Radiofrequency tissue ablation in the rabbit lung: efficacy and complications.
Palavras-chave
Resumo
OBJECTIVE
We assessed the feasibility and safety of performing percutaneous radiofrequency ablation of pulmonary tissue in rabbits.
METHODS
Using an aseptic technique and computed tomography (CT) guidance, insulated 19-gauge aspiration biopsy needles were inserted into the right lower lobe of eight New Zealand White rabbits. Radiofrequency was applied via a coaxial electrode for 6 min at 90 degrees C. Probe-tip temperature, tissue impedance, and wattage were recorded at baseline and at 60-sec intervals throughout the procedure. CT scanning was used to assess tissue destruction and the presence or absence of pneumothorax immediately after the procedure and at 24 hr, 3 days, 10 days, 21 days, and 28 days. Three rabbits were sacrificed immediately, and the remaining rabbits were euthanized at 24 hr and at 3 days. 10 days, and 28 days (two rabbits). Gross and microscopic pathology were obtained and correlated with CT findings.
RESULTS
The mean initial tissue impedance was 509 +/- 197 omega, marked changes in tissue impedance were found during the procedure (240-1380 omega). Rigid temperature control required continuous manual fine-tuning of generator output. Increased respiratory rate was noted in one rabbit during the first 30 sec of radiofrequency application. Homogeneous, ovoid opacities 8.4 +/- 2.4 mm in diameter and 1.4 +/- 0.1 cm in length were found by CT scanning immediately after the procedure. These opacities showed maximal consolidation at 3 days, corresponding to coagulative necrosis and a peripheral acute inflammatory reaction. At 10 days, peripheral hyperattenuation with central hypoattenuation (early fibrosis surrounding degenerating blood products) was seen. Minimal residual fibrosis, pleural scarring, or both were noted by 28 days, suggesting a rapid, near-total recovery from the procedure. Lesion sizes were within 2 mm of gross pathologic findings. Pneumothoraces were noted in three of the eight rabbits (37.5%).
CONCLUSIONS
Radiofrequency tissue ablation was safely performed in pulmonary parenchyma via a percutaneous, transthoracic approach using a coaxial needle technique. Tissue response to thermal injury was predictable and easily monitored by CT scanning with excellent radiologic-pathologic correlation.
