Considerations for Thermal Injury Analysis for RF Ablation Devices

BACKGROUND The estimation of lesion size is an integral part of treatment planning for the clinical applications of radiofrequency ablation. However, to date, studies have not directly evaluated the impact of different computational estimation techniques for predicting lesion size. In this study, we focus on three common methods used for predicting tissue injury: (1) iso-temperature contours, (2) Cumulative equivalent minutes, (3) Arrhenius based thermal injury. METHODS We created a geometric model of a multi-tyne ablation electrode and simulated thermal and tissue injury profiles that result from three calculation methods after 15 minutes exposure to a constant RF voltage source. A hybrid finite element technique was used to calculate temperature and tissue injury. Time-temperature curves were used in the assessment of iso-temperature thresholds and the method of cumulative equivalent minutes. An Arrhenius-based formulation was used to calculate sequential and recursive thermal injury to tissues. RESULTS The data demonstrate that while iso-temperature and cumulative equivalent minute contours are similar in shape, these two methodologies grossly over-estimate the amount of tissue injury when compared to recursive thermal injury calculations, which have previously been shown to correlate closely with in vitro pathologic lesion volume measurement. In addition, Arrhenius calculations that do not use a recursive algorithm result in a significant underestimation of lesion volume. The data also demonstrate that lesion width and depth are inadequate means of characterizing treatment volume for multi-tine ablation devices. CONCLUSIONS Recursive thermal injury remains the most physiologically relevant means of computationally estimating lesion size for hepatic tumor applications. Iso-thermal and cumulative equivalent minute approaches may produce significant errors in the estimation of lesion size.