Radio-frequency thermal ablation with hypertonic saline solution injection of the lung: Ex vivo and in vivo feasibility studies

The aim of this study was to assess the effects of simultaneous instillation of NaCl solutions during radio-frequency ablation (RFA) on the dimension of the ablated lesion in ex vivo bovine lung tissue and in vivo rabbit lung tissue. The RFA was induced in ex vivo bovine lung tissue which was inflated with room air and in vivo rabbit lung tissue by a 500-kHz RF generator and a 17-G cooled-tip electrode. In in vivo experiments, RFA was performed using CT guidance. The RF energy was applied for 5 min with or without instillation of 0.9 or 36% NaCl solutions. The changes in tissue impedance, current, power output, and temperature of the electrode tip were automatically measured. The maximum diameter of all thermal lesions was measured perpendicular to the electrode axis by two observers. In an ex vivo study, the mean lesion diameters using 36 and 0.9% NaCl solutions were larger than those of the control group: 51±8, 34±6, and 5±2 min (p<0. 05). In in vivo rabbit lung tissue, the mean lesion diameter with NaCl solution (15.3±3.1 mm) was larger than that of the lesion without NaCl solution (8.5±1.4 mm; p<0.05). With instillation of NaCl solutions, a marked decrease of tissue impedance (>100 Ω) and corresponding increase of current flow occurred in both ex vivo and in vivo studies. This experimental study demonstrates that RF ablation with simultaneous NaCl solution infusion of the lung is more effective in achieving coagulation necrosis than conventional RFA procedure.