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Munier, Sean M., Eric L. Hargreaves, Nitesh V. Patel, and Shabbar F. Danish. "Ablation dynamics of subsequent thermal doses delivered to previously heat-damaged tissue during magnetic resonance–guided laser-induced thermal therapy." Journal of Neurosurgery 131, no. 6 (December 2019): 1958–65. http://dx.doi.org/10.3171/2018.7.jns18886.
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OBJECTIVEIntraoperative dynamics of magnetic resonance–guided laser-induced thermal therapy (MRgLITT) have been previously characterized for ablations of naive tissue. However, most treatment sessions require the delivery of multiple doses, and little is known about the ablation dynamics when additional doses are applied to heat-damaged tissue. This study investigated the differences in ablation dynamics between naive versus damaged tissue.METHODSThe authors examined 168 ablations from 60 patients across various surgical indications. All ablations were performed using the Visualase MRI-guided laser ablation system (Medtronic), which employs a 980-nm diffusing tip diode laser. Cases with multiple topographically overlapping doses with constant power were selected for this study. Single-dose intraoperative thermal damage was used to calculate ablation rate based on the thermal damage estimate (TDE) of the maximum area of ablation achieved (TDEmax) and the total duration of ablation (tmax). We compared ablation rates of naive undamaged tissue and damaged tissue exposed to subsequent thermal doses following an initial ablation.RESULTSTDEmax was significantly decreased in subsequent ablations compared to the preceding ablation (initial ablation 227.8 ± 17.7 mm2, second ablation 164.1 ± 21.5 mm2, third ablation 124.3 ± 11.2 mm2; p = < 0.001). The ablation rate of subsequent thermal doses delivered to previously damaged tissue was significantly decreased compared to the ablation rate of naive tissue (initial ablation 2.703 mm2/sec; second ablation 1.559 mm2/sec; third ablation 1.237 mm2/sec; fourth ablation 1.076 mm/sec; p = < 0.001). A negative correlation was found between TDEmax and percentage of overlap in a subsequent ablation with previously damaged tissue (r = −0.164; p < 0.02).CONCLUSIONSAblation of previously ablated tissue results in a reduced ablation rate and reduced TDEmax. Additionally, each successive thermal dose in a series of sequential ablations results in a decreased ablation rate relative to that of the preceding ablation. In the absence of a change in power, operators should anticipate a possible reduction in TDE when ablating partially damaged tissue for a similar amount of time compared to the preceding ablation.
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Kim, Sang Hyun, Jae Min Lee, Kang Won Lee, Sang Hoon Kim, Se Hyun Jang, Han Jo Jeon, Seong Ji Choi, et al. "Irreversible electroporation of the bile duct in swine: A pilot study." Journal of Clinical Oncology 38, no. 4_suppl (February 1, 2020): 541. http://dx.doi.org/10.1200/jco.2020.38.4_suppl.541.
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541 Background: Irreversible electroporation (IRE) is a relatively new ablative method. However, the application of IRE ablation has not been attempted for the treatment of biliary disease. Minimally invasive approach using endoscopic retrograde cholangio-pancreatography (ERCP) can be a novel therapeutic modality for IRE ablation. In this study, we investigated the feasibility and effect of endoscopic IRE for biliary tract in animal model. Methods: A new catheter electrode was developed for endoscopic IRE ablation of biliary tract. The electrode for IRE ablation has two band-shaped electrodes on catheter tip. We performed ERCP and endoscopic IRE ablations on normal common bile duct in 6 Yorkshire pigs. Experimental parameters of IRE were 500V/cm, 1000V/cm and 2000V/cm (under 50 pulses, 100 µs length). Animals were sacrificed after 24 hours and ablated bile duct were collected. H & E stain, immunohistochemistry and western blot were performed. Results: Well-demarcated focal color changes were observed on the mucosa of the common bile duct under all experimental parameters. After IRE ablation, bile duct epithelium was disappeared around ablated area and it showed fibrotic change in H&E stain. Depth of change after IRE was different between each experimental parameters. Apoptotic change of bile duct was localized around mucosa in 500V. Diffuse transmural fibrosis of bile duct was shown after IRE ablation with 2000V. TUNEL immunohistochemistry showed the cell death of bile duct mucosa and submucosa along the electrode. Within 24 hours, no complication was observed in pigs after endoscopic IRE ablation. Conclusions: Endoscopic IRE ablation using ERCP was successfully performed on common bile duct by using catheter-shaped electrode. It can be a potential therapeutic option as minimally invasive ablation for treatment of biliary tumors.
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SANZ, J., R. BETTI, and V. N. GONCHAROV. "Rayleigh–Taylor instability analysis of targets with a low-density ablation layer." Laser and Particle Beams 17, no. 2 (April 1999): 237–44. http://dx.doi.org/10.1017/s0263034699172094.
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Irregularities on the outer surface of Inertial Confinement Fusion (ICF) capsules accelerated by laser irradiation are amplified by the Rayleigh–Taylor instability (RTI), which occurs at the ablation front (ablative RTI), where density gradient and acceleration have the same direction. The analytic stability theory of subsonic ablation fronts, for Froude number larger than one, shows that the main stabilization mechanisms are blowoff convection (rocket effect equilibrating the gravity force) and ablation (Sanz 1994; Betti et al. 1996). Blowoff convection and ablation are enhanced if the ablator material is mixed with high-Z dopants. The latest enhances radiation emission setting the ablator on a higher adiabat, lowering its density, and increasing the ablation velocity. When such an ablator is used to push a solid deuterium-tritium (D–T) shell, the D–T-ablator interface becomes classically unstable. The aim of this paper is to investigate the stability of such a configuration, represented by a low-density ablator pushing a heavier shell, and study the interplay between the classical and ablative RTIs occurring simultaneously. The stability analysis is carried out using a sharp boundary model (Piriz et al. 1997), which contains all the basic physics of the RTI in ICF.
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Munier, Sean M., Allison S. Liang, Akshay N. Desai, Jose K. James, and Shabbar F. Danish. "Characterization of Magnetic Resonance Thermal Imaging Signal Artifact During Magnetic Resonance Guided Laser-Induced Thermal Therapy." Operative Neurosurgery 19, no. 5 (July 31, 2020): 619–24. http://dx.doi.org/10.1093/ons/opaa229.
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Abstract BACKGROUND Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a minimally invasive procedure that utilizes intraoperative magnetic resonance thermal imaging (MRTI) to generate a thermal damage estimate (TDE) of the ablative area. In select cases, the MRTI contains a signal artifact or defect that distorts the ablative region. No study has attempted to characterize this artifact. OBJECTIVE To characterize MRTI signal the artifact in select cases to better understand its potential relevance and impact on the ablation procedure. METHODS All ablations were performed using the Visualase magnetic resonance imaging-guided laser ablation system (Medtronic). Patients were included if the MRTI contained signal artifact that distorted the ablative region during the first thermal dose delivered. Ablation artifact was quantified using MATLAB version R2018a (Mathworks Inc, Natick, Massachusetts). RESULTS A total of 116 patients undergoing MRgLITT for various surgical indications were examined. MRTI artifact was observed in 37.0% of cases overall. Incidence of artifact was greater at higher powers (P < .001) and with longer ablation times (P = .024), though artifact size did not correlate with laser power or ablation duration. CONCLUSION MRTI signal artifact is common during LITT. Higher powers and longer ablation times result in greater incidence of ablation artifact, though artifact size is not correlated with power or duration. Future studies should aim to evaluate effects of artifact on postoperative imaging and, most notably, patient outcomes.
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Zhao, Fei, Lanhai Su, Rong Zhu, and Zhihui Li. "Study of linear ablative rate of D6AC steel wing used on supersonic missile." Thermal Science 23, no. 6 Part B (2019): 4107–16. http://dx.doi.org/10.2298/tsci180910323z.
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The D6AC steel wing used on supersonic missile is the object in this study. Its service environment was generated and simulated. The ablation experiment of D6AC steel missile wing was carried out under different parameters of flow field. The ablation process of D6AC steel wing was studied and analyzed under the supersonic aerodynamic heating environment. The results show that the ablation process of D6AC steel missile wing could be divided into three stages: aerodynamic heating, oxidation reaction, and shear stripping. The influence factors of the D6AC, steel wing ablation include the total temperature, Mach number, oxygen content, and water content. The higher the total temperature is, the more early the initial ablation time of wing is. The linear ablative rate of the D6AC steel wing is the result of the interaction of the Mach number, oxygen content, and water content. The higher the Mach number is, the larger the oxygen content is, and the larger the linear ablative rate of missile wing is. The influence of water content on the linear ablative rate of D6AC steel wing is the opposite.
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Liu, Gui Min, and Bin Li. "Study on the Electrical Arc Ablation Performance of Nano-SiCW Reinforced Cu-Matrix Composites." Advanced Materials Research 228-229 (April 2011): 509–13. http://dx.doi.org/10.4028/www.scientific.net/amr.228-229.509.
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The nano-SiC whisker reinforced Cu-matrix composites (SiCw/Cu) were obtained by powder metallurgy processes. The electrical arc ablation performance of composite SiCw/Cu was compared with copper H62 through stagnation-point ablation experiments. The results indicated that the qualities of copper H62 samples decreased with the increasing of ablating current; and the qualities of SiCw/Cu samples firstly increased and then decreased with the increasing of ablating current. Ablation mechanism research indicates the ablation hole of SiCw/Cu is smaller than copper H62, but it produced micro cracks because of different thermal expansion coefficients between nano-SiC whisker and Cu-matrix. At the same time, nano-SiC whisker happens to intricate oxidation reaction during arc ablation, it can reduce Cu-matrix smelts and sprays by absorbing arc energy. The anchoring effect and protection for the copper matrix of the uniformly dispersing nano-SiC whiskers have been considered to contribute the excellent arc ablation performance of composite SiCw/Cu.
