Switching bipolar hepatic radiofrequency ablation using internally cooled wet electrodes: Comparison with consecutive monopolar and switching monopolar modes

J. H. Yoon, Jeong Min Lee, S. Woo, E. J. Hwang, I. Hwang, W. Choi, J. K. Han, B. I. Choi

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18 Scopus citations

Abstract

Objective: To evaluate whether switching bipolar radiofrequency ablation (SB-RFA) using three internally cooled wet (ICW) electrodes can induce coagulations >5cm in porcine livers with better efficiency than consecutive monopolar (CM) or switching monopolar (SM) modes. Methods: A total of 60 coagulations were made in 15 in vivo porcine livers using three 17-gauge ICW electrodes and a multichannel radiofrequency (RF) generator. RF energy (approximately 200 W) was applied in CM mode (Group A, n = 20) for 24 min, SM mode for 12 min (Group B, = 5 20) or switching bipolar (SB) mode for 12 min (Group C, n = 20) in in vivo porcine livers. Thereafter, the delivered RFA energy, as well as the shape and dimension of coagulations were compared among the groups. Results: Spherical- or oval-shaped ablations were created in 30% (6/20), 85% (17/20) and 90% (18/20) of coagulations in the CM, SM and SB groups, respectively (p = 0.003). SB-RFA created ablations >5 cm in minimum diameter (Dmin) in 65% (13/20) of porcine livers, whereas SM- or CM-RFA created ablations >5cm in only 25% (5/20) and 20% (4/20) of porcine livers, respectively (p = 0.03). The mean Dmin of coagulations was significantly larger in Group C than in Groups A and B (5.1 ± 0.9, 3.9 ± 1.2 and 4.4 ± 1.0 cm, respectively, p = 0.002) at a lower delivered RF energy level (76.8 ± 14.3, 120.9 ± 24.5 and 114.2 ± 18.3 kJ, respectively, p < 0.001). Conclusion: SB-RFA using three ICW electrodes can create coagulations .5 cm in diameter with better efficiency than do SM- or CM-RFA. Advances in knowledge: SB-RFA can create large, regular ablation zones with better time-energy efficiency than do CM- or SM-RFA.

Original languageEnglish
Article number20140468
JournalBritish Journal of Radiology
Volume88
Issue number1050
DOIs
StatePublished - 1 Jun 2015

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