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Quantification of Tissue Shrinkage and Dehydration Caused by Microwave Ablation: Experimental Study in Kidneys for the Estimation of Effective Coagulation Volume
Authors:Christof M Sommer  Steffen A Sommer  Theresa Mokry  Theresa Gockner  Daniel Gnutzmann  Nadine Bellemann  Anne Schmitz  Boris A Radeleff  Hans U Kauczor  Ulrike Stampfl  Philippe L Pereira
Institution:2. Kapp and Geissler Rechtsanwälte (S.A.S.), Stuttgart;3. and Clinic for Radiology, Minimally Invasive Therapies and Nuclear Medicine (P.L.P.), SLK Kliniken Heilbronn, Heilbronn, Germany
Abstract:PurposeTo quantify the extent of tissue shrinkage and dehydration caused by microwave (MW) ablation in kidneys for estimation of effective coagulation volume.Materials and MethodsMW ablations were carried out in ex vivo porcine kidneys. Six study groups were defined: groups 1A, 2A, and 3A for MW ablation (90 W for 5 min, 7.5 min, or 10 min), and groups 1B, 2B, and 3B for control (without MW ablation). Pre- and postinterventional volume analyses were performed. Effective coagulation volumes (original tissue included in coagulation) were determined. Postinterventional dehydration analyses were performed with calculation of mean mass fractions of water.ResultsMean deployed energies were 21.6 kJ ± 1.1 for group 1A, 29.9 kJ ± 1.0 for group 2A, and 42.1 kJ ± 0.5 kJ for group 3A, and were significantly different (P < .0001). Differences between pre- and postinterventional volumes were ?3.8% ± 0.6 for group 1A, ?5.6% ± 0.9 for group 2A, and ?7.2% ± 0.4 for group 3A, and ?1.1% ± 0.3 for group 1B, ?1.8% ± 0.4 for group 2B, and ?1.1% ± 0.4 for group 3B. Postinterventional volumes were significantly smaller than preinterventional volumes for all groups (P < .01). Underestimations of effective coagulation volume from visualized coagulation volume were 26.1% ± 3.5 for group 1A, 35.2% ± 11.2 for group 2A, and 42.1% ± 4.9 for group 3A, which were significantly different (P < .01). Mean mass fractions of water were 64.2% ± 1.4 for group 1A, 63.2% ± 1.7 for group 2A, and 62.6% ± 1.8% for group 3A, with significant differences versus corresponding control groups (P < .01).ConclusionsFor MW ablation in kidneys, underestimation of effective coagulation volume based on visualized coagulation volume is significantly greater with greater deployed energy. Therefore, local dehydration with tissue shrinkage is a potential contributor.
Keywords:AKS"}  {"#name":"keyword"  "$":{"id":"key0010"}  "$$":[{"#name":"text"  "_":"appearance of kidney surface  MW"}  {"#name":"keyword"  "$":{"id":"key0020"}  "$$":[{"#name":"text"  "_":"microwave  RF"}  {"#name":"keyword"  "$":{"id":"key0030"}  "$$":[{"#name":"text"  "_":"radiofrequency
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