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Published in: CardioVascular and Interventional Radiology 11/2018

01-11-2018 | Laboratory Investigation

Evaluation of the Heat Sink Effect After Transarterial Embolization When Performed in Combination with Thermal Ablation of the Liver in a Rabbit Model

Authors: Charles J. Puza, Qi Wang, Charles Y. Kim

Published in: CardioVascular and Interventional Radiology | Issue 11/2018

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Abstract

Purpose

To assess the contribution of the heat sink effect when combining thermal ablation with transarterial embolization (TAE).

Materials and Methods

Radiofrequency ablation (RFA) or microwave ablation (MWA) were performed in the liver of non-tumor bearing rabbits. Three perfusion groups were used: rabbits that were killed then immediately ablated (non-perfused liver group to simulate embolized tumor with no heat sink), rabbits that underwent hepatic TAE followed by ablation (embolized liver group), and rabbits that underwent ablation while alive (normally perfused liver control group). For each perfusion group, 8 RFAs and 8 MWAs were performed. Probes were inserted using ultrasound guidance to avoid areas with major blood vessels. During ablation, temperatures were obtained from a thermocouple located 1 cm away from the ablation probe to assess heat conduction. With MWA, temperatures were also measured from the antennae tip.

Results

For RFA, embolization of normal liver did not increase temperature conduction when compared to the control group. However, temperature conduction was significantly increased in the non-perfused group (simulating embolized tumor) compared to controls (p = 0.007). For MWA, neither embolization nor non-perfusion increased temperature conduction compared to controls. With MWA, the probe tip temperature was significantly higher in the non-perfused group compared to the control and embolized group.

Conclusions

In non-perfused tissue simulating tumor, RFA demonstrated modest enhancement of temperature conduction, whereas MWA did not. Embolization of normal liver did not affect RFA or MWA. Findings suggest that heat sink mitigation plays a limited role with combination embolization-ablation therapies, albeit more with RFA than MWA.
Literature
2.
go back to reference Benson AB 3rd, D’Angelica MI, Abbott DE, Abrams TA, Alberts SR, Saenz DA, et al. NCCN guidelines insights: hepatobiliary cancers, version 1.2017. J Natl Compr Canc Netw. 2017;15(5):563–73.CrossRef Benson AB 3rd, D’Angelica MI, Abbott DE, Abrams TA, Alberts SR, Saenz DA, et al. NCCN guidelines insights: hepatobiliary cancers, version 1.2017. J Natl Compr Canc Netw. 2017;15(5):563–73.CrossRef
10.
go back to reference Lu Z, Wen F, Guo Q, Liang H, Mao X, Sun H. Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: a meta-analysis of randomized-controlled trials. Eur J Gastroenterol Hepatol. 2013;25(2):187–94.CrossRef Lu Z, Wen F, Guo Q, Liang H, Mao X, Sun H. Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: a meta-analysis of randomized-controlled trials. Eur J Gastroenterol Hepatol. 2013;25(2):187–94.CrossRef
12.
go back to reference Takuma Y, Takabatake H, Morimoto Y, Toshikuni N, Kayahara T, Makino Y, et al. Comparison of combined transcatheter arterial chemoembolization and radiofrequency ablation with surgical resection by using propensity score matching in patients with hepatocellular carcinoma within Milan criteria. Radiology. 2013;269(3):927–37. https://doi.org/10.1148/radiol.13130387.CrossRefPubMed Takuma Y, Takabatake H, Morimoto Y, Toshikuni N, Kayahara T, Makino Y, et al. Comparison of combined transcatheter arterial chemoembolization and radiofrequency ablation with surgical resection by using propensity score matching in patients with hepatocellular carcinoma within Milan criteria. Radiology. 2013;269(3):927–37. https://​doi.​org/​10.​1148/​radiol.​13130387.CrossRefPubMed
20.
go back to reference Bierman HR, Byron RL Jr, Kelley KH, Grady A. Studies on the blood supply of tumors in man. III. Vascular patterns of the liver by hepatic arteriography in vivo. J Natl Cancer Inst. 1951;12(1):107–31.PubMed Bierman HR, Byron RL Jr, Kelley KH, Grady A. Studies on the blood supply of tumors in man. III. Vascular patterns of the liver by hepatic arteriography in vivo. J Natl Cancer Inst. 1951;12(1):107–31.PubMed
Metadata
Title
Evaluation of the Heat Sink Effect After Transarterial Embolization When Performed in Combination with Thermal Ablation of the Liver in a Rabbit Model
Authors
Charles J. Puza
Qi Wang
Charles Y. Kim
Publication date
01-11-2018
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 11/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-018-2034-9

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