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Angeline, Aruldass K., and Mahesh Shiva. "Radiofrequency Ablation Study." Pondicherry Journal of Nursing 12, no. 4 (2019): 102–4. http://dx.doi.org/10.5005/jp-journals-10084-12134.
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Hlavsa, Jan, Vladimír Procházka, Michal Crha, Iva Svobodová, Tomáš Andrašina, Petr Raušer, Lucie Urbanová, et al. "Healing dynamics of porcine pancreatic parenchyma after radiofrequency ablation - in vivo experimental pilot study." Acta Veterinaria Brno 81, no. 4 (2012): 427–31. http://dx.doi.org/10.2754/avb201281040427.
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Radiofrequency ablation is a tumour destruction method, widely used in human as well veterinary medicine. Recently, it has been applied to pancreatic disorder treatment. However, little is known about healing of the pancreatic parenchyma after radiofrequency ablation as it is important for the prevention of complications and treatment strategy. The aim of this experimental in vivo study on pigs was to evaluate the pancreatic parenchyma healing dynamics after damage by radiofrequency ablation. Radiofrequency ablations of the duodenal lobe of the pancreas were performed on 8 cross-bred laboratory pigs. They were euthanized in pairs at seven, fourteen, forty and eighty days after the procedure. Histological and cytological changes of the ablated zone were evaluated after autopsy. It was proved that pancreatic necrosis after radiofrequency ablation heals by means of fibrotic scar. There was no sign of exocrine and endocrine regeneration, respectively, during 80 days after the procedure. This is the first study verifying that the healing process of an ablation zone in the pancreatic parenchyma after radiofrequency ablation is similar to healing in the liver, lung, heart and other parenchymal organs.
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Goode, S. D., A. Chowdhury, M. Crockett, A. Beech, R. Simpson, T. Richards, and B. D. Braithwaite. "Laser and Radiofrequency Ablation Study (LARA study): A Randomised Study Comparing Radiofrequency Ablation and Endovenous Laser Ablation (810nm)." Journal of Vascular Surgery 52, no. 2 (August 2010): 522. http://dx.doi.org/10.1016/j.jvs.2010.06.097.
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Goode, S. D., A. Chowdhury, M. Crockett, A. Beech, R. Simpson, T. Richards, and B. D. Braithwaite. "Laser and Radiofrequency Ablation Study (LARA study): A Randomised Study Comparing Radiofrequency Ablation and Endovenous Laser Ablation (810nm)." European Journal of Vascular and Endovascular Surgery 40, no. 2 (August 2010): 246–53. http://dx.doi.org/10.1016/j.ejvs.2010.02.026.
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Luo, Ma, Si-Liang Chen, Jiawen Chen, Huzheng Yan, Zhenkang Qiu, Guanyu Chen, Ligong Lu, and Fujun Zhang. "Resection vs. ablation for lesions characterized as resectable-ablative within the colorectal liver oligometastases criteria: a propensity score matching from retrospective study." PeerJ 8 (January 27, 2020): e8398. http://dx.doi.org/10.7717/peerj.8398.
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Background There has been no prospective or retrospective studies reporting the comparison outcome between surgery and ablation for resectable-ablative (lesions could be treated by resection or complete ablation) colorectal liver oligometastases (CLOM). The purpose of this study was to compare the efficacy and prognostic difference in patients who underwent R0 resection vs. complete ablation within the resectable-ablative CLOM criteria. Methods From January 2008 to May 2018, a total of 2,367 patients diagnosed with colorectal liver metastases were included in this observational study. The metastasis was characterized by only limited to liver with number ≤5, size ≤5 cm, and resectable-ablative (lesions could be treated by resection or complete ablation). The evaluated indications, including liver progression-free survival (LPFS), overall survival (OS), survival rates, pattern and number of recurrences, and complications, were compared by using propensity score matching (PSM). The Kaplan−Meier curves were generated, and a log-rank test was performed. The Cox regression model was used for univariate and multivariate analyses to identify predictors of outcomes. Results A total of 421 consecutive patients were eligible for this study, with 250 and 171 undergoing R0 resection and complete ablation, respectively. PSM identified 145 patients from each group. The 1-, 3-, 5- and 8-year OS rates in the resection group and the ablation group were 95.8% vs. 95.0%, 69.8% vs. 60.1%, 53.6% vs. 42.5%, and 45.1% vs. 32.9% (p = 0.075), respectively. The median LPFS in the resection group was significantly longer than that in the ablation group (35 months vs. 15 months, p = 0.011). No statistical difference was found in LPFS between the two groups when comparing ≤3 cm liver metastases. For liver metastasis >3 cm, the median LPFS in the resection group and ablation group was 11 months and 5 months, respectively (p = 0.001). In terms of high risk of clinical risk score (CRS), the resection group showed longer LPFS than the ablation group (median 18 months vs. 10 months, p = 0.043). Conclusion For patients within the CLOM criteria suggesting that liver metastases were resectable as well as ablative, resection could result in longer liver recurrence-free survival than ablation in cases with size >3 cm or high risk of CRS. But for ≤3 cm liver metastases, their treatment efficacies were comparable.
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Minami, Yasunori, Tomohiro Minami, Kazuomi Ueshima, Yukinobu Yagyu, Masakatsu Tsurusaki, Takuya Okada, Masatoshi Hori, Masatoshi Kudo, and Takamichi Murakami. "Three-Dimensional Radiological Assessment of Ablative Margins in Hepatocellular Carcinoma: Pilot Study of Overlay Fused CT/MRI Imaging with Automatic Registration." Cancers 13, no. 6 (March 23, 2021): 1460. http://dx.doi.org/10.3390/cancers13061460.
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Background: We investigate the feasibility of image fusion application for ablative margin assessment in radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) and possible causes for a wrong initial evaluation of technical success through a side-by-side comparison. Methods: A total of 467 patients with 1100 HCCs who underwent RFA were reviewed retrospectively. Seventeen patients developed local tumor progressions (LTPs) (median size, 1.0 cm) despite initial judgments of successful ablation referring to contrast-enhanced images obtained in the 24 h after ablation. The ablative margins were reevaluated radiologically by overlaying fused images pre- and post-ablation. Results: The initial categorizations of the 17 LTPs had been grade A (absolutely curative) (n = 5) and grade B (relatively curative) (n = 12); however, the reevaluation altered the response categories to eight grade C (margin-zero ablation) and nine grade D (existence of residual HCC). LTP occurred in eight patients re-graded as C within 4 to 30.3 months (median, 14.3) and in nine patients re-graded as D within 2.4 to 6.7 months (median, 4.2) (p = 0.006). Periablational hyperemia enhancements concealed all nine HCCs reevaluated as grade D. Conclusion: Side-by-side comparisons carry a risk of misleading diagnoses for LTP of HCC. Overlay fused imaging technology can be used to evaluate HCC ablative margin with high accuracy.
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Molitor, Nadine, Emre Yalcinkaya, Angelo Auricchio, Haran Burri, Etienne Delacretaz, Michael Kühne, Andrea Menafoglio, et al. "Swiss National Registry on Catheter Ablation Procedures: Changing Trends over the Last 20 Years." Journal of Clinical Medicine 10, no. 14 (July 7, 2021): 3021. http://dx.doi.org/10.3390/jcm10143021.
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The Swiss Ablation Registry provides a national database for electrophysiologic studies and catheter ablations. We analyzed the database to provide an in-depth look at changing trends over the last 20 years. During the study period a total of 78622 catheter ablations (age 61.0 ± 1.2 years; 63.7% male) were performed in 29 centers. The number of ablations increased by approximately ten-fold in 20 years. Ablation for atrial fibrillation (AF) was the main driver behind this increase, with more than hundred-fold (39.7% of all ablations in 2019). Atrioventricular-nodal-reentrant-tachycardia (AVNRT) and accessory pathways, being the main indications for ablation in 2000 (44.1%/25.1%, respectively), made up of only a small proportion (15.2%/3.5%,) respectively in 2019. Fluoroscopy, ablation, and procedure durations were reduced for all ablations over time. The highest repeat ablations were performed for ventricular tachycardia and AF (24.4%/24.3%). The majority of ablations (63.0%) are currently performed in private hospitals and non-university public hospitals whereas university hospitals had dominated (82.4%) at the turn of the century. A pronounced increase in the number of catheter ablations in Switzerland was accompanied by a marked decrease in fluoroscopy, ablation, and procedure durations. We observed a shift toward more complex procedures in older patients with comorbidities.
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Krasnick, Bradley Aaron, David Sindram, Kerri Simo, Ryan Goss, Jeetendra Bharadwaj, Kreg Howk, Katherine A. Herdina, and Chet W. Hammill. "Tumor Ablation Using 3-Dimensional Electromagnetic-Guided Ultrasound Versus Standard Ultrasound in a Porcine Model." Surgical Innovation 26, no. 4 (January 29, 2019): 420–26. http://dx.doi.org/10.1177/1553350619825717.
