Radiofrequency liver ablation: Experimental comparative study of water-cooled versus expandable systems

OBJECTIVE. We evaluate the uniformity and reproducibility of thermal lesion ablation and quantify the volume of tissue destruction and hemorrhage induced with two different commercially available radiofrequency ablation devices. MATERIALS AND METHODS. A four-array anchor expandable needle electrode and a triple-cluster cooled-tip needle electrode were used to induce lesions in three explanted calf livers and in vivo in eight swine livers. The sizes of the radiofrequency-induced lesions were macroscopically evaluated by measuring two perpendicular dimensions immediately after the experiment. Bleeding was evaluated by weighing gauze swabs used to dry the hemorrhage caused by electrode insertions. RESULTS. In explanted liver, the mean diameter of the radiofrequency-induced lesion was 5.3 ± 0.7 cm for the cooled-tip needle and 3.7 ± 0.4 cm for the expandable needle (p = 0.042), which correspond to approximate volumes of 65.35 ± 26.22 cm³ and 26.67 ± 9.59 cm³, respectively (p < 0.002). In vivo, the mean diameter was 3.7 ± 0.4 cm for the cooled-tip needle and 3 ± 0.4 cm for the expandable needle (p < 0.0001), which correspond to approximate volumes of 24.18±7.56 cm³ and 11.16 ± 3.65 cm³, respectively (p < 0.0001). Blood loss attained a median value of 3.5 g for the cooled-tip needle and 2.6 g for the expandable needle; this difference was not statistically significant (p = 0.06). CONCLUSION. The cooled-tip needle induced significantly larger lesions than the expandable needle, but the lesions produced by the expandable needle are more reproducible, uniform, and spheric. The larger size of the lesions produced by the cooled-tip needle may be attributed to the higher maximum power used by the generator and the higher energy deposition, which is due to the cooling of the needle electrode.