Feasibility and Safety of Radiofrequency Ablation Guided by Bronchoscopic Transparenchymal Nodule Access in Canines

Background: The treatment of pulmonary malignancies remains a challenge. The efficacy and safety of bronchoscopic radiofrequency ablation (RFA) for the treatment of lung cancer are not well elucidated. Objective: This study aimed to evaluate the feasibility and safety of RFA guided by bronchoscopic transparenchymal nodule access (BTPNA) in vivo. Methods: In an attempt to determine the parameters of RFA, we first performed RFA in conjunction with automatic saline microperfusion in the lung in vitro with various ablation energy (10, 15, 20, 25, and 30 W) and ablation times (3, 5, 8, and 10 min). The correlation between ablated area and RFA parameter was recorded and analyzed. Further, we conducted a canine study with RFA by BTPNA in vivo, observing the ablation effect and morphological changes in the lung assessed by chest CT and histopathologic examination at various follow-up time points (1 day, n = 3; 30 days, n = 4; 90 days, n = 4). The related complications were also observed and recorded. Results: More ablation energy, but not ablation time, induced a greater range of ablation area in the lung. Ablation energy applied with 15 W for 3 min served as the appropriate setting for pulmonary lesions

背景：肺部恶性肿瘤的治疗仍然是一个挑战。支气管镜射频消融（RFA）治疗肺癌的有效性和安全性尚未得到很好的阐明。 目的：本研究旨在评估在体内通过支气管镜经肺实质结节通路（BTPNA）引导的RFA的可行性和安全性。 方法：为了确定RFA的参数，我们首先在体外肺中联合自动生理盐水微量灌注，采用不同的消融能量（10、15、20、25和30瓦）以及消融时间（3、5、8和10分钟）进行RFA。记录并分析消融面积与RFA参数之间的相关性。此外，我们在体内通过BTPNA进行犬类RFA研究，在不同的随访时间点（1天，n = 3；30天，n = 4；90天，n = 4）通过胸部CT和组织病理学检查观察肺部的消融效果和形态学变化。同时观察并记录相关并发症。 结果：更高的消融能量而非消融时间会导致肺部更大范围的消融区域。15瓦持续3分钟的消融能量是肺部病变的合适设置。