Enlarging the thermal coagulation volume during thermochemical ablation with alternating acid-base injection by shortening the injection interval : a computational study
- Authors: Mak, Nguoy , Ng, Wen , Ooi, Ean , Lau, Ee , Pamidi, Narendra , Foo, Ji , Ooi, Ean Tat , Ali, Ahmad
- Date: 2024
- Type: Text , Journal article
- Relation: Computer Methods and Programs in Biomedicine Vol. 243, no. (2024), p.
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- Description: Background and objectives: Thermochemical ablation (TCA) is a cancer treatment that utilises the heat released from the neutralisation of acid and base to raise tissue temperature to levels sufficient to induce thermal coagulation. Computational studies have demonstrated that the coagulation volume produced by sequential injection is smaller than that with simultaneous injection. By injecting the reagents in an ensuing manner, the region of contact between acid and base is limited to a thin contact layer sandwiched between the distribution of acid and base. It is hypothesised that increasing the frequency of acid-base injections into the tissue by shortening the injection interval for each reagent can increase the effective area of contact between acid and base, thereby intensifying neutralisation and the exothermic heat released into the tissue. Methods: To verify this hypothesis, a computational model was developed to simulate the thermochemical processes involved during TCA with sequential injection. Four major processes that take place during TCA were considered, i.e., the flow of acid and base, their neutralisation, the release of exothermic heat and the formation of thermal damage inside the tissue. Equimolar acid and base at 7.5 M was injected into the tissue intermittently. Six injection intervals, namely 3, 6, 15, 20, 30 and 60 s were investigated. Results: Shortening of the injection interval led to the enlargement of coagulation volume. If one considers only the coagulation volume as the determining factor, then a 15 s injection interval was found to be optimum. Conversely, if one places priority on safety, then a 3 s injection interval would result in the lowest amount of reagent residue inside the tissue after treatment. With a 3 s injection interval, the coagulation volume was found to be larger than that of simultaneous injection with the same treatment parameters. Not only that, the volume also surpassed that of radiofrequency ablation (RFA); a conventional thermal ablation technique commonly used for liver cancer treatment. Conclusion: The numerical results verified the hypothesis that shortening the injection interval will lead to the formation of larger thermal coagulation zone during TCA with sequential injection. More importantly, a 3 s injection interval was found to be optimum for both efficacy (large coagulation volume) and safety (least amount of reagent residue). © 2023 The Author(s)
Comparisons between impedance-based and time-based switching bipolar radiofrequency ablation for the treatment of liver cancer
- Authors: Yap, Shelley , Ooi, Ean , Foo, Ji , Ooi, Ean Tat
- Date: 2021
- Type: Text , Journal article
- Relation: Computers in Biology and Medicine Vol. 134, no. (2021), p.
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- Description: Switching bipolar radiofrequency ablation (bRFA) is a cancer treatment technique that activates multiple pairs of electrodes alternately based on a predefined criterion. Various criteria can be used to trigger the switch, such as time (ablation duration) and tissue impedance. In a recent study on time-based switching bRFA, it was determined that a shorter switch interval could produce better treatment outcome than when a longer switch interval was used, which reduces tissue charring and roll-off induced cooling. In this study, it was hypothesized that a more efficacious bRFA treatment can be attained by employing impedance-based switching. This is because ablation per pair can be maximized since there will be no interruption to RF energy delivery until roll-off occurs. This was investigated using a two-compartment 3D computational model. Results showed that impedance-based switching bRFA outperformed time-based switching when the switch interval of the latter is 100 s or higher. When compared to the time-based switching with switch interval of 50 s, the impedance-based model is inferior. It remains to be investigated whether the impedance-based protocol is better than the time-based protocol for a switch interval of 50 s due to the inverse relationship between ablation and treatment efficacies. It was suggested that the choice of impedance-based or time-based switching could ultimately be patient-dependent. © 2021 Elsevier Ltd
The effects of the no-touch gap on the no-touch bipolar radiofrequency ablation treatment of liver cancer : a numerical study using a two compartment model
- Authors: Yap, Shelley , Cheong, Jason , Foo, Ji , Ooi, Ean Tat , Ooi, Ean Hin
- Date: 2020
- Type: Text , Journal article
- Relation: Applied Mathematical Modelling Vol. 78, no. (2020), p. 134-147
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- Description: The no-touch bipolar radiofrequency ablation (RFA) for cancer treatment is advantageous primarily because of its capability to prevent tumour track seeding (TTS). In this technique, the RF probes are placed at a distance (no-touch gap) away from the tumour boundary. Ideally, the RF probes should be placed sufficiently far from the tumour in order to avoid TTS. However, having a gap that is too large can lead to ineffective ablation. This paper investigates how the selection of the no-touch gap can affect the tissue electrical and thermal responses during the no-touch bipolar RFA treatment. Simulations were carried out on a two compartment model using the finite element method. Results obtained indicated that a gap that is too large may lead to incomplete ablation and failure to achieve significant ablation margin. However, keeping the gap to be too small may not be clinically practical. It was suggested that the incomplete ablation and the insufficient ablation margin observed in some of the cases may require the placement of additional probes around the tumour. The present study stresses on the importance of identifying the optimal no-touch gap that can avoid TTS without compromising the treatment outcome. © 2019 Elsevier Inc.