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Experimental and Clinical Radiofrequency Ablation: Proposal for Standardized Description of Coagulation Size and Geometry

¹ Department of Radiology, Gasthuisberg University Hospital, Herestraat 49, 3000 Leuven, Belgium
² Department of Surgery, Rikshospitalet University Hospital, Sognsvannsveien 20, 0027 Oslo, Norway
³ Unity of Liver Surgery and Liver Transplantation, Bellvitge University Hospital, Feixa Llarga, sn, 08907 Hospitalet de Llobregat, Barcelona, Spain
⁴ Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011 Lausanne, Switzerland
⁵ Department of Radiology, Mont-Godinne University Hospital, Avenue du Dr. Thérasse 1, 5530 Yvoir, Belgium
⁶ Central Service of Radiology and Medical Imaging, Hôtel Dieu, University Hospital of Nantes, Place Alexis Ricordeau 1, 44093 Nantes Cedex 01, France
⁷ Department of Liver and Pancreas Surgery, Imperial College London, Hammersmith Hospital, Du Cane Road, W12 0NN London, UK
⁸ Biomedical Engineer, 5733 Pond Drive, Shoreview, Minnesota 55126, USA
⁹ Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
¹⁰ Division of Endourology, Laparoscopy and Minimally Invasive Surgery, University of Miami School of Medicine, Professional Arts Center, 1150 NW 14th Street, Suite 309, Miami, Florida 33101, USA
¹¹ Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
¹² Biomedical Engineer, 8140 Lake Elmo Avenue, Stillwater, Minnesota 55082, USA
¹³ Department of General Surgery, University Hospital of Strasbourg, Place de l’Hôpital, 67091 Strasbourg Cedex, France
¹⁴ Department of Surgery, University of Hong Kong, Queen Mary Hospital, 102 Pofulam Road, Hong Kong 852, China
¹⁵ Unit of Bilio-pancreatic Surgery, Ospedale San Paolo, University of Milan, via A. di Rudinì 8, 20142 Milan, Italy
¹⁶ Department of Visceral and Vascular Surgery, University of Cologne, Joseph Stelzmann Strasse 9, 50924 Cologne, Germany
¹⁷ Department of Digestive and Cardiovascular Medicine, Tokushima University School of Medicine, (3-18-15) Kuramoto-cho, Tokushima 770-8503, Japan
¹⁸ Department of Surgery, Mont-Godinne University Hospital, Avenue du Dr. Thérasse 1, 5530 Yvoir, Belgium

Correspondence: Address correspondence and reprint requests to: Luc Michel, MD, FACS; E-mail: michel{at}chir.ucl.ac.be

Background: Radiofrequency (RF) ablation is used to obtain local control of unresectable tumors in liver, kidney, prostate, and other organs. Accurate data on expected size and geometry of coagulation zones are essential for physicians to prevent collateral damage and local tumor recurrence. The aim of this study was to develop a standardized terminology to describe the size and geometry of these zones for experimental and clinical RF.

Methods: In a first step, the essential geometric parameters to accurately describe the coagulation zones and the spatial relationship between the coagulation zones and the electrodes were defined. In a second step, standard terms were assigned to each parameter.

Results: The proposed terms for single-electrode RF ablation include axial diameter, front margin, coagulation center, maximal and minimal radius, maximal and minimal transverse diameter, ellipticity index, and regularity index. In addition a subjective description of the general shape and regularity is recommended.

Conclusions: Adoption of the proposed standardized description method may help to fill in the many gaps in our current knowledge of the size and geometry of RF coagulation zones.

Key Words: Radiofrequency ablation • Tumor ablation • Size • Geometry • Liver • Kidney

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