Thermographic real-time-monitoring of surgical radiofrequency and microwave ablation in a perfused porcine liver model

Primavesi,Florian; Swierczynski,Stefan; Klieser,Eckhard; Kiesslich,Tobias; Jäger,Tarkan; Urbas,Romana; Hutter,Jörg; Neureiter,Daniel; Öfner,Dietmar; Stättner,Stefan

doi:10.3892/ol.2017.7634

Thermographic real-time-monitoring of surgical radiofrequency and microwave ablation in a perfused porcine liver model

Authors:
- Florian Primavesi
- Stefan Swierczynski
- Eckhard Klieser
- Tobias Kiesslich
- Tarkan Jäger
- Romana Urbas
- Jörg Hutter
- Daniel Neureiter
- Dietmar Öfner
- Stefan Stättner
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Affiliations: Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University Innsbruck, A‑6020 Innsbruck, Austria, Department of Surgery, Paracelsus Medical University, A‑5020 Salzburg, Austria, Institute of Pathology, Paracelsus Medical University, A‑5020 Salzburg, Austria, Department of Internal Medicine I, Paracelsus Medical University, A‑5020 Salzburg, Austria
Published online on: December 18, 2017 https://doi.org/10.3892/ol.2017.7634
Pages: 2913-2920
Copyright : © Primavesi et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

Radiofrequency ablation (RFA) and microwave ablation (MWA) are currently the dominant modalities to treat unresectable liver tumors. Monitoring the ablation process with b‑mode‑sonography is often hampered by artefacts. Furthermore, vessels may cause cooling in the adjacent tumor target (heat‑sink‑effect) with risk of local recurrence. The present study evaluated infrared‑thermography to monitor surgical RFA/MWA and detect heat‑sink‑effects in real‑time. RFA and MWA of perfused porcine livers was conducted at peripheral and central‑vessel‑adjacent locations, and monitored by real‑time thermography. Ablation was measured and evaluated by gross pathology. The mean time for ablation was significantly longer in RFA compared with MWA (8 vs. 2 min). Although mean macroscopic ablation diameter was similar (RFA, 3.17 cm; MWA, 3.38 cm), RFA showed a significant heat‑sink‑effect compared with MWA. The surface temperature during central RFA near vessels was 1/3 lower compared with peripheral RFA (47.11±8.35˚C vs. 68.72±12.70˚C; P<0.001). There was no significant difference in MWA (50.52±8.35˚C vs. 50.18±10.35˚C; P=0.74). In conclusion, thermography is suitable to monitor the correct ablation with MWA and RFA. The results of the current study demonstrated a significant heat‑sink‑effect for RFA, but not MWA near vessels. MWA reaches consistent surface temperatures much faster than RFA. With further in vivo validation, thermography may be useful to ensure appropriate ablation particularly near vulnerable or vascular structures.

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