Learning Objectives: To illustrate the spectrum of percutaneous radiogequency ablation (RFA) using new perfusion electrode [cool-wet tip electrode® (CWT), RF Medical, Seoul, Korea] for hepatic lesions with varying location and pathologic condition
Background: CWT is a variation of cool tip electrode (CT) with two side holes in active tip. A side hole is 0.02 mm in diameter for leaking normal saline at the rate of 1.6 mL/min each. CWT with 2 cm and 3 cm active tip produces large ablating zone up to 3.0 cm and 4.5 cm in diameter, respectively. So it can ablate 0.5 - 0.8 cm apart from the tip of electrode and produce a spherical zone rather than elliptical. It is useful to ablate a hard mass such as recurred hepatocellular carcinoma after transarterial chemoembolizations or calcified metastasis, exophytic mass, and mass broadly attached to the diaphragm.
Imaging Findings or Procedure Details:
Between January 2008 and August 2008, 104 nodules in 79 patients were ablated by CWT. We will describe the experiences of RFA using CWT in hepatic tumors with suitable indications, technique, advantages and limitations compared with RFA using existing CE. We also ablated an explanted bullock's liver as ex vivo study to compare the exact size of ablated zone.
Conclusion: RFA using CWT showed better performance in terms of creating a larger and spherical ablating zone than that using CT. CWT was useful in ablation of variable hepatic tumors which is difficult to ablate by CT.