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Introduction. The objective of this study was to compare the placement of ablation needles using 3-dimensional electromagnetic-guided ultrasound (guided) to standard ultrasound guidance (standard) in both laparoscopic surgery and open surgery. Endpoints for this study included targeting accuracy and number of required needle withdrawals and reorientations. Methods. Using a porcine model, fiducial markers were placed into the kidney and liver to represent tumors. Navigation and identification of target sites was achieved using standard or guided ultrasound. Intraprocedural observations as well as the number of needle placement attempts per target were recorded. Three board-certified general surgeons performed the navigation and ablation procedures. After completion of the navigation and ablation procedures, necropsy was performed. The position of the ablation zones relative to the fiducial markers was recorded. Results. A total of 48 procedures were performed across 6 animals (50% open and 50% laparoscopic). Overall, the guided ablations required 50% fewer attempts to successfully target the marker ( P = .01). There was a 62% reduction of attempts for guided laparoscopic ablation ( P = .006). On subgroup analysis of laparoscopic ablation, the benefit remained for liver ( P = .041) ablations, but not for renal ablations ( P = .093). There was no significant difference between the groups with regard to targeting accuracy (91.3% guided vs 95.4% standard, P = .58). Conclusions. The number of targeting attempts required during laparoscopic ablation procedures was significantly less with guided than with standard ultrasound, particularly for laparoscopic ablation of liver lesions. These findings suggest that the guided ultrasound can potentially reduce complications during laparoscopic ablation procedures.
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Steinfort, Daniel P., Michael Christie, Phillip Antippa, Kanishka Rangamuwa, Robert Padera, Michael Rolf Müller, Louis B. Irving, and Arschang Valipour. "Bronchoscopic Thermal Vapour Ablation for Localized Cancer Lesions of the Lung: A Clinical Feasibility Treat-and-Resect Study." Respiration 100, no. 5 (2021): 432–42. http://dx.doi.org/10.1159/000514109.
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<b><i>Background:</i></b> Bronchoscopic thermal vapour ablation (BTVA) is an established and approved modality for minimally invasive lung volume reduction in severe emphysema. Preclinical data suggest potential for BTVA in minimally invasive ablation of lung cancer lesions. <b><i>Objectives:</i></b> The objective of this study is to establish the safety, feasibility, and ablative efficacy of BTVA for minimally invasive ablation of lung cancers. <b><i>Methods:</i></b> Single arm treat-and-resect clinical feasibility study of patients with biopsy-confirmed lung cancer. A novel BTVA for lung cancer (BTVA-C) system for minimally invasive treatment of peripheral pulmonary tumours was used to deliver 330 Cal thermal vapour energy via bronchoscopy to target lesion. Patients underwent planned lobectomy to complete oncologic care. Pre-surgical CT chest and post-resection histologic analysis were performed to evaluate ablative efficacy. <b><i>Results:</i></b> Six patients underwent BTVA-C, and 5 progressed to planned lobectomy. Median procedure duration was 12 min. No major procedure-related complications occurred. All 5 resected lesions were part-solid lung adenocarcinomas with median solid component size 1.32±0.36 cm. Large uniform ablation zones were seen in 4 patients where thermal dose exceeded 3 Cal/mL, with complete/near-complete necrosis of target lesions seen in 2 patients. Tumour positioned within ablation zones demonstrated necrosis in >99% of cross-sectional area examined. <b><i>Conclusion:</i></b> BTVA of lung tumours is feasible and well tolerated, with preliminary evidence suggesting high potential for effective ablation of tumours. Thermal injury is well demarcated, and uniform tissue necrosis is observed within ablation zones receiving sufficient thermal dose per volume of lung. Treatment of smaller volumes and ensuring adequate thermal dose may be important for ablative efficacy.
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Li, Bin, Gui Min Liu, Jian Hua Du, Xiao Hui Zheng, and Qing Song Yong. "Study on the Electrical Arc Ablation Performance of Al2O3 Reinforced Cu-Matrix Composites." Advanced Materials Research 557-559 (July 2012): 267–71. http://dx.doi.org/10.4028/www.scientific.net/amr.557-559.267.
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The Al2O3 particle reinforced Cu-based composites (Al2O3/Cu) were prepared by internal oxidation technology. The electrical arc ablation performance of Al2O3/Cu composite was compared with copper H62 through a series of ablation experiments. The results indicate that both the quality lost and ablation diameter of copper H62 samples are larger than those of Al2O3/Cu composites in condition of the same ablating current. The large ablation pits observed by scanning electron microscopy (SEM) indicated that the arc ablation of copper H62 is concentrate and serious. The result of energy dispersive spectrometer (EDS) shows that the molten copper alloy of H62 has been transferred and sprayed. However, the arc ablation pits of Al2O3/Cu composites are dispersing and slight. The transferring and spaying material of Al2O3/Cu composite is mainly from Cu-matrix. The anchoring effect and protection function of the uniformly dispersing Al2O3 grains, which are executed onto the Cu-matrix, has been considered to contribute to the excellent arc ablation performance of composite Al2O3/Cu.
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Poch, Franz G. M., Christina A. Neizert, Ole Gemeinhardt, Beatrice Geyer, Katharina Eminger, Christian Rieder, Stefan M. Niehues, Janis Vahldiek, Stefan F. Thieme, and Kai S. Lehmann. "Intermittent Pringle maneuver may be beneficial for radiofrequency ablations in situations with tumor-vessel proximity." Innovative Surgical Sciences 3, no. 4 (May 11, 2018): 245–51. http://dx.doi.org/10.1515/iss-2018-0008.
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AbstractBackgroundRadiofrequency ablation (RFA) represents a treatment option for non-resectable liver malignancies. Larger ablations can be achieved with a temporary hepatic inflow occlusion (Pringle maneuver – PM). However, a PM can induce dehydration and carbonization of the target tissue. The objective of this study was to evaluate the impact of an intermittent PM on the ablation size.MethodsTwenty-five multipolar RFAs were performed in porcine livers ex vivo. A perfused glass tube was used to simulate a natural vessel. The following five test series (each n=5) were conducted: (1) continuous PM, (2–4) intermittent PM, and (5) no PM. Ablations were cut into half. Ablation area, minimal radius, and maximal radius were compared.ResultsNo change in complete ablation size could be measured between the test series (p>0.05). A small rim of native liver tissue was observed around the glass tube in the test series without PM. A significant increase of ablation area could be measured on the margin of the ablations with an intermittent PM, starting without hepatic inflow occlusion (p<0.05).ConclusionAn intermittent PM did not lead to smaller ablations compared to a continuous or no PM ex vivo. Furthermore, an intermittent PM can increase the ablation area when initial hepatic inflow is succeeded by a PM.
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Chen, Jindong, Hao Wang, Mengmeng Zhou, and Liang Zhao. "Catheter ablation for lone atrial fibrillation in individuals aged under 35 years." Cardiology in the Young 29, no. 5 (May 2019): 643–48. http://dx.doi.org/10.1017/s1047951119000416.
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AbstractBackground:To assess the effectiveness of radiofrequency catheter ablation for lone atrial fibrillation in young adults.Methods:This single-centre, retrospective, observational study enrolled 75 consecutive patients (86.7% men) under 35 (median, 30) years old with lone atrial fibrillation (68% paroxysmal, 26.7% persistent, and 5.3% long-standing persistent) without other cardiopulmonary diseases who underwent catheter ablation between April 2009 and May 2017. Procedural endpoints were circumferential pulmonary vein ablation for atrial fibrillation with pulmonary vein trigger, and target ablation or bidirectional block of lines and disappearance of complex fractionated atrial electrograms for atrial fibrillation with clear and unclear non-pulmonary vein triggers, respectively.Results:Main study outcome was rate of survival free from atrial tachyarrhythmia recurrence, which at median 61 (range, 5–102) months follow-up was 62.7% (64.7 and 58.3% for paroxysmal and non-paroxysmal atrial fibrillation, respectively) after single ablation, and 69.3% (68.6 and 70.8% for paroxysmal and non-paroxysmal atrial fibrillation, respectively) after mean 1.2 ablations (two and three ablations in 11 and 2 patients, respectively). In multivariate analysis, non-pulmonary vein trigger was a significant independent predictor of recurrent atrial tachyarrhythmia (OR, 10.60 [95%CI, 2.25–49.96]; p = 0.003). There were no major periprocedural adverse events.Conclusions:In patients under 35 years old with lone atrial fibrillation, radiofrequency catheter ablation appeared effective particularly for atrial fibrillation with pulmonary vein trigger and regardless of left atrial size or atrial fibrillation duration or type. Atrial tachyarrhythmia recurrence after multiple ablations warrants further study.
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Schreiber, T., N. Kähler, S. Biewener, V. Tscholl, P. Nagel, P. Attanasio, U. Landmesser, and M. Huemer. "Results from a real-time dosimetry study during left atrial ablations performed with ultra-low dose radiation settings." Herzschrittmachertherapie + Elektrophysiologie 32, no. 2 (May 11, 2021): 244–49. http://dx.doi.org/10.1007/s00399-021-00762-7.
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Abstract Background Three-dimensional mapping systems and the use of ultra-low dose radiation protocols have supported minimization of radiation dose during left atrial ablation procedures. By using optimal shielding, scattered radiation reaching the operator can be further reduced. This prospective study was designed to determine the remaining operator radiation exposure during left atrial catheter ablations using real-time dosimetry. Methods Radiation dose was recorded using real-time digital dosimetry badges outside the lead apron during 201 consecutive left atrial fibrillation ablation procedures. All procedures were performed using the same X‑ray system (Siemens Healthineers Artis dBc; Siemens Healthcare AG, Erlangen, Germany) programmed with ultra-low dose radiation settings including a low frame rate (two frames per second), maximum copper filtration, and an optimized detector dose. To reduce scattered radiation to the operators, table-suspended lead curtains, ceiling-suspended leaded plastic shields, and radiation-absorbing shields on the patient were positioned in an overlapping configuration. Results The 201 procedures included 139 (69%) pulmonary vein isolations (PVI) (20 cryoballoon ablations, 119 radiofrequency ablations, with 35 cases receiving additional ablation of the cavotricuspid isthmus) and 62 (31%) PVI plus further left atrial substrate ablation. Mean radiation dose measured as dose area product for all procedures was 128.09 ± 187.87 cGy ∙ cm2 with a mean fluoroscopy duration of 9.4 ± 8.7 min. Real-time dosimetry showed very low average operator doses of 0.52 ± 0.10 µSv. A subanalysis of 51 (25%) procedures showed that the radiation burden for the operator was highest during pulmonary vein angiography. Conclusion The use of ultra-low dose radiation protocols in combination with optimized shielding results in extremely low scattered radiation reaching the operator.
