TCRT June 2007

category image Volume 6
No. 3 (p 151-254)
June 2007
ISSN 1533-0338
Thermal Therapy

Conductive Interstitial Thermal Therapy (CITT) Device Evaluation in VX2 Rabbit Model (p. 235-246)

We have developed a conductive interstitial thermal therapy (CITT) device to precisely and reliably deliver controlled thermal doses to the surgical margins at the cavity site following tumor resection, intraoperatively. The temperature field created by CITT ablation of a perfused tissue was modeled with a finite element package Femlab™. The modeling suggested that a maximum probe temperature of 120 °C and an ablation time of 20 minutes were required to ablate highly perfused tissue such as the VX2 carcinoma. Deployable pins enable faster and more reliable thermal ablation. The model predictions were tested by thermal ablation of VX2 carcinoma tumors implanted in adult New Zealand rabbits. The size of the ablated region was confirmed with a viability stain, triphenyltetrazolium chloride (TTC). Histopathological examination revealed 3 regions in the ablated area: a carbonized region (1-3 mm); a region that contained thermally fixed cells; and an area of coagulated necrosis cells. Cells in the thermally fixed region stained for PCNA (proliferating cell nuclear antigen) and were bounded by the carbonized layer at the cavity wall, and by necrotic cells that exhibit nuclear fragmentation and cell dissociation, 5 to 10 mm away from the CITT probe. Adjacent tissue outside the target region was spared with a clear demarcation between ablated and normal viable tissue. It is suggested that the CITT device can be used, clinically, to inhibit local recurrence by creating negative surgical margins following the resection of a primary tumor in non-metastatic early staged tumors.

Key words: Thermal ablation, conductive interstitial thermal therapy (CITT), VX2 carcinoma, triphenyltetrazolium chloride (TTC), PCNA (proliferating cell nuclear antigen, finite element method (FEM), Mathematical modeling.

Gal Shafirstein, Ph.D.1*
Leah Hennings, D.V.M.2
Yihong Kaufmann, Ph.D.3
Petr Novak, Ph.D.4
Eduardo G. Moros, Ph.D.4
Scott Ferguson1
Eric Siegel, M.S.5
Suzanne V. Klimberg, M.D.2,6
Milton Waner, M.D.1
Paul Spring, M.D.1,3

1Dept. of Otolaryngology
Univ. of Arkansas, Medical Sciences
4301 West Markham
Little Rock, AR, USA
2Dept. of Pathology
Univ. of Arkansas, Medical Sciences
Little Rock, AR, USA
3Dept. of Surgery
John McClellan VA Hospital
Little Rock, AR, USA
4Dept. of Radiation Oncology
Univ. of Arkansas, Medical Sciences
Little Rock, AR, USA
5Dept. of Biostatistics
Univ. of Arkansas, Medical Sciences
Little Rock, AR, USA
6Dept of Surgery and Pathology
Univ. of Arkansas, Medical Sciences
Little Rock, AR, USA

*Shafirsteingal@uams.edu

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