Korean J Radiol.  2012 Apr;13(2):195-201. 10.3348/kjr.2012.13.2.195.

Effects of Arsenic Trioxide on Radiofrequency Ablation of VX2 Liver Tumor: Intraarterial versus Intravenous Administration

Affiliations
  • 1Division of Intervention, Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707, Korea. yooncj1@gmail.com
  • 2Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, Seoul 110-744, Korea.

Abstract


OBJECTIVE
Arsenic trioxide (As2O3) can be used as a possible pharmaceutical alternative that augments radiofrequency (RF) ablation by reducing tumor blood flow. The aim of this study was to assess the effect of intraarterial and intravenous administration of As2O3 on RF-induced ablation in an experimentally induced liver tumor.
MATERIALS AND METHODS
VX2 carcinoma was grown in the livers of 30 rabbits. As2O3 (1 mg/kg) was administered through the hepatic artery (n = 10, group A) or ear vein (n = 10, group B), 30 minutes before RF ablation (125 mA +/- 35; 90 +/- 5degrees C). As a control group, 10 rabbits were treated with RF ablation alone (group C). RF was intentionally applied to the peripheral margin of the tumor so that ablation can cover the tumor and adjacent hepatic parenchyma. Ablation areas of the tumor and adjacent parenchymal changes among three groups were compared by the Kruskal-Wallis and Mann-Whitney U test.
RESULTS
The overall ablation areas were 156 +/- 28.9 mm2 (group A), 119 +/- 31.7 (group B), and 92 +/- 17.4 (group C, p < 0.04). The ablation area of the tumor was significantly larger in group A (73 +/- 19.7 mm2) than both group B (50 +/- 19.4, p = 0.02) and group C (28 +/- 2.2, p < 0.01). The ratios of the tumoral ablation area to the overall ablation area were larger in group A (47 +/- 10.5%) than that of the other groups (42 +/- 7.3% in group B and 32 +/- 5.6% in group C) (p < 0.03).
CONCLUSION
Radiofrequency-induced ablation area can be increased with intraarterial or intravenous administration of As2O3. The intraarterial administration of As2O3 seems to be helpful for the selective ablation of the tumor.

Keyword

Arsenic trioxide; Radiofrequency ablation; Pharmacologic modulation; Chemotherapy; Experimental study

MeSH Terms

Animals
Arsenicals/*pharmacology
Catheter Ablation/*methods
Combined Modality Therapy
Contrast Media/diagnostic use
Disease Models, Animal
Liver/radiography
Liver Neoplasms, Experimental/*drug therapy/radiography/*surgery
Oxides/*pharmacology
Rabbits
Statistics, Nonparametric
Tomography, X-Ray Computed

Figure

  • Fig. 1 Experimental concept of intentional marginal ablaion.A. Radiofrequency electrode (small black dot) was placed at peripheral margin of tumor to simultaneously induce tumor and hepatic parenchymal ablation. B. Overall ablation area. Illustration showing overall ablation area (white circle) includes tumor ablation area and hepatic parenchymal area. C. Selectivity of As2O3 effect. Illustration showing coagulated tumor area (A) and coagulated hepatic parenchymal area (B). Each area was measured to verify whether selective antivascular property of As2O3 on liver tumor has influence on radiofrequency ablation. Radios of coagulated tumor area versus coagulated hepatic parenchymal area were calculated.

  • Fig. 2 Triphenyltetrazolium chloride stained specimens. With triphenyltetrazolium chloride staining, viable tissue with intact mitochondrial enzyme activity stains red, while ablated tissue remains white. Arrow indicating VX2 carcinoma and arrowheads point to ablated area. Ablated area of specimen from group A is larger than that from group B and C.A. Specimen from group A administered through hepatic artery. B. Specimen from group B administered through auricular vein. C. Specimen from group C, control group, administered phosphate-buffered saline through auricular vein.

  • Fig. 3 Result of tumor ablation in each experimental group.A. Graph demonstrating overall ablation area in each group confirmed by triphenyltetrazolium chloride staining. Ablation was performed one hour after administration of arsenic trioxide in each group. Overall ablation area of group A was larger than that of group B (p < 0.01) and C (p < 0.001). Difference between group B and C was also statistically significant (p < 0.04). B. Graph demonstrating coagulated tumor area in each group. Ablation tumor area in group A was significantly larger than that of group B (p = 0.02) and C (p < 0.01). Difference between group B and C was not statistically significant. C. Graph demonstrating ratio tumor ablation of overall ablation area in each group, confirmed by triphenyltetrazolium chloride staining.


Cited by  1 articles

Evaluation of the In Vivo Efficiency and Safety of Hepatic Radiofrequency Ablation Using a 15-G Octopus® in Pig Liver
Eun Sun Lee, Jeong Min Lee, Kyung Won Kim, In Joon Lee, Joon Koo Han, Byung Ihn Choi
Korean J Radiol. 2013;14(2):194-201.    doi: 10.3348/kjr.2013.14.2.194.


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