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Poch, Franz G. M., Christian Rieder, Hanne Ballhausen, Verena Knappe, Jörg Peter Ritz, Ole Gemeinhardt, Martin E. Kreis, and Kai S. Lehmann. "Finding Optimal Ablation Parameters for Multipolar Radiofrequency Ablation." Surgical Innovation 24, no. 3 (February 13, 2017): 205–13. http://dx.doi.org/10.1177/1553350617692492.
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Purpose. Radiofrequency ablation (RFA) for primary liver tumors and liver metastases is restricted by a limited ablation size. Multipolar RFA is a technical advancement of RFA, which is able to achieve larger ablations. The aim of this ex vivo study was to determine optimal ablation parameters for multipolar RFA depending on applicator distance and energy input. Methods. RFA was carried out ex vivo in porcine livers with three internally cooled, bipolar applicators in multipolar ablation mode. Three different applicator distances were used and five different energy inputs were examined. Ablation zones were sliced along the cross-sectional area at the largest ablation diameter, orthogonally to the applicators. These slices were digitally measured and analyzed. Results. Sixty RFA were carried out. A limited growth of ablation area was seen in all test series. This increase was dependent on ablation time, but not on applicator distance. A steady state between energy input and energy loss was not observed. A saturation of the minimum radius of the ablation zone was reached. Differences in ablation radius between the three test series were seen for lowest and highest energy input ( P < .05). No differences were seen for medium amounts of energy ( P > .05). Conclusions. The ablation parameters applicator distance and energy input can be chosen in such a way, that minor deviations of the preplanned ablation parameters have no influence on the size of the ablation area.
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Min, Geeho, Hyuk Soon Choi, Woojung Kim, Seong ji Choi, Jung Min Lee, Seung Han Kim, Jae Min Lee, et al. "Development of new endoscopic irreversible electroporation ablation device: Animal experimental study." Journal of Clinical Oncology 36, no. 4_suppl (February 1, 2018): 188. http://dx.doi.org/10.1200/jco.2018.36.4_suppl.188.
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188 Background: Irreversible electroporation (IRE) is a promising novel technique for the ablation of tumors. An advantage of IRE is its mechanism to remove undesired cells by affecting the cell membrane without thermally destructing blood vessels, nerves and the surrounding tissues. Several clinical trials for applying IRE to human organs such as liver, pancreas, and kidney are conducted and studies about IRE ablation for gastrointestinal tumors also have been conducted recently. Here, we developed new endoscopic IRE device, and studied about its effectiveness and feasibility in animal model. Methods: Newly developed endoscopic IRE ablative catheter works with single channel of endoscope. A pair of dipolar electrodes consist of pre-shaped f 0.63mm nitinol wire and the distance between each electrode is 10 mm. The electrodes are loaded within braided tube for stent delivery system then deployed when IRE catheter put in stomach through the endoscope. We performed endoscopy and IRE ablation was done on pig’s stomach mucosa by using endoscopy with newly developed IRE catheter. We divided pig’s stomach into 2 parts(antrum & body), and IRE ablation was applied on each part of the stomach. Pigs were sacrificed after 24hours, and we collected their stomachs with surgical technique. Following fixation, tissues were stained with H&E. Results: Ten male Yorkshire pigs and in vitro stomachs were used in this study. The tissue with H&E stain showed diffuse cell death 24hr after IRE ablation. Consistent with the mechanism of action of IRE on the cell membrane only, there was complete cell death within the IRE lesions without intervening live cells. But there was no difference in histology depending on gastric part in which ablation was applied. During the study, no complication was observed in pigs in 24 hours after ablation. Conclusions: The new endoscopic IRE device, which can perform IRE ablation on gastrointestinal tract using endoscopy showed safe and feasible result.
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van den Bos, W., D. M. de Bruin, B. G. Muller, I. M. Varkarakis, A. A. Karagiannis, P. J. Zondervan, M. P. Laguna Pes, et al. "The safety and efficacy of irreversible electroporation for the ablation of prostate cancer: a multicentre prospective human in vivo pilot study protocol." BMJ Open 4, no. 10 (October 2014): e006382. http://dx.doi.org/10.1136/bmjopen-2014-006382.
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IntroductionCurrent surgical and ablative treatment options for prostate cancer have a relatively high incidence of side effects, which may diminish the quality of life. The side effects are a consequence of procedure-related damage of the blood vessels, bowel, urethra or neurovascular bundle. Ablation with irreversible electroporation (IRE) has shown to be effective in destroying tumour cells and harbours the advantage of sparing surrounding tissue and vital structures. The aim of the study is to evaluate the safety and efficacy and to acquire data on patient experience of minimally invasive, transperineally image-guided IRE for the focal ablation of prostate cancer.Methods and analysisIn this multicentre pilot study, 16 patients with prostate cancer who are scheduled for a radical prostatectomy will undergo an IRE procedure, approximately 30 days prior to the radical prostatectomy. Data as adverse events, side effects, functional outcomes, pain and quality of life will be collected and patients will be controlled at 1 and 2 weeks post-IRE, 1 day preprostatectomy and postprostatectomy. Prior to the IRE procedure and the radical prostatectomy, all patients will undergo a multiparametric MRI and contrast-enhanced ultrasound of the prostate. The efficacy of ablation will be determined by whole mount histopathological examination, which will be correlated with the imaging of the ablation zone.Ethics and disseminationThe protocol is approved by the ethics committee at the coordinating centre (Academic Medical Center (AMC) Amsterdam) and by the local Institutional Review Board at the participating centres. Data will be presented at international conferences and published in peer-reviewed journals.ConclusionsThis pilot study will determine the safety and efficacy of IRE in the prostate. It will show the radiological and histopathological effects of IRE ablations and it will provide data to construct an accurate treatment planning tool for IRE in prostate tissue.Trial registration numberClinicaltrials.gov database: NCT01790451.
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Zhou, Weiguo, Keyu Gong, Jie Wan, Lulu Quan, Yuchuan Chu, and Yong Cao. "Molecular dynamics simulation study on ablation of silicon by water-jet-guided laser." Proceedings of the Institution of Mechanical Engineers, Part E: Journal of Process Mechanical Engineering 231, no. 6 (August 8, 2016): 1217–25. http://dx.doi.org/10.1177/0954408916662088.
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Stillinger–Weber potential and Z-layer energy model were adopted in molecular dynamics simulation to study the ablation of silicon by water-jet-guided femtosecond laser, and comparison was made by ablating silicon with or without water-jet cooling in our simulations. Simulation results indicated that with water-jet cooling, the thermal-affected zone could be reduced in area, and the peak of density could disappear more quickly. It was therefore concluded that water-jet-guided laser could be used to considerably improve the ablation quality of silicon.
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Vogel, Jantien A., Eran van Veldhuisen, Lindy K. Alles, Olivier R. Busch, Frederike Dijk, Thomas M. van Gulik, Goos M. Huijzer, Marc G. Besselink, Krijn P. van Lienden, and Joanne Verheij. "Time-Dependent Impact of Irreversible Electroporation on Pathology and Ablation Size in the Porcine Liver: A 24-Hour Experimental Study." Technology in Cancer Research & Treatment 18 (January 1, 2019): 153303381987689. http://dx.doi.org/10.1177/1533033819876899.
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Irreversible electroporation causes cell death through low frequency, high voltage electrical pulses and is increasingly used to treat non-resectable cancers. A recent systematic review revealed that tissue damage through irreversible electroporation is time-dependent, but the impact of time on the ablation zone size remains unknown. Irreversible electroporation ablations were performed hourly during 24 consecutive hours in the peripheral liver of 2 anaesthetized domestic pigs using clinical treatment settings. Immediately after the 24th ablation, the livers were harvested and examined for tissue response in time based on macroscopic and microscopic pathology. The impact of time on these outcomes was assessed with Spearman rank correlation test. Ablation zones were sharply demarcated as early as 1 hour after treatment. During 24 hours, the ablation zones showed a significant increase in diameter (rs = 0.493, P = .014) and total surface (rs = 0.499, P = .013), whereas the impact of time on the homogeneous ablated area was not significant (rs = 0.172, P = .421). Therefore, the increase in size could mainly be attributed to an increase in the transition zone. Microscopically, the ablation zones showed progression in cell death and inflammation. This study assessed the dynamics of irreversible electroporation on the porcine liver during 24 consecutive hours and found that the pathological response (ie, cell death/inflammation), and ablation size continue to develop for at least 24 hours. Consequently, future studies on irreversible electroporation should prolong their observation period.
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Xiao, Jie, Lin Jiang, and Qiang Xu. "Insight into chemical reaction kinetics effects on thermal ablation of charring material." Thermal Science, no. 00 (2021): 85. http://dx.doi.org/10.2298/tsci201010085x.
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Thermal ablation plays an important role in the aerospace field. In this paper, to study the chemical kinetics effects on heat transfer and surface ablation of the charring ablative material during aerodynamic heating, a charring ablation model was established using the finite element method. AVCOAT5026-39H/CG material, one typical thermal protection material used in thermal protection system, was employed as the ablative material and heated by aerodynamic heating condition experienced by Apollo 4. The finite element model considers the decomposition of the resin within the charring material and the removal of the surface material, and uses Darcy?s law to simulate the fluid flow in the porous char. Results showed that the model can be used for the ablation analysis of charring materials. Then effects of chemical kinetics on ablation were discussed in terms of four aspects, including temperature, surface recession, density distribution, and mass flux of pyrolysis gas. The pre-exponential factor and activation energy have different effects on ablation, while the effect of the reaction order is little. This paper is helpful to understand the heating and ablation process of charring ablative materials and to provide technical references for the selection and design of thermal protection materials.
