a Department of Minimally Invasive Interventional Radiology , Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine , Guangzhou , P.R. China.
b Department of Oncology , Panyu Central Hospital , Guangzhou , P.R. China.
Int J Hyperthermia. 2018 Nov;34(7):925-933. doi: 10.1080/02656736.2018.1442588. Epub 2018 Feb 26.
Our objective was to determine the safety and ablation size of hydrochloric acid-perfused radiofrequency ablation (HCl-RFA) in liver tissues, prospectively using in vivo rabbit and ex vivo porcine liver models.
The livers in 30 rabbits were treated in vivo with perfusions of normal saline (controls) and HCl concentrations of 5%, 10%, 15%, and 20%, during RFA at 103 °C and 30 W for 3 min. For each experimental setting, six ablations were created. Safety was assessed by comparing baseline weight and selected laboratory values with those at 2, 7, and 14 days' post-ablation, and by histopathological analysis. The livers in 25 pigs were treated ex vivo with the same five perfusions during RFA at 103 °C, at both 30 W and 60 W, for 30 min. Ablation diameters and volumes were measured by two examiners.
Rabbit weights and selected laboratory values did not differ significantly from baseline to 7 and 14 days' post-ablation, liver tissues outside the ablation zones were normal histologically, and adjacent organs showed no macroscopic damage. The mean ablation volumes in the porcine livers treated with HCl-RFA were all larger than those treated with normal saline perfusion during RFA (NS-RFA), at both 30 W and 60 W (p < 0.001). The largest ablation volume and transverse diameter were observed in the porcine livers during 10% HCl-RFA at 60 W, measuring 179.22 (SD = 24.79) cm and 6.84 (SD = 0.36) cm, respectively.
Based on our experiments, HCl-RFA in the liver appears to be as safe as NS-RFA while also resulting in larger ablation zones.
本研究旨在通过体内兔和离体猪肝脏模型，前瞻性地评估盐酸灌注射频消融（HCl-RFA）的安全性和消融范围。
在 30 只兔子的肝脏中，于 RFA 时分别以生理盐水（对照组）和 5%、10%、15%、20% HCl 进行灌注，RFA 条件为 103°C 和 30 W 持续 3 分钟。对于每个实验条件，创建了 6 个消融灶。通过比较基线体重和选定的实验室值与消融后 2、7 和 14 天的相应值，并进行组织病理学分析，评估安全性。在 25 头猪的离体肝脏中，于 RFA 时，在 103°C 下，分别以 30 W 和 60 W 的功率，进行相同的 5 种灌注，持续 30 分钟。由两位检查者测量消融直径和体积。
兔子的体重和选定的实验室值与消融后 7 天和 14 天相比无显著差异，消融灶外的肝组织组织学正常，相邻器官未见明显的宏观损伤。在 30 W 和 60 W 时，HCl-RFA 处理的猪肝脏的平均消融体积均大于生理盐水灌注 RFA（NS-RFA）（p<0.001）。在 60 W 时，10% HCl-RFA 处理的猪肝脏中观察到最大的消融体积和横径，分别为 179.22（SD=24.79）cm 和 6.84（SD=0.36）cm。
根据我们的实验结果，与 NS-RFA 相比，HCl-RFA 在肝脏中似乎同样安全，但会导致更大的消融范围。
