Abstract：
Thermal ablation offers a minimally invasive alternative in the treatment of hepatic tumours. Several types of ablation are utilised with different methods and indications. However, to this day, ablation size remains limited due to the formation of a central non-conductive boundary layer. In thermal ablation, this boundary layer is formed by carbonisation. Our goal was to prevent or delay carbonisation, and subsequently increase ablation size. We used bovine liver to compare ablation diameter and volume, created by a stand-alone laser applicator, with those created when utilising a spacer between laser applicator and hepatic tissue. Two spacer variants were developed: one with a closed circulation of cooling fluid and one with an open circulation into hepatic tissue. We found that the presence of a spacer significantly increased ablation volume up to 75.3 cm3, an increase of a factor of 3.19 (closed spacer) and 3.02 (open spacer) when compared to the stand-alone applicator. Statistical significance between spacer variants was also present, with the closed spacer producing a significantly larger ablation volume (p < 0.001, MDiff = 3.053, 95% CI[1.612, 4.493]) and diameter (p < 0.001, MDiff = 4.467, 95% CI[2.648, 6.285]) than the open spacer. We conclude that the presence of a spacer has the potential to increase ablation size.
摘要：
热消融在肝肿瘤的治疗中提供了微创替代方案。几种类型的消融与不同的方法和适应症一起使用。然而,直到今天,由于形成了中央非导电边界层，消融尺寸仍然有限。在热消融中，该边界层由碳化形成。我们的目标是防止或延迟碳化，并随后增加消融尺寸。我们使用牛肝脏来比较消融直径和体积，由独立的激光涂抹器创建，与使用激光敷贴器和肝组织之间的间隔器时产生的那些。开发了两种间隔物变体：一种具有冷却液的封闭循环，一种具有进入肝组织的开放循环。我们发现,间隔物的存在显著增加了消融体积高达75.3cm3,当与独立的施加器相比时,增加了3.19倍(封闭间隔物)和3.02倍(开放间隔物)。间隔区变体之间也存在统计显著性,封闭间隔物产生的消融体积(p<0.001,MDiff=3.053,95%CI[1.612,4.493])和直径(p<0.001,MDiff=4.467,95%CI[2.648,6.285])明显大于开放间隔物。我们得出的结论是，间隔物的存在可能会增加消融尺寸。