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Raut, Roshan, Prashanta Bajracharya, Man Bahadur KC, Murari Dhungana, Mukunda Sharma, Surakshya Joshi, Prashanta Bajracharya, Kunjang Sherpa, Mandita Chamlagain, and Sujeeb Rajbhandari. "Efficacy and Safety of Focal Atrial Tachycardia and Typical Atrial Flutter Ablation in Nepal-A Single Center Experience." Nepalese Heart Journal 18, no. 1 (April 30, 2021): 25–28. http://dx.doi.org/10.3126/njh.v18i1.36776.
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Background and Aims: Atrial tachycardia is classified as focal atrial tachycardia or macro-reentrant atrial tachycardia. Macro-reentrant atrial tachycardia involves large circuit and is also called atrial flutter in which cavotricuspid isthmus dependent flutter, also called typical atrial flutter is the most common. The aim of this study is to report the efficacy and safety of catheter ablations of these arrhythmias, for the first time in Nepal.
Methods: This is a retrospective observational study of the patients who underwent electrophysiological study with ablation for focal atrial tachycardia and typical atrial flutters at Shahid Gangalal National Heart Center (SGNHC) from March, 2015 to February 2020.
Results: Altogether, 49 patients, 27 for focal atrial tachycardia and 22 for typical atrial flutter, underwent electrophysiology study with intent to ablation. In two patients, atrial tachycardia could not be induced, therefore 25 patients underwent ablation for atrial tachycardia. Out of 25 patients, the successful ablation achieved in 24 patients (96%) with recurrence in three patients (12%), with no major complications. Atrial tachycardia more commonly originated from right atrium than the left atrium (68% vs. 32%). Among 22 patients who underwent cavotricuspid isthmus ablation for typical atrial flutter; successful ablation achieved in 21 patients (95%) with recurrence in two patients (9%) and a single case of access site hematoma. Counterclockwise flutter was found to be more common than clockwise flutter (91% vs. 9%).
Conclusion: In SGNHC, the ablations of focal atrial tachycardia and the typical atrial flutter has a high success and low complication rate.
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Sebek, Jan, Steve Kramer, Rob Rocha, Kun-Chang Yu, Radoslav Bortel, Warren L. Beard, David S. Biller, et al. "Bronchoscopically delivered microwave ablation in an in vivo porcine lung model." ERJ Open Research 6, no. 4 (October 2020): 00146–2020. http://dx.doi.org/10.1183/23120541.00146-2020.
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BackgroundPercutaneous microwave ablation is clinically used for inoperable lung tumour treatment. Delivery of microwave ablation applicators to tumour sites within lung parenchyma under virtual bronchoscopy guidance may enable ablation with reduced risk of pneumothorax, providing a minimally invasive treatment of early-stage tumours, which are increasingly detected with computed tomography (CT) screening. The objective of this study was to integrate a custom microwave ablation platform, incorporating a flexible applicator, with a clinically established virtual bronchoscopy guidance system, and to assess technical feasibility for safely creating localised thermal ablations in porcine lungs in vivo.MethodsPre-ablation CTs of normal pigs were acquired to create a virtual model of the lungs, including airways and significant blood vessels. Virtual bronchoscopy-guided microwave ablation procedures were performed with 24–32 W power (at the applicator distal tip) delivered for 5–10 mins. A total of eight ablations were performed in three pigs. Post-treatment CT images were acquired to assess the extent of damage and ablation zones were further evaluated with viability stains and histopathologic analysis.ResultsThe flexible microwave applicators were delivered to ablation sites within lung parenchyma 5–24 mm from the airway wall via a tunnel created under virtual bronchoscopy guidance. No pneumothorax or significant airway bleeding was observed. The ablation short axis observed on gross pathology ranged 16.5–23.5 mm and 14–26 mm on CT imaging.ConclusionWe have demonstrated the technical feasibility for safely delivering microwave ablation in the lung parenchyma under virtual bronchoscopic guidance in an in vivo porcine lung model.
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Sardu, Celestino, Gaetano Santulli, Germano Guerra, Maria Consiglia Trotta, Matteo Santamaria, Cosimo Sacra, Nicola Testa, et al. "Modulation of SERCA in Patients with Persistent Atrial Fibrillation Treated by Epicardial Thoracoscopic Ablation: The CAMAF Study." Journal of Clinical Medicine 9, no. 2 (February 17, 2020): 544. http://dx.doi.org/10.3390/jcm9020544.
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Objectives: To evaluate atrial fibrillation (AF) recurrence and Sarcoplasmic Endoplasmic Reticulum Calcium ATPase (SERCA) levels in patients treated by epicardial thoracoscopic ablation for persistent AF. Background: Reduced levels of SERCA have been reported in the peripheral blood cells of patients with AF. We hypothesize that SERCA levels can predict the response to epicardial ablation. Methods: We designed a prospective, multicenter, observational study to recruit, from October 2014 to June 2016, patients with persistent AF receiving an epicardial thoracoscopic pulmonary vein isolation. Results: We enrolled 27 patients. Responders (n = 15) did not present AF recurrence after epicardial ablation at one-year follow-up; these patients displayed a marked remodeling of the left atrium, with a significant reduction of inflammatory cytokines, B type natriuretic peptide (BNP), and increased levels of SERCA compared to baseline and to nonresponders (p < 0.05). Furthermore, mean AF duration (Heart rate (HR) 1.235 (1.037–1.471), p < 0.05), Left atrium volume (LAV) (HR 1.755 (1.126–2.738), p < 0.05), BNP (HR 1.945 (1.895–1.999), p < 0.05), and SERCA (HR 1.763 (1.167–2.663), p < 0.05) were predictive of AF recurrence. Conclusions: Our data indicate for the first time that baseline values of SERCA in patients with persistent AF might be predictive of failure to epicardial ablative approach. Intriguingly, epicardial ablation was associated with increased levels of SERCA in responders. Therefore, SERCA might be an innovative therapeutic target to improve the response to epicardial ablative treatments.
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Wyss, Pius, Rosmarie Caduff, Yona Tadir, Andrea Degen, Georges Wagnières, Viola Schwarz, Urs Haller, and Mathias Fehr. "Photodynamic endometrial ablation: Morphological study." Lasers in Surgery and Medicine 32, no. 4 (April 2003): 305–9. http://dx.doi.org/10.1002/lsm.10163.
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Horisawa, Shiro, Atsushi Fukui, Taku Nonaka, Takakazu Kawamata, and Takaomi Taira. "Radiofrequency Ablation for Movement Disorders: Risk Factors for Intracerebral Hemorrhage, a Retrospective Analysis." Operative Neurosurgery 21, no. 3 (June 7, 2021): 143–49. http://dx.doi.org/10.1093/ons/opab169.
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Abstract BACKGROUND One of the greatest concerns associated with radiofrequency ablation is intracerebral hemorrhage (ICH). However, the majority of previous studies have mainly evaluated Parkinson disease patients with ablation of the globus pallidus internus (GPi). OBJECTIVE To investigate the hemorrhagic risk associated with radiofrequency ablation using ventro-oral (Vo) nucleus, ventral intermediate (Vim) nucleus, GPi, and pallidothalamic tract. METHODS Radiofrequency ablations for movement disorders from 2012 to 2019 at our institution were retrospectively analyzed. Multivariate analyses were performed to evaluate associations between potential risk factors and ICH. RESULTS A total of 558 patients underwent 721 stereotactic radiofrequency ablations for movement disorders. Among 558 patients, 356 had dystonia, 111 had essential tremor, and 51 had Parkinson disease. Among 721 procedures, the stereotactic targets used in this study were as follows: Vo: 230; Vim: 199; GPi: 172; pallidothalamic tract: 102; Vim/Vo: 18. ICH occurred in 37 patients (5.1%, 33 with dystonia and 4 with essential tremor). Symptomatic ICH developed in 3 Vo nuclei (1.3%), 3 Vim nuclei (1.5%), and 2 GPi (1.2%). Hypertension (odds ratio = 2.69, P = .0013), higher number of lesions (odds ratio = 1.23, P = .0221), and younger age (odds ratio = 1.04, P = .0055) were significant risk factors for ICH associated with radiofrequency ablation. CONCLUSION The present study revealed that younger age, higher number of lesions, and history of hypertension were independent risk factors for ICH associated with stereotactic radiofrequency ablation.
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Oster, Matthew E., Zhou Yang, Kay Stewart-Huey, Michelle Glanville, Arlene Porter, Robert Campbell, Brad Webb, and Margaret Strieper. "Radiofrequency ablation versus cryoablation for atrioventricular nodal re-entrant tachycardia in children: a value comparison." Cardiology in the Young 27, no. 2 (April 18, 2016): 224–28. http://dx.doi.org/10.1017/s1047951116000299.
