Effect of Change in Portal Vein Flow Rates on Hepatic Ablations Created with a Bipolar Radiofrequency Ablation Device.

Purpose To investigate the effect of change in portal vein flow rates on the size and shape of ablations created by a bipolar radiofrequency (RF) ablation device. Materials and Methods This study was exempt from institutional animal care and use committee review. An in vitro bovine liver model perfused with autologous blood via the portal vein at three flow rates (60, 80, 100 mL/min per 100 g of liver) was used. Four ablations, two bipolar and two monopolar (control probe), were made in each of five livers perfused at each flow rate. Short- and long-axis diameters were measured from gross specimens, and volume and sphericity index were calculated for each ablation. A general linear mixed model accounting for correlation within the liver was used to evaluate the effects of flow on ablations. Analyses were performed by using software. Results There was no significant difference in the size or shape of ablations created by the bipolar device at the different flow rates (P > .05 for all outcomes). The monopolar device demonstrated the expected inverse association between ablation size and change in flow (P < .01 for all outcomes). The mean ± standard deviation of short-axis diameter, long-axis diameter, volume, and sphericity index of the bipolar ablations was 4.3 cm ± 0.1, 4.2 cm ± 0.1, 41.0 cm3 ± 1.8, and 1.1 ± 0.1, respectively. Conclusion Unlike monopolar RF ablation, change in portal vein flow rates does not have a statistically significant effect on the size or shape of ablations created by the bipolar RF ablation device tested. © RSNA, 2016.

The prediction of radiofrequency ablation zone volume using vascular indices of 3-dimensional volumetric colour Doppler ultrasound in an in vitro blood-perfused bovine liver model.

OBJECTIVE: To determine the most reliable predictor of radiofrequency (RF) ablation zone volume among three-dimensional (3D) volumetric colour Doppler vascular indices in an in vitro blood-perfused bovine liver model. METHODS: 3D colour Doppler volume data of the local hepatic parenchyma were acquired from 37 areas of 13 bovine livers connected to an in vitro oxygenated blood perfusion system. Doppler vascular indices of vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were obtained from the volume data using 3D volume analysis software. 37 RF ablations were performed at the same locations where the ultrasound data were obtained from. The relationship of these vascular indices and the ablation zone volumes measured from gross specimens were analyzed using a general linear mixed model fit with random effect for liver and backward stepwise regression analysis. RESULTS: FI was significantly associated with ablation zone volumes measured on gross specimens (p = 0.0047), but explained little of the variance (Rß2 = 0.21). Ablation zone volume decreased by 0.23 cm3 (95% confidence interval: -0.38, -0.08) for every 1 increase in FI. Neither VI nor VFI was significantly associated with ablation zone volumes (p > 0.05). CONCLUSION: Although FI was associated with ablation zone volumes, it could not sufficiently explain their variability, limiting its clinical applicability. VI, FI and VFI are not clinically useful in the prediction of RF ablation zone volume in the liver. Advances in knowledge: Despite a significant association of FI with ablation zone volumes, VI, FI and VFI cannot be used for their prediction. Different Doppler vascular indices need to be investigated for clinical use.

Effect of Change in Portal Venous Blood Flow Rates on the Performance of a 2.45-GHz Microwave Ablation Device.

PURPOSE: To investigate the effect of change in portal venous blood flow rates on the size and shape of ablations created by a 2.45-GHz microwave ablation device. MATERIALS AND METHODS: This study was exempt from review by the institutional animal care and use committee. An in vitro bovine liver model perfused with autologous blood via the portal vein at five flow rates (60, 70, 80, 90, and 100 mL/min per 100 g of liver) was used to evaluate the effect of change in flow rates on the size and shape of coagulation created by a 2.45-GHz, 140-W microwave ablation device operated for 5 and 10 minutes. Three ablations per ablation time were conducted in each of 10 livers, with two livers perfused at each flow rate. Short- and long-axis diameters were measured from gross specimens, and volume and sphericity index were calculated. General linear mixed models that accounted for correlations within the liver were used to evaluate the effects of lobe, flow, and ablation time on size and sphericity index of ablations. RESULTS: Flow did not have a significant effect on the size or shape of coagulation created at 5 or 10 minutes (P > .05 for all tests). The mean short- and long-axis diameters and volume were 3.2 cm (95% confidence interval [CI]: 3.1, 3.3), 5.6 cm (95% CI: 5.4, 5.8), and 30.2 cm(3) (95% CI: 28.4, 32.1) for the 5-minute ablations and 3.8 cm (95% CI: 3.7, 3.9), 6.5 cm (95% CI: 6.3, 6.7), and 49.3 cm(3) (95% CI: 47.5, 51.2), for the 10-minute ablations, respectively. The mean sphericity index for both 5- and 10-minute ablations was 34.4% (95% CI: 32%, 36.7%). CONCLUSION: Change in portal venous blood flow rates did not have an effect on the size and shape of ablations created by a 2.45-GHz microwave ablation device.

Effect of variation of portal venous blood flow on radiofrequency and microwave ablations in a blood-perfused bovine liver model.

