Diluted hydrochloric acid generates larger radiofrequency ablation lesions in excised porcine livers

Abstract

PURPOSEThis study evaluated the influence of continuous infusion of diluted hydrochloric acid during radiofrequency ablation (RFA) on the size of ablated lesions. MATERIALS AND METHODSExperiments were performed in 20 excised porcine livers using three different treatment modalities: (1) normal saline-enhanced RFA (NS-RFA), which was normal saline pumped into ablated tissue during RFA; (2) diluted hydrochloric acid ablation (DHAA), which was 3 mol/L diluted hydrochloric acid (HCl) injected into hepatic tissue without RFA; and (3) HCl-enhanced RFA (HCl-RFA), which was 3 mol/L diluted HCl continuously infused into ablated tissue during RFA. We produced 20 HCl-RFA and NS-RFA lesions, respectively, using a monopolar perfusion electrode connected to a commercially available radiofrequency generator, and 20 DHAA lesions using an 18-gauge Chiba needle. The ablated lesions were evaluated both macroscopically and histologically. Dimensions of lesions were compared among HCl-RFA, NS-RFA, and DHAA. RESULTSThe ablated lesions had an elliptical-like shape and were well-demarcated with normal liver tissue. The mean volume, longitudinal diameter, and transverse diameter of NS-RFA lesions were 11.24±0.29 cm3, 3.49±0.07 cm, and 2.48±0.03 cm, those of HCl-RFA lesions were 58.14±3.05 cm3, 5.51±0.05 cm, and 4.49±0.11 cm, and those of DHAA lesions were 4.41±0.16 cm3, 2.43±0.08 cm, and 1.8±0.03 cm, respectively. The mean dimensions of HCl-RFA lesions were the largest among the three types of ablation (P < 0.001). Under the present experimental conditions, the continuous infusion of diluted HCl during RFA can generate larger ablated lesions than NS-RFA or DHAA in excised porcine livers.