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AbstractBackgroundIt is unclear whether cryoablation or radiofrequency ablation offers better value for treating atrioventricular nodal re-entrant tachycardia in children. We aimed to compare the value of these procedures for treating atrioventricular nodal re-entrant tachycardia in children, with value being outcomes relative to costs.MethodsWe performed a retrospective cohort study of all atrioventricular nodal re-entrant tachycardia ablations for children (age⩽18 years) from July, 2009 to June, 2011 at our institution. Costs included fixed costs, miscellaneous hospital costs, and labour costs, and key outcomes were acute and long-term success (6 months) of the ablations. We conducted T-tests and regression analyses to investigate the associations between the ablation procedure type and the cost and success of the ablations.ResultsOf 96 unique cases performed by three paediatric electrophysiologists, 48 were cryoablation only, 42 radiofrequency ablation only, and six were a combination. Acute success was 100% for the cryoablation only and radiofrequency ablation only cases and 83% for the combination cases. There were no notable adverse events. The average total cost was $9636 for cryoablation cases, $9708 for radiofrequency ablation cases, and $10,967 for combination cases (p=0.51 for cryoablation only versus radiofrequency ablation only). The long-term success rate was 79.1% for cryoablation only, 92.8% for radiofrequency ablation only, and 66.7% for the combination (p=0.01 for cryoablation only versus radiofrequency ablation only), but long-term success varied notably by provider.ConclusionsCryoablation and radiofrequency ablation offer similar value in the short term for the treatment of atrioventricular nodal re-entrant tachycardia in children. Differences in long-term success may vary substantially by physician, and thus may lead to differences in long-term value.
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Sparchez, Zeno, Tudor Mocan, Nadim All Hajjar, Adrian Bartos, Claudia Hagiu, Daniela Matei, Rares Craciun, Lavinia Patricia Mocan, Mihaela Sparchez, and Daniel Corneliu Leucuta. "Percutaneous ultrasound guided radiofrequency and microwave ablation in the treatment of hepatic metastases. A monocentric initial experience." Medical Ultrasonography 21, no. 3 (August 31, 2019): 217. http://dx.doi.org/10.11152/mu-1957.
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Aim: Percutaneous radiofrequency (RFA) and microwave ablation (MWA) are currently the best treatment options forpatients with liver metastases (LM) who cannot undergo a liver resection procedure. Presently, few studies have evaluated theefficacy of tumor ablation in beginner’s hands but none at all in hepatic metastasis. Our aim was to report the initial experiencewith ultrasound as a tool to guide tumor ablation in a low volume center with no experience in tumor ablation.Material and methods: We conducted a retrospective cohort study, on a series of 61 patients who had undergone percutaneous US-guided ablations for 82 LM between 2010 and 2015. Long term outcome predictors were assessed using univariate and multivariate analysis.Results: Complete ablation was achieved in 86.9% of cases (53/61). All MWA sessions (20/20) attained ablation margins >5mm, compared to 79% (49/62) for RFA sessions (p=0.031). Ablation time was significantly shorter for MWA, with a median duration of 10 minutes (range: 6-12) vs. 14 minutes (range: 10-19.5, p=0.003). There was no statistically significant difference in local tumor progression (LTP)-free survival rates between MWA and RFA (p=0.154). On univariate analysis, significant predictors for local recurrence were multiple metastases (p=0.013) and ablation margins <5 mm (p<.001), both retaining significance on multivariate analysis. Significant predictors for distant recurrence on both univariate and multivariate analysis were multiple metastases (p<0.001) and non-colorectal cancer metastases (p<0.05).Conclusion: A larger than 5 mm ablation size is critical for local tumor control. We favor the use of MWA due to its ability to achieve ablation in significantlyshorter times with less incomplete ablations.
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Jermakowicz, Walter J., Samir Sur, Iahn Cajigas, Pierre D’Haese, and Jonathan R. Jagid. "215 Laser Thermal Ablation for Mesiotemporal Epilepsy: Relation of Ablation Cavities to Seizure and Neurocognitive Outcomes." Neurosurgery 64, CN_suppl_1 (August 24, 2017): 258. http://dx.doi.org/10.1093/neuros/nyx417.215.
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Abstract INTRODUCTION Laser interstitial thermal therapy (LiTT) has dramatically changed the management of mesiotemporal epilepsy (mTLE) in recent years. The goal of this study was to identify features of ablations and trajectories that correlate with optimal seizure control and minimize the risk of neurocognitive deficits in patients undergoing LiTT for mTLE. METHODS Clinical and radiographic data were reviewed from a prospectively maintained database of patients undergoing LiTT for epilepsy at the University of Miami. Standard preoperative and postoperative evaluations, including contrast-enhanced MRI and neurocognitive testing, were performed in all patients. Laser trajectory and ablation volumes were computed both by manual tracing of mesiotemporal structures and by nonrigid registration of ablation cavities to a common reference system based on 7T MRI data. RESULTS >Of the 28 patients with at least 1-year follow-up, sparing of the mesial hippocampal head was significantly correlated with persistent disabling seizures (P = 0.01). Projecting all ablation cavities onto a common reference frame showed a clear tendency towards lateral placement of the laser with inadequate mesial hippocampal head ablation in these patients compared to those free of seizures. Patients that suffered deficits in memory, on the other hand, tended to have larger ablations with greater insult to entorrhinal and perirhinal cortex than those free of memory deficits. CONCLUSION Better understanding of the impact of ablation volume and location through the use of image normalization tools could potentially fine-tune this novel technique to improve seizure-freedom rates and associated neurocognitive deficits.
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Bartoș, Adrian, Dana Bartos, Zeno Spârchez, Ioana Iancu, Lidia Ciobanu, Cornel Iancu, and Caius Breazu. "Laparoscopic Contrast-Enhanced Ultrasonography for Real Time Monitoring of Laparoscopic Radiofrequency Ablation for Hepatocellular Carcinoma: an Observational Pilot Study." Journal of Gastrointestinal and Liver Diseases 28, no. 4 (December 9, 2019): 457–62. http://dx.doi.org/10.15403/jgld-263.
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Background and Aims: Laparoscopic radio-frequency ablation (L-RFA) for hepatocellular carcinoma (HCC) is used for unresectable tumors, with difficult location, unfitted for a percutaneous ablation technique. L-RFA has a high incidence of local recurrence. Even if intraoperative-ultrasound is standardized for staging and RFA probe guidance, the role of laparoscopic contrast-enhanced ultrasound (L-CEUS) for the real time monitoring of L-RFA efficacy has not been previously reported. We evaluated in a pilot observational study the efficacy of L-CEUS to assess the necrotic post-ablative area in difficult to treat HCC.
Methods: Eight consecutive patients diagnosed with HCC (peripherally located) on liver cirrhosis were referred for L-RFA between May 2016 and December 2018. For L-RFA a SturBurst XL (AngioDinamics®) internally cooled electrode was used, being placed under ultrasound guidance. L-CEUS was used to assess the necrotic post-ablative area. The median follow up period was 18 months.
Results: L-CEUS real time monitoring of the L-RFA efficacy indicated residual neoplastic tissue in 4 cases (50%). The procedure was repeated by reinserting the needle in the suspected areas indicated by L-CEUS. Complete tumor ablation was achieved in all treated patients. After a median follow-up of 18 months no recurrence of HCC was observed in 7 patients (87.5%).
Conclusions: L-CEUS was a reliable procedure for the immediate assessment of L-RFA efficacy; half of the ablated HCC nodules required a second ablation session. This approach might decrease the local recurrences, but its role must be further investigated in larger cohorts.
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Bradley, Elisa A., Ali N. Zaidi, Justin Morrison, Curt J. Daniels, Steven Kalbfleisch, and Naomi J. Kertesz. "Effectiveness of Early Invasive Therapy for Atrial Tachycardia in Adult Atrial-Baffle Survivors." Texas Heart Institute Journal 44, no. 1 (February 1, 2017): 16–21. http://dx.doi.org/10.14503/thij-15-5470.
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Adults who underwent complex atrial baffling as children via Mustard or Senning procedures are at heightened risk for atrial arrhythmias. Antiarrhythmic therapies are typically ineffective in this population. Accordingly, our team of pediatric and adult electrophysiologists investigated the effectiveness of early invasive transbaffle-access techniques to perform early radiofrequency ablation at the source of these clinically significant arrhythmias. For this retrospective study, we selected 11 adult survivors of atrial baffling (mean age, 34 ± 9 yr) who underwent clinically indicated electrophysiologic study after no more than one trial of antiarrhythmic therapy. Using transbaffle-access techniques and 3-dimensional mapping of the venous atria, we found 12 inducible arrhythmias in 10 patients: intra-atrial reentrant tachycardia (n=6), atrioventricular nodal reentrant tachycardia (n=3), focal atrial tachycardia (n=2), and repetitive double firing of the atrioventricular node (n=1). Defining success as short- and midterm freedom from arrhythmia, we analyzed outcomes of radiofrequency ablation at 1 and 6 months. At 1 month, ablation was 100% successful. At 6 months, after 11 ablations in 9 patients, 5 patients had no clinical recurrence, 2 had improved arrhythmia control from minimal medical therapy, and 2 were to undergo repeat study for recurrent tachycardia. In the recurrence-free patients, arrhythmias during electrophysiology study matched the types found clinically before the study. To our knowledge, this is the largest one-year cohort of adult survivors of atrial baffling to have undergone study by a combined pediatric–adult electrophysiology team. We conclude that early invasive transbaffle access for ablating diverse atrial tachyarrhythmias was effective in these patients.
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Zhang, J., H. W. Zhong, Z. A. Ye, J. Shen, G. Y. Liang, X. J. Cui, X. Yu, et al. "Study on ablation products of zinc by intense pulsed ion beam irradiation." Laser and Particle Beams 35, no. 1 (January 16, 2017): 108–13. http://dx.doi.org/10.1017/s0263034616000938.
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AbstractAs a kind of flash heat source, intense pulsed ion beam (IPIB) can be used for material surface modification. The ablation effect has important influence on interaction between IPIB and material. Therefore, the understanding of ablation mechanism is of great significance to IPIB application. In this work, pure zinc targets were irradiated and ablated by IPIB. In the ablation process under the different ion beam energy densities, the ablation products were collected by a monocrystalline silicon substrate. By analyzing the ablation products with scanning electron microscope and energy-dispersive spectrometer, the surface morphology, and the spatial distribution of ablation products quantity were obtained. The results are useful for clearing the ablation process and the influence of beam parameter on the ablation effect.
