Department of Diagnostic Radiology and Neuroradiology, Ernst-Moritz-Arndt-Universitaet Greifswald, Sauerbruchstrasse, 17487, Greifswald, Germany.
MAGMA. 2012 Feb;25(1):63-74. doi: 10.1007/s10334-011-0261-z. Epub 2011 Jun 9.
Histology is the gold standard for confirming thermally induced necrosis. Generally, however, no specimen is obtained from thermal ablation therapy for pathological examination. The aim of this study was to provide evidence for the relationship between temperatures reached and resulting tissue coagulation during laser ablation in a near-physiological ex vivo lung tumor model by combining viability staining and direct temperature measurement.
In all, 17 human lung specimens with primary non-small-cell lung cancer (NSCLC) were examined in this study. Organs were resected with curative intent from patients of either gender (5 female, 12 male) with an average age of 65 years (51-78). Here, 11/17 specimens were subjected to interstitial laser thermal ablation in an ex vivo lung perfusion and ventilation model after surgery. A control group of 6/17 specimens was tested for viability without laser ablation. Tissue temperature was measured invasively in real-time during the ablation process using thermocouples. Afterwards, representative slices of all 17 specimens were tested for viability with triphenyltetrazolium chloride (TTC). Maximum tissue temperature Tmax[°C] measured at a distance of 10 and 20 mm from the laser tip and time of temperature exposure were correlated with the diameter of the induced coagulation as ascertained with viability staining. CH evaluated the results.
Mean maximum temperature was 75.9°C ± 14.4°C at a distance of 10 mm from the laser tip and 50.3°C ± 14.6°C at a distance of 20 mm, respectively. The mean distance between the coagulation margin and the laser tip was 17.8 mm ± 7.3 mm.
We found that coagulation size correlated positively with temperature. There was a clear trend towards the correlation of time over 44°C and ablation depth. Maximum temperatures did not significantly correlate with coagulation size. Laser ablation of lung tumors using the IHLP (isolated human lung perfusion) model represents a possible method for evaluating ex vivo the interrelationships of temperature, time of temperature exposure, and resulting coagulation.
组织学是确认热诱导坏死的金标准。然而，一般来说，热消融治疗后没有标本用于病理检查。本研究的目的是通过结合活细胞染色和直接温度测量，为在接近生理的离体肺肿瘤模型中激光消融时达到的温度与组织凝固之间的关系提供证据。
总共检查了 17 个人类原发性非小细胞肺癌（NSCLC）肺标本。这些器官是从 5 名女性和 12 名男性（平均年龄 65 岁，范围 51-78 岁）的患者中以根治性切除的方式获得的。在这里，17 个标本中有 11 个在手术后的离体肺灌注和通气模型中接受了间质激光热消融。17 个标本中有 6 个作为对照组，在没有激光消融的情况下进行了活细胞染色测试。在消融过程中，使用热电偶实时测量组织温度。然后，用氯化三苯基四氮唑（TTC）对所有 17 个标本的代表性切片进行活细胞染色测试。测量距离激光尖端 10 和 20 毫米处的最大组织温度 Tmax[°C]和暴露时间与通过活细胞染色确定的诱导凝固直径相关。CH 评估了结果。
距离激光尖端 10 毫米处的平均最大温度为 75.9°C ± 14.4°C，距离激光尖端 20 毫米处的平均最大温度为 50.3°C ± 14.6°C。凝固边界与激光尖端之间的平均距离为 17.8 毫米 ± 7.3 毫米。
我们发现凝固大小与温度呈正相关。在 44°C 以上的时间和消融深度的相关性上有明显的趋势。最大温度与凝固大小没有显著相关性。使用 IHLP（离体人肺灌注）模型对肺肿瘤进行激光消融代表了一种评估离体温度、温度暴露时间和产生的凝固之间相互关系的潜在方法。
