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Volume 18, Issue 10, Pages (October 2011)

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1 Volume 18, Issue 10, Pages 1318-1323 (October 2011)
Effects of Radiofrequency Ablation on Normal Lung Tissue in a Swine Model  Thomas G. Lesser, MD, Frank Ritter, MD, Hilmar Schlosser, MD, Carsten Boltze, MD, Christoph Hackenbroich, MD  Academic Radiology  Volume 18, Issue 10, Pages (October 2011) DOI: /j.acra Copyright © 2011 AUR Terms and Conditions

2 Figure 1 Experimental setting for radiofrequency ablation: anesthetized and spontaneously breathing swine in the left lateral decubitus. Computed tomography confirmation of needle position in the right lung. Academic Radiology  , DOI: ( /j.acra ) Copyright © 2011 AUR Terms and Conditions

3 Figure 2 Computed tomography–guided monitoring of ablation in the lung periphery. Twelve minutes after ablation, an oval opacity, 3.7 × 2.7 cm in size, was observed. Academic Radiology  , DOI: ( /j.acra ) Copyright © 2011 AUR Terms and Conditions

4 Figure 3 Effects of radiofrequency ablation on normal lung tissue (60 days after ablation in the lung periphery). (a) Computed tomography scan shows a irregular lesion, 1.3 × 0.7 cm in size, with small scars radiating to the pleura (arrow). (b) Lung specimen with a small retraction of the pleura. (c) Specimen in (b) with an incision through the lesion shows a small necrosis, scar tissue, normal surrounding lung parenchyma, and intact bronchi. Academic Radiology  , DOI: ( /j.acra ) Copyright © 2011 AUR Terms and Conditions

5 Figure 4 Computed tomography–guided monitoring of ablation in the hilar region of the lung. Twelve minutes after ablation, there was an oval opacity, 2.4 × 1.6 cm in size, with a cavity along the needle. The lesion is in close contact with the pulmonary artery. Academic Radiology  , DOI: ( /j.acra ) Copyright © 2011 AUR Terms and Conditions

6 Figure 5 Effects of radiofrequency ablation on normal lung tissue (2 hours after ablation in the hilar region). The animal died of myocarditis. (a) Lung specimen photomacrograph shows coagulative necrosis (↔) with close contact to a pulmonary artery (black arrow) and bronchus (Λ). Mucous bronchial obstruction caused atelectasis (∗). A well demarked 2- to 5-mm hyperemic zone (→ ←) surrounding necrosis. (b) Specimen photomicrograph (×40, hematoxylin-eosin) from the margin of the lesion shows a well-demarked zone of congestion with hyperemia and hemorrhage (middle of the picture) shown both from the fluid-filled alveolar spaces at the periphery of the thermal lesion (right side) and the normal tissue (left side). Academic Radiology  , DOI: ( /j.acra ) Copyright © 2011 AUR Terms and Conditions

7 Figure 6 Effects of radiofrequency ablation on normal lung tissue (7 days after ablation in the hilar region). (a) Computed tomography scan shows a well-demarked, high-density mass-like lesion with air-filled bronchi, 1.5 mm in diameter, in the center of the necrosis. There is a weak opacification extending from the lesion to the pleura, representing dystelectatic lung tissue. (b) Lung specimen photomacrograph shows well-demarked coagulative necrosis. Small bronchi within the rim zone of the necrosis are undamaged but filled with mucus. There is a rim of hypoventilated tissue surrounding the necrosis. (c) Specimen photomicrograph (10×, hematoxylin-eosin) shows the coagulative necrosis surrounded by a small rim of connective tissue. (d) Specimen (c) enlarged in the selected range (120×, hematoxylin-eosin). The alveoli are filled with inflammatory cells and closed by granulation tissue and new connective tissue (right lower corner). Academic Radiology  , DOI: ( /j.acra ) Copyright © 2011 AUR Terms and Conditions

8 Figure 7 Effects of radiofrequency ablation on normal lung tissue (60 days after ablation in the hilar region). (a) Computed tomography scan shows an irregularly blurred radiating lesion in contact with the pulmonary artery (arrow). (b) Specimen photomacrograph shows an incision through the scarred lesion (arrow), abutting the pulmonary artery wall, normal surrounding lung parenchyma, and intact pulmonary artery. Academic Radiology  , DOI: ( /j.acra ) Copyright © 2011 AUR Terms and Conditions


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