PURPOSE: To assess whether there is a significant difference in the effect of incremental changes of portal venous blood flow rates on the size of radiofrequency (RF) versus microwave (MW) ablation lesions in an ex vivo blood-perfused bovine liver model. MATERIALS AND METHODS: This study was exempt from approval by the Institutional Animal Care and Use Committee. Sixty ablations (30 MW and 30 RF ablations) were performed ex vivo in 15 bovine livers perfused with autologous blood via the portal vein at 60, 70, 80, 90, and 100 mL/min per 100 g of liver tissue (three livers were used for each flow rate). Long-axis diameter (LAD), short-axis diameter (SAD), and volume were measured for each ablation lesion. A general linear mixed model was used to examine the effect of location, ablation device, and flow rate on LAD, SAD, and volume. Results were considered to indicate a significant difference at P less than .05. RESULTS: Location was not a significant predictor of LAD, SAD, or volume (P ≥ .4). The slope of the relationship between flow rate and LAD, SAD, and volume was significantly different according to ablation device (P < .0001). For RF ablation lesions, the mean LAD, SAD, and volume demonstrated a significant inverse relationship with flow rate, while the measurements for MW ablation did not change with variation in flow rates. CONCLUSION: The size of RF ablation lesions is highly variable, with a significant inverse relationship to the rate of portal venous blood flow. Conversely, the size of MW ablation lesions is unaffected by changes in portal venous blood flow. The consistency of the size of MW ablation lesions could translate into a higher local tumor eradication rate than that reported with RF ablation.

Radiofrequency ablation of the liver: effect of variation of portal venous blood flow on lesion size in an in-vitro perfused bovine liver.

RATIONALE AND OBJECTIVES: An in vitro perfused bovine liver model was used to evaluate the relationship between the sizes of radiofrequency ablation lesions and variation in portal venous blood flow. MATERIALS AND METHODS: Fourteen bovine livers were perfused with autologous heparinized blood at 37°C and 40% to 50% oxygenation via the portal vein. Flow rates were adjusted from 10 to 50 mL/min/100 g tissue. A 480-kHz generator and a 3.0-cm monopolar internally cooled electrode were used to create 57 ablations. The long-axis diameter, short-axis diameter (SAD), and volume of each ablation zone were measured and calculated from the dissected livers. Correlations between SAD, long-axis diameter, and volume versus blood flow were assessed using linear regression analysis. RESULTS: SAD and lesion volume demonstrated inverse linear correlations with blood flow (for SAD, y = -0.044x + 3.925, r = 0.836, P < .001; for volume, y = -0.556x + 31.574, r = 0.842, P < .001). A 10 mL/min/100 g change in flow rate produced an average 4.4 ± 0.4 mm change in SAD and an average 5.6 ± 0.5 cm(3) change in volume. Long-axis diameter was not correlated with blood flow (y = -0.7694x + 4.1899, r = 0.2173, P = .111). CONCLUSIONS: The SAD and volume of radiofrequency ablation lesions have statistically significant inverse linear correlations with portal venous blood flow, with an average 4.4-mm change in SAD and an average 5.6-cm(3) change in volume for each 10 mL/min/100 g change in flow rate.

Maintenance of low sodium and high potassium levels in cells and in tendon/collagen.

Mammalian cells have a higher concentration of potassium and a lower concentration of sodium than their extracellular environment. The mechanisms responsible for the unequal distribution of these ions are commonly ascribed to the presence of an energy requiring plasma membrane ATPase pump, and the presence of membrane channels that pass one ion selectively, while excluding others. This report deals with other mechanisms that might explain this heterogeneous distribution of ions. To study other mechanisms, we turned to a non-living system, specifically tendon/collagen to eliminate the contribution of the membrane pump and channels. A simple gravimetric method was designed to measure solute accumulation or exclusion during rehydration of a well-washed, carefully dried and well-characterized protein specimen (tendon/collagen). Exposure to physiological salt concentrations resulted in selective exclusion of Na+ over K+, whereas exposure to low-salt concentration resulted in accumulation of these solutes. It is postulated that this solute redistribution occurs in all hydrated proteins and is partially responsible for the heterogeneous solute distribution in cells presently assigned to pump and channel mechanisms. Physical and thermodynamic mechanisms are offered to explain the observed heterogeneous solute distributions.

The molecular stoichiometric hydration model (SHM) as applied to tendon/collagen, globular proteins and cells.

This report describes and documents the presence of multiple water-of-hydration fractions on proteins and in cells. Initial studies of hydration fractions in g of water/g of DM (dry mass) for tendon/collagen led to the development of the molecular SHM (stoichiometric hydration model) and the development of methods for calculating the size of hydration fractions on a number of different proteins of known amino acid composition. The water fractions have differences in molecular motion and other physical properties due to electrostatic interactions of polar water molecules with electric fields generated by covalently bound pairs of opposite partial charge on the protein backbone. The methods allow calculation of the size of four hydration fractions: single water bridges, double water bridges, dielectric water clusters over polar-hydrophilic surfaces and water clusters over hydrophobic surfaces. These four fractions provide monolayer water coverage. The predicted SHM hydration fractions match closely measured hydration fraction values for collagen and for globular proteins. This report also presents water sorption findings that support the SHM. The SHM is applicable for cell systems where it has been studied. In seven cell systems studied, more than half of all of the cell water had properties unlike those of bulk water. The SHM predicts and explains the commonly cited and measured bound water fraction of 0.2-0.4 g of water/g of DM on proteins. The commonly accepted concept that water beyond this bound water fraction can be considered bulk-like water in its physical properties is unwarranted.