right lobe. At the end of the procedure, the pig was killed by lethal injection and the liver harvested. From the explanted liver, the diameter of each ablation was measured and the modified ablations were compared with controls using restricted maximum likelihood variance analysis. From 4 pigs, 14 controls and 12 modified ablations were produced. The mean diameter of the controls was 27.78 mm (+/- SE 3.37 mm). The mean diameter of the modified ablation was 49.55 mm (+/- SE 3.46 mm), which was significantly larger than the controls (P < 0.001). This study has shown that by modification of the standard RFA circuit with the addition of a direct electrical current, significantly larger ablations can be produced. By using this technique, the number of ablations required to treat one tumor would be less and it is anticipated this could reduce the rate of local recurrence.