Rationale and objectives: To develop an experimental tumor model for RF ablation of breast tumors surrounded by fat and to investigate the minimally invasive treatment of such tumors by saline-enhanced RF ablation monitored by ultrasound (US).
Methods: Twenty-eight VX2 tumors were implanted into the retroperitoneum of 14 rabbits and monitored by B-mode US at regular intervals of 2 to 3 days. Saline-enhanced RF ablation (25-mm tip length) was performed 16 days after tumor implantation (10-minute treatment time, 28 W, 15 mL/h infusion of 0.9% NaCl, which was increased to 30 mL/h in cases of an impedance increase). Thermal lesion growth was monitored by B-mode US. Treatment was considered complete if no relapse was detectable histopathologically after a follow-up period of up to 3 weeks.
Results: All tumor implantations were successful, reaching sizes from 5 to 38 mm 16 days after implantation. Tumors >20 mm showed central necrosis on US. Smaller tumors without signs of necrosis required greater needle perfusion to maintain constant needle-to-tissue impedance. Local relapses occurred in 14 of 27 tumors (51.8%), all with tumors >20 mm. In 12 cases, they were already detected sonographically. In 2 cases, "islands" of vital tumor were detected only during histopathological assessment.
Conclusions: VX2 tumors are implantable into hypovascular adipose tissue with a high success rate and may be used as a model for RF ablation of breast tumors. B-mode US is not suitable for guiding RF ablation of tumors embedded in fat. The method appears to be more successful with smaller tumors.