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Hagmeyer, Lars. "Bronchoskopische Thermoablation beim Lungenkarzinom: Ermutigende Daten eines experimentellen Verfahrens." Kompass Pneumologie 9, no. 4 (2021): 189–91. http://dx.doi.org/10.1159/000517810.
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<b>Background:</b> Bronchoscopic thermal vapour ablation (BTVA) is an established and approved modality for minimally invasive lung volume reduction in severe emphysema. Preclinical data suggest potential for BTVA in minimally invasive ablation of lung cancer lesions. <b>Objectives:</b> The objective of this study is to establish the safety, feasibility, and ablative efficacy of BTVA for minimally invasive ablation of lung cancers. <b>Methods:</b> Single arm treat-and-resect clinical feasibility study of patients with biopsy-confirmed lung cancer. A novel BTVA for lung cancer (BTVA-C) system for minimally invasive treatment of peripheral pulmonary tumours was used to deliver 330 Cal thermal vapour energy via bronchoscopy to target lesion. Patients underwent planned lobectomy to complete oncologic care. Pre-surgical CT chest and post-resection histologic analysis were performed to evaluate ablative efficacy. <b>Results:</b> Six patients underwent BTVA-C, and 5 progressed to planned lobectomy. Median procedure duration was 12 min. No major procedure-related complications occurred. All 5 resected lesions were part-solid lung adenocarcinomas with median solid component size 1.32 ± 0.36 cm. Large uniform ablation zones were seen in 4 patients where thermal dose exceeded 3 Cal/mL, with complete/near-complete necrosis of target lesions seen in 2 patients. Tumour positioned within ablation zones demonstrated necrosis in >99% of cross-sectional area examined. <b>Conclusion:</b> BTVA of lung tumours is feasible and well tolerated, with preliminary evidence suggesting high potential for effective ablation of tumours. Thermal injury is well demarcated, and uniform tissue necrosis is observed within ablation zones receiving sufficient thermal dose per volume of lung. Treatment of smaller volumes and ensuring adequate thermal dose may be important for ablative efficacy.
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Neira, Luz Maria, R. Owen Mays, James F. Sawicki, Amanda Schulman, Josephine Harter, Lee G. Wilke, Nader Behdad, Barry D. Van Veen, and Susan C. Hagness. "A Pilot Study of the Impact of Microwave Ablation on the Dielectric Properties of Breast Tissue." Sensors 20, no. 19 (October 6, 2020): 5698. http://dx.doi.org/10.3390/s20195698.
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Percutaneous microwave ablation (MWA) is a promising technology for patients with breast cancer, as it may help treat individuals who have less aggressive cancers or do not respond to targeted therapies in the neoadjuvant or pre-surgical setting. In this study, we investigate changes to the microwave dielectric properties of breast tissue that are induced by MWA. While similar changes have been characterized for relatively homogeneous tissues, such as liver, those prior results are not directly translatable to breast tissue because of the extreme tissue heterogeneity present in the breast. This study was motivated, in part by the expectation that the changes in the dielectric properties of the microwave antenna’s operation environment will be impacted by tissue composition of the ablation target, which includes not only the tumor, but also its margins. Accordingly, this target comprises a heterogeneous mix of malignant, healthy glandular, and adipose tissue. Therefore, knowledge of MWA impact on breast dielectric properties is essential for the successful development of MWA systems for breast cancer. We performed ablations in 14 human ex-vivo prophylactic mastectomy specimens from surgeries that were conducted at the UW Hospital and monitored the temperature in the vicinity of the MWA antenna during ablation. After ablation we measured the dielectric properties of the tissue and analyzed the tissue samples to determine both the tissue composition and the extent of damage due to the ablation. We observed that MWA induced cell damage across all tissue compositions, and found that the microwave frequency-dependent relative permittivity and conductivity of damaged tissue are lower than those of healthy tissue, especially for tissue with high fibroglandular content. The results provide information for future developments on breast MWA systems.
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Sequeiros, Roberto Blanco, Juho Kariniemi, Risto Ojala, Li Chengli, Marianne Haapea, Andreas Blanco Sequeiros, and Osmo Tervonen. "Liver tumor laser ablation – increase in the subacute ablation lesion volume detected with post procedural MRI." Acta Radiologica 51, no. 5 (June 2010): 505–11. http://dx.doi.org/10.3109/02841851003694783.
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Background: The use of image-guided thermoablative methods in liver tumor treatment has expanded rapidly due to encouraging results and advanced imaging. However, little is known about the treatment-induced tissue response and effects on imaging findings during the subacute post procedural period. Purpose: To study the development of subacute ablation zone volume with magnetic resonance imaging (MRI) after laser-mediated liver tumor thermal therapy. Material and Methods: In all, 16 laser ablations were performed on 16 liver tumors resulting in 16 ablation zones in 11 consecutive patients. A low-field 0.23 T C-arm MRI scanner was used for imaging and procedural guidance. Repeated dynamic contrast-enhanced T1, contrast-enhanced T1 FSE, and T2 FSE studies of liver were performed at 0 and 72 h after the procedure. Ablation zone volumes were registered from the acquired image data. Results: MRI scans showed a significant increase of ablation volume in all imaging sequences obtained at 72 h after the initial therapy. Conclusion: After laser ablation, there is a progressive perfusion decrease in the ablation site leading to an increase in the ablation volume. Post procedural baseline MRI at 72 h from the treatment provides more precise information about the ablation result than can be obtained with immediate post procedural MRI.
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Shaheen, Mohamed E., and Brian J. Fryer. "Femtosecond laser ablation of brass: A study of surface morphology and ablation rate." Laser and Particle Beams 30, no. 3 (July 10, 2012): 473–79. http://dx.doi.org/10.1017/s0263034612000407.
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AbstractThe interaction of near infrared femtosecond laser pulses with a Cu based alloy (brass) in ambient air at atmospheric pressure and under different laser conditions was investigated. The effects of laser fluence and number of pulses on surface morphology and ablation rate were studied using scanning electron microscopy (SEM) and optical microscopy. Ablation rates were found to rapidly increase from 83 to 604 nm/pulse in the fluence range 1.14–12.21 J/cm2. At fluence >12.21 J/cm2, ablation rates increased slowly to a maximum (607 nm/pulse at 19.14 J/cm2), and then decreased at fluence higher than 20.47 J/cm2 to 564 nm/pulse at 24.89 J/cm2. Large amounts of ablated material in a form of agglomerated fine particles were observed around the ablation craters as the number of laser pulses and fluence increased. The study of surface morphology shows reduced thermal effects with femtosecond laser ablation in comparison to nanosecond laser ablation at low fluence.
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Schaible, Jan, Benedikt Pregler, Niklas Verloh, Ingo Einspieler, Wolf Bäumler, Florian Zeman, Andreas Schreyer, Christian Stroszczynski, and Lukas Beyer. "Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system." Radiology and Oncology 54, no. 3 (May 28, 2020): 295–300. http://dx.doi.org/10.2478/raon-2020-0033.
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AbstractBackgroundThe aim of the study was to assess the primary efficacy of robot-assisted microwave ablation and compare it to manually guided microwave ablation for percutaneous ablation of liver malignancies.Patients and methodsWe performed a retrospective single center evaluation of microwave ablations of 368 liver tumors in 192 patients (36 female, 156 male, mean age 63 years). One hundred and nineteen ablations were performed between 08/2011 and 03/2014 with manual guidance, whereas 249 ablations were performed between 04/2014 and 11/2018 using robotic guidance. A 6-week follow-up (ultrasound, computed tomography and magnetic resonance imaging) was performed on all patients.ResultsThe primary technique efficacy outcome of the group treated by robotic guidance was significantly higher than that of the manually guided group (88% vs. 76%; p = 0.013). Multiple logistic regression analysis indicated that a small tumor size (≤ 3 cm) and robotic guidance were significant favorable prognostic factors for complete ablation.ConclusionsIn addition to a small tumor size, robotic navigation was a major positive prognostic factor for primary technique efficacy.
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Voeller, Rochus K., Andreas Zierer, Richard B. Schuessler, and Ralph J. Damiano. "Performance of a Novel Dual-Electrode Bipolar Radiofrequency Ablation Device a Chronic Porcine Study." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 6, no. 1 (January 2011): 17–22. http://dx.doi.org/10.1097/imi.0b013e31820bc57f.
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Objective Over recent years, a variety of energy sources, including bipolar radiofrequency, have been used to replace the traditional incisions of the Cox-Maze procedure for the surgical treatment of atrial fibrillation (AF). The purpose of this study was to evaluate the safety and efficacy of a novel dual-electrode bipolar radiofrequency ablation device Synergy (Atricure, Inc., Cincinnati, OH USA) for AF in a chronic porcine model. Methods Six domestic pigs underwent a modified Cox-Maze IV procedure without cardiopulmonary bypass using the Synergy device. Animals survived for 30 days. Each pig then underwent induction of AF and was killed to remove the heart en bloc for histologic assessment. Each ablation line was dissected perpendicularly at 5-mm intervals to assess the lesion width, depth, and transmurality. Results All animals survived the operation. Electrical isolation of the left atrial appendage and the pulmonary veins were documented by pacing acutely and at 30 days after the operation in all six animals. All animals failed to be induced in AF at 30 days. There was no gross evidence of intra-atrial thrombus formation or stricture of the pulmonary veins. All ablations (n = 209) examined were discrete, linear, and transmural, with a mean lesion width of 3.0 ± 0.7 mm and a mean lesion depth of 5.4 ± 3.3 mm. The mean ablation time was 16.3 ± 4.4 seconds, with a mean total energy delivery of 238 ± 170 J. Conclusions The Atricure Synergy was able to create reliable chronic transmural lesions of the modified Cox-Maze IV procedure on a porcine beating heart without cardiopulmonary bypass. The ablation lines were significantly wider when compared with its predecessor, the Isolator II.
