Spacer-Supported Thermal Ablation to Prevent Carbonisation and Improve Ablation Size: A Proof of Concept Study
Thermal ablation offers a minimally invasive alternative in the treatment of hepatic tumours. Several types of ablation are utilised with different methods and indications. However, to this day, ablation size remains limited due to the formation of a central non-conductive boundary layer. In thermal...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/2/575 |
| _version_ | 1797622129437442048 |
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| author | Fiona Mankertz Ole Gemeinhardt Ute Felbor Stefan Hadlich Norbert Hosten |
| author_facet | Fiona Mankertz Ole Gemeinhardt Ute Felbor Stefan Hadlich Norbert Hosten |
| author_sort | Fiona Mankertz |
| collection | DOAJ |
| description | Thermal ablation offers a minimally invasive alternative in the treatment of hepatic tumours. Several types of ablation are utilised with different methods and indications. However, to this day, ablation size remains limited due to the formation of a central non-conductive boundary layer. In thermal ablation, this boundary layer is formed by carbonisation. Our goal was to prevent or delay carbonisation, and subsequently increase ablation size. We used bovine liver to compare ablation diameter and volume, created by a stand-alone laser applicator, with those created when utilising a spacer between laser applicator and hepatic tissue. Two spacer variants were developed: one with a closed circulation of cooling fluid and one with an open circulation into hepatic tissue. We found that the presence of a spacer significantly increased ablation volume up to 75.3 cm<sup>3</sup>, an increase of a factor of 3.19 (closed spacer) and 3.02 (open spacer) when compared to the stand-alone applicator. Statistical significance between spacer variants was also present, with the closed spacer producing a significantly larger ablation volume (<i>p</i> < 0.001, M<sub>Diff</sub> = 3.053, 95% CI[1.612, 4.493]) and diameter (<i>p</i> < 0.001, M<sub>Diff</sub> = 4.467, 95% CI[2.648, 6.285]) than the open spacer. We conclude that the presence of a spacer has the potential to increase ablation size. |
| first_indexed | 2024-03-11T09:06:56Z |
| format | Article |
| id | doaj.art-669bba6ab7b048a2b98c2ff73a842645 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T09:06:56Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-669bba6ab7b048a2b98c2ff73a8426452023-11-16T19:20:16ZengMDPI AGBiomedicines2227-90592023-02-0111257510.3390/biomedicines11020575Spacer-Supported Thermal Ablation to Prevent Carbonisation and Improve Ablation Size: A Proof of Concept StudyFiona Mankertz0Ole Gemeinhardt1Ute Felbor2Stefan Hadlich3Norbert Hosten4Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, GermanyDepartment of Radiology, Charité—Universitätsmedizin Berlin, 10117 Berlin, GermanyInstitute for Human Genetics, University Medicine Greifswald, 17475 Greifswald, GermanyInstitute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, GermanyInstitute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, GermanyThermal ablation offers a minimally invasive alternative in the treatment of hepatic tumours. Several types of ablation are utilised with different methods and indications. However, to this day, ablation size remains limited due to the formation of a central non-conductive boundary layer. In thermal ablation, this boundary layer is formed by carbonisation. Our goal was to prevent or delay carbonisation, and subsequently increase ablation size. We used bovine liver to compare ablation diameter and volume, created by a stand-alone laser applicator, with those created when utilising a spacer between laser applicator and hepatic tissue. Two spacer variants were developed: one with a closed circulation of cooling fluid and one with an open circulation into hepatic tissue. We found that the presence of a spacer significantly increased ablation volume up to 75.3 cm<sup>3</sup>, an increase of a factor of 3.19 (closed spacer) and 3.02 (open spacer) when compared to the stand-alone applicator. Statistical significance between spacer variants was also present, with the closed spacer producing a significantly larger ablation volume (<i>p</i> < 0.001, M<sub>Diff</sub> = 3.053, 95% CI[1.612, 4.493]) and diameter (<i>p</i> < 0.001, M<sub>Diff</sub> = 4.467, 95% CI[2.648, 6.285]) than the open spacer. We conclude that the presence of a spacer has the potential to increase ablation size.https://www.mdpi.com/2227-9059/11/2/575thermal ablationlaser ablationexperimental radiologyablation zoneNd:YAG |
| spellingShingle | Fiona Mankertz Ole Gemeinhardt Ute Felbor Stefan Hadlich Norbert Hosten Spacer-Supported Thermal Ablation to Prevent Carbonisation and Improve Ablation Size: A Proof of Concept Study Biomedicines thermal ablation laser ablation experimental radiology ablation zone Nd:YAG |
| title | Spacer-Supported Thermal Ablation to Prevent Carbonisation and Improve Ablation Size: A Proof of Concept Study |
| title_full | Spacer-Supported Thermal Ablation to Prevent Carbonisation and Improve Ablation Size: A Proof of Concept Study |
| title_fullStr | Spacer-Supported Thermal Ablation to Prevent Carbonisation and Improve Ablation Size: A Proof of Concept Study |
| title_full_unstemmed | Spacer-Supported Thermal Ablation to Prevent Carbonisation and Improve Ablation Size: A Proof of Concept Study |
| title_short | Spacer-Supported Thermal Ablation to Prevent Carbonisation and Improve Ablation Size: A Proof of Concept Study |
| title_sort | spacer supported thermal ablation to prevent carbonisation and improve ablation size a proof of concept study |
| topic | thermal ablation laser ablation experimental radiology ablation zone Nd:YAG |
| url | https://www.mdpi.com/2227-9059/11/2/575 |
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