Simulating radiofrequency ablation of hepatocellular carcinomas proximal to bare area of liver

Abstract

Purpose

To numerically assess the significance of dextrose 5% in water (D5W) thermo-protection during radiofrequency ablation (RFA) of hepatocellular carcinomas (HCCs) located near the ‘bare area of liver’.

Material and methods

This study utilises quasi-anatomical structures extracted from CT images. A multi-tine electrode, deployed inside the extracted organs and operated under temperature-controlled mode was used as the source of ablation. Geometrically, D5W was modelled around the ‘bare area’ and sandwiched between the liver and diaphragm. RFA at different sites relative to the ‘bare area’ was simulated to answer when to consider modelling D5W.

Results

For targets near the edge of ‘bare area’ and at 0.5 mm gap (between the electrode and the ‘bare area’), ignoring D5W and using ground conditions could result in underestimation of ablation volume by almost 25%. The importance of D5W becomes negligible for ablations near the centre of the ‘bare area’.

Conclusions

Consideration of D5W during RFA of HCCs proximal to the ‘bare area’ can significantly influence the ablation outcome, especially when ablation is performed near the edge of the ‘bare area’.

Keywords:

• Radiofrequency ablation
• multi-tine electrode
• thermal injury
• extrahepatic organs
• thermoprotections

Acknowledgements

The authors acknowledge IIT Ropar for providing essential infrastructure to carry out the present research.

Disclosure statement

No potential conflict of interest was reported by the author(s).