| ObjectiveThe aim of this study was to investigate the efficacy of bipolar radiofrequency ablation (RFA) with the cluster electrode to create large area of necrosis with new ablation technics to differentiate the area of necrosis with single triangular array with overlapping multi triangular array method.Materials and MethodsAS we have new upgrade RFA technology we used bipolar Current instead of unipolar as before unipolar RITA cool tip was good choice but now it becomes old, we used upgrade instrument in our experiment Olympus celon lab power 250W/60Ω,470KHZ Line 100-240V,50-60 HZ,380VA to perform with T4.0.3 (15.5G)bipolar cluster 15 cm electrode, [our first experiment performed with three electrodes which placed in a triangular array method to form a triangle to see the necrosis area placed at equidistance of 3cm] and [the second experiment model is placed equidistance of 4cm]. [the third experiment is placed equidistance of 5cm]. our [fourth experiment performed with overlapping triangle method X,Y= 6cm to see its efficacy of necrosis area A+b+C+D, where two points placed at 3 cm and one is 4cm in a triangle array pattern, in our [fifth experiment we perform X,Y= 8cm in this way we get four triangle then with our overlapping technique we perform ablation procedure with single triangle getting two side 4cm and one is 5.7cm then we get the total necrosis area A+B+C+D]. in our [Sixth procedure we create 6 ablation zones with our overlapping technique A+B+C+D+E+F than we combine them together to see its effect and the necrosis area of ablation zone was created by RF energy delivered together with the continues saline, power mode is set to be on 120 w for 3 electrodes T4.0.]ResultsThe multi triangle overlapping created a significantly larger ablation volume than compare with single triangle with the help of celon cluster electrodes T4.0x3. Experiment- 1 single triangle 3 cm equidistance we get the ablation area X= 5 cm, Y= 5 cm and Z=5 cm with total ablation volume= 65.41 cm3,Experiment- 2 single triangle 4 cm equidistance we get the ablation area X= 6 cm, Y= 6 cm and Z=6 cm with total ablation volume= 113.03 cm3 Experiment-3 single triangle 5 cm equidistance we get the ablation area X= 7 cm, Y= 5 cm and Z=4 cm with total ablation volume= 73.26 cm3 Multi triangle overlapping ablation method Experiment-4 Multi triangle overlapping technique where X and Y axis 6cm creating 4 triangle ablation area, we get area X= 7 cm, Y= 7 cm and Z=5 cm with total ablation volume= 128.21 cm3Experiment-5 Multi triangle overlapping technique where X and Y axis 8cm creating 4 triangle ablation area, we get area X= 8 cm, Y= 8 cm and Z=7 cm with total ablation volume= 234.45 cm3 Experiment- 6 Multi triangle overlapping technique creating 6 triangle ablation area withequidistance of 4 cm inter electrode spacing we get ablation area X= 9 cm, Y= 7 cm and Z=7 cm with total ablation volume= 230.79 cm3 Performing with Celon T4.0.3 electrode We can adjust or change Z axis as desirable.ConclusionRFA using celon cluster electrodes can help to create large ablative zones with overlappingmulti triangle ablation method. as celon cluster Bipolar electrode can achieve large ablative zones with improved time efficiency, this method may provide a useful tool for the treatment of large malignant tumors of the liver. As combine with TACE it will be a life saving treatment for the large tumor patient with HCC, in our interventional radiology department we experience some patient who undergone TACE have a recurrence chances for a tumor growth in large hepatocellular carcinoma upto X=14cm in size we can stop the tumor growth by performing Radiofrequency ablation after transartery chemoembolization procedure, this combination will be a life saving treatment for large hepatocellular carcinoma. |
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