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Kim, Daehoon, Pil-Sung Yang, Jung-Hoon Sung, Eunsun Jang, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, et al. "Less dementia after catheter ablation for atrial fibrillation: a nationwide cohort study." European Heart Journal 41, no. 47 (October 6, 2020): 4483–93. http://dx.doi.org/10.1093/eurheartj/ehaa726.
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Abstract Aims Accumulating evidence shows that atrial fibrillation (AF) is associated with an increased risk of dementia. Catheter ablation for AF prolongs the duration of sinus rhythm, thereby improving the quality of life. We investigated the association of catheter ablation for AF with the occurrence of dementia. Methods and results Using the Korean National Health Insurance Service database, among 194 928 adults with AF treated with ablation or medical therapy (antiarrhythmic or rate control drugs) between 1 January 2005 and 31 December 2015, we studied 9119 patients undergoing ablation and 17 978 patients managed with medical therapy. The time-at-risk was counted from the first medical therapy, and ablation was analysed as a time-varying exposure. Propensity score-matching was used to correct for differences between the groups. During a median follow-up of 52 months, compared with patients with medical therapy, ablated patients showed lower incidence and risk of overall dementia (8.1 and 5.6 per 1000 person-years, respectively; hazard ratio 0.73, 95% confidence interval 0.58–0.93). The associations between ablation and dementia risk were consistently observed after additionally censoring for incident stroke (hazard ratio 0.76, 95% confidence interval 0.61–0.95) and more pronounced in cases of ablation success whereas no significant differences observed in cases of ablation failure. Ablation was associated with lower risks of dementia subtypes including Alzheimer’s disease and vascular dementia. Conclusion In this nationwide cohort of AF patients treated with catheter ablation or medical therapy, ablation was associated with decreased dementia risk. This relationship was evident after censoring for stroke and adjusting for clinical confounders.
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Wetzel, Rebecca, M. Cecilia Monge B., Changqing Xie, Donna Mabry-Hrones, Santhana Webb, Elizabeth Akoth, Bernadette Redd, Elliot B. Levy, Bradford Wood, and Tim F. Greten. "A pilot study of the combination of checkpoint inhibition with ablation in subjects with biliary tract cancer." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e16150-e16150. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e16150.
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e16150 Background: Immune checkpoint inhibition has demonstrated modest activity in biliary tract carcinoma (BTC). Augmentation of the immune response by ablative procedures to improve efficacy of immune checkpoint inhibition has been previously demonstrated in hepatocellular carcinoma, however the outcome of the combination of immune checkpoint inhibition with tremelimumab (anti-CTLA4) and durvalumab (anti-PD1) with ablation in advanced biliary tract carcinoma is unclear. The primary objective of this study was to establish the efficacy via 6-month progression-free survival (PFS) of combining tremelimumab and durvalumab in patients with advanced BTC either alone or with tumor ablation. Secondary objectives were safety and feasibility of combination treatment. An exploratory objective was overall survival (OS). Methods: Eligible patients had histologically confirmed advanced or unresectable BTC (intra- or extrahepatic cholangiocarcinoma, gallbladder cancer, or ampullary cancer) who had progressed on, been intolerant to, or refused prior chemotherapy. Disease had to be technically amenable to cryoablation with at least two measurable lesions. Adequate organ function and an ECOG of 0 or 1 were required. Patients were treated with tremelimumab and durvalumab with or without tumor ablation. Tremelimumab and durvalumab were administered intravenously every 28 days for four cycles followed by durvalumab every 28 days until disease progression. Cryoablation was performed on day 36. Patients were imaged every 8 weeks and response was defined per RECIST v 1.1 criteria. Results: In total, 22 patients have been enrolled into the BTC cohort. Half underwent ablation and half received immunotherapy alone. The median age was 59 years (range 21-80). All patients had received prior systemic chemotherapy, locally advanced disease was present in 68% of patients. Median PFS was 2.1m and median OS was 5.6 m. DCR was 45% (SD). Median OS and PFS was similar in the group that received ablation vs immunotherapy alone with a median OS of 6.8 m vs 6.7 m and 2.0 m vs 2.7 m respectively. The most common grade 3- 4 adverse events were lymphopenia (27%), increased AST (41%), increased alkaline phosphatase (32%) and elevated bilirubin (27%). Conclusions: Combination checkpoint inhibition combined with tumor ablative procedures is a safe and effective treatment strategy for patients with advanced BTC, however the addition of ablative therapy may not enhance efficacy in this small cohort of patients. Results illustrate the poor prognosis of advanced BTC and may represent a non-chemotherapeutic approach to treatment in this patient population. Further studies are warranted to identify patient populations most likely to respond to these interventions. Clinical trial information: NCT02821754.
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Sufian, S., S. Lakhanpal, and J. Marquez. "Superficial vein ablation for the treatment of primary chronic venous ulcers." Phlebology: The Journal of Venous Disease 26, no. 7 (June 24, 2011): 301–6. http://dx.doi.org/10.1258/phleb.2010.010058.
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Objective This retrospective study was undertaken to review our experience with ablation of superficial veins with significant reflux, using VNUS ClosureFAST RF (radiofrequency) or laser 980 nm, in patients with primary chronic venous ulcers, and also determine its effects in ulcer healing and ulcer recurrence. Method Included were 25 limbs (18 patients with chronic primary venous ulcers (clinical, aetiological, anatomical and pathological elements [CEAP] classification C6), who underwent endovenous ablation with RF for the axial veins or laser for the perforating veins during a two-year period. Results Of the 18 patients, there were eight men and 10 women. The median age of the group was 68 (range 37–89) years. The number of ablations done in each leg with an ulcer varied from one to eight, with a median of three. During a follow-up period of 6–12 months, one patient failed ulcer healing despite sequential ablations of refluxing veins. There was one case that developed recurrence of a small ulcer after six months and was successfully treated with a perforator ablation. Conclusion Endovenous ablation of incompetent superficial veins improves the healing of chronic primary venous ulcers and decreases the recurrence rates.
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Pérez Casero, R., F. Kerhervé, J. P. Enard, J. Perrière, and P. Regnier. "Study of laser ablation of BiSrCaCuO." Applied Surface Science 54 (January 1992): 147–53. http://dx.doi.org/10.1016/0169-4332(92)90035-v.
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HIRANUMA, Kouichiro, and Takayoshi INOUE. "914 MD Study of Laser Ablation." Proceedings of the JSME annual meeting 2005.7 (2005): 65–66. http://dx.doi.org/10.1299/jsmemecjo.2005.7.0_65.
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Liu, Lina, Fang Huang, Bin Liu, and Rui Huang. "Detection of distant metastasis at the time of ablation in children with differentiated thyroid cancer: the value of pre-ablation stimulated thyroglobulin." Journal of Pediatric Endocrinology and Metabolism 31, no. 7 (July 26, 2018): 751–56. http://dx.doi.org/10.1515/jpem-2018-0075.
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Abstract Background The present study was designed to determine the value of pre-ablation stimulated thyroglobulin (s-Tg) in predicting distant metastasis (DM) at the time of ablation in children with differentiated thyroid cancer. Methods From August 2009 to December 2016, consecutive children with differentiated thyroid cancer undergoing remnant ablation were retrospectively analyzed. Serum s-Tg was measured with the high-sensitive electrochemiluminescence immunoassay during hypothyroidism at ablation just before the ablative radioactive iodine (131I) administration. Post-ablation, whole body planar scintigraphy was obtained 5 days after administration of ablation activity of 131I. Single photon emission computed tomography/low-dose computed tomography (SPECT/CT) was added for children whose planar findings were inconclusive. Receiver-operating characteristics (ROC) curve analysis was employed to find a cut-off level of pre-ablation s-Tg as a predictor of DM at the time of ablation. Results Fifty-seven children were included for the analysis. Metastases were noticed on post-ablation scintigraphy in 20 (35%) children: five post-operative residual neck lymph node metastases, four post-operative residual neck lymph node and lung metastases, three mediastinal lymph node and lung metastases and eight lung metastases. A significant difference in pre-ablation s-Tg levels was found in children with DM compared with those without DM, 603.5 vs. 5.7 ng/mL, respectively. A pre-ablation s-Tg level of 156 ng/mL was established as the optimal cut-off point to predict DM. Conclusions This study demonstrated that pre-ablation s-Tg could potentially act as a predictor of DM at the time of ablation in children with differentiated thyroid cancer. We also propose a specific pre-ablation s-Tg cut-off value of 156 ng/mL as an optimal threshold for practical use.
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Ogake, Keita, Shinichi Ikuta, Tsukasa Aihara, Takayoshi Nakajima, Hidehiko Waki, and Naoki Yamanaka. "Experimental study on optimal endpoint for ablation using bipolar radiofrequency ablation system." Journal of Microwave Surgery 33, no. 1 (2015): 1–6. http://dx.doi.org/10.3380/jmicrowavesurg.33.1.
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Wei, Ying, Cheng-zhong Peng, Shu-rong Wang, Jun-feng He, Li-li Peng, Zhen-long Zhao, Xiao-jing Cao, Yan Li, Hui-hui Chai, and Ming-an Yu. "Microwave ablation versus radiofrequency ablation for primary hyperparathyroidism: a multicenter retrospective study." International Journal of Hyperthermia 38, no. 1 (January 1, 2021): 1023–30. http://dx.doi.org/10.1080/02656736.2021.1945689.
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