Microwave ablation of the adrenal gland: experimental study and clinical application

Kigure, Teruaki; Harada, Tadashi; Satoh, Yoshinobu; Fujieda, Nobuo; Wakayama, Yukiko

doi:10.1046/j.1464-410x.1996.86210.x

Cited by 11 publications

(7 citation statements)

References 1 publication

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“…Similarly, peak temperatures of 48-50 C for 90 s have been shown to produce necrosis in myocardium in vitro and ex-vivo 42,43 . Results obtained by Kigure et al 21 for microwave heating of the adrenal gland in dogs suggest that a thermal profile >60 C for 25 s leads to coagulative necrosis. All these studies used histology as the marker of tissue injury and analysed injury 24-72 h after thermal treatment.…”

Section: Injury Thresholdsmentioning

confidence: 94%

“…However, the 'thermal lag' or time required to reach the desired target temperature (above 50 C) associated with this assay is excessive and, therefore, clonogenic assays are sub-optimal for quantifying cell destruction after thermal therapy in vitro 14 . Investigators have used various qualitative techniques to measure post-thermal tissue injury, including tumour size reduction [15][16][17][18] , histology and/or viability dye analyses 2,[19][20][21][22] . These studies have correlated global tissue injury with either the probe tip temperature 2,19,22 or temperature measurements at discrete distances from the probe 20,21 .…”

Section: Introductionmentioning

confidence: 99%

“…Investigators have used various qualitative techniques to measure post-thermal tissue injury, including tumour size reduction [15][16][17][18] , histology and/or viability dye analyses 2,[19][20][21][22] . These studies have correlated global tissue injury with either the probe tip temperature 2,19,22 or temperature measurements at discrete distances from the probe 20,21 . While cell-based studies help identify irreversible cell injury thresholds, the lack of correlation between regional tissue injury and local in vivo temperatures cause difficulty in establishing the thermal threshold required for irreversible tissue injury 23 .…”

Section: Introductionmentioning

confidence: 99%

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In vitrothermal therapy of AT-1 Dunning prostate tumours

Bhowmick

Coad

Swanlund

et al. 2004

International Journal of Hyperthermia

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To advance the utility of prostate thermal therapy, this study investigated the thermal thresholds (temperature-time) for prostate tissue destruction in vitro. The AT-1 Dunning prostate tumour model was chosen for the study. Three hundred micron thick sections were subjected to controlled temperature-time heating, which ranged from low (40 degrees C, 15 min) to high thermal exposures (70 degrees C, 2 min) (n = 6). After subsequent tissue culture at 37 degrees C, the sections were evaluated for tissue injury at 3, 24 and 72 h by two independent methods: histology and dye uptake. A graded increase in injury was identified between the low and high thermal exposures. Maximum histologic injury occurred above 70 degrees C, 1 min with >95% of the tissue area undergoing significant cell injury and coagulative necrosis. The control and 40 degrees C, 15 min sections showed histologic evidence of apoptosis following 24 and 72 h in culture. Similar signs of apoptosis were minimal or absent at higher thermal histories. Vital-dye uptake quantitatively confirmed complete cell death after 70 degrees C, 2 min. Using the dye data, Arrhenius analysis showed an apparent breakpoint at 50 degrees C, with activation energies of 135.8 kcal/mole below and 4.7 kcal/mole above the threshold after 3 h in culture. These results can be used as a conservative benchmark for thermal injury in the cancerous prostate. Further characterization of the response to thermal therapy in an animal model and in human tissues will be important in establishing the efficacy of the procedure

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Section: Injury Thresholdsmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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In vitrothermal therapy of AT-1 Dunning prostate tumours

Bhowmick

Coad

Swanlund

et al. 2004

International Journal of Hyperthermia

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“…vasive surgical alternatives. 7,[11][12][13][14] Thermal ablation of tumors including cryosurgery, microwave ablation, and radiofrequency ablation (RFA) have developed rapidly in human surgery. 7,11,[15][16][17] Most tumor ablation devices currently used clinically in humans use radiofrequency current, which generate frictional heating from ion agitation, i.e.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Changes During Laparoscopic Radiofrequency Ablation of Normal Adrenal Tissue in Dogs

et al. 2009

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“…Although treatment of APAs with venous infarction and radiofrequency ablation have been reported,66 the treatment of choice for APA and PAH is unilateral total adrenalectomy. The preoperative blood pressure response to spironolactone often predicts the blood pressure response to unilateral adrenalectomy in patients with APA.…”

Section: Treatmentmentioning

confidence: 99%

Primary Aldosteronism

Young

2002

Annals of the New York Academy of Sciences

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Since its initial description in 1955, primary aldosteronism was thought to be a rare cause of hypertension. However, improved screening methods show that primary aldosteronism is a common form of secondary hypertension. Diagnosis of this disorder results in improved or cured hypertension or targeted pharmacotherapy. Patients with hypertension and hypokalemia and most patients with treatment-resistant hypertension should undergo screening for primary aldosteronism. A random and ambulatory ratio of plasma aldosterone concentration (PAC) to plasma renin activity (PRA) that is elevated and a PAC higher than a set cutoff is a positive screen for primary aldosteronism. An increased PAC/PRA ratio alone is not diagnostic of primary aldosteronism; primary aldosteronism must be confirmed by demonstrating inappropriate aldosterone secretion with either the intravenous saline suppression test or measurement of 24-hr urinary aldosterone while the patient is on a high-sodium diet. The two major subtypes of primary aldosteronism are unilateral aldosterone-producing adenoma (APA) and bilateral idiopathic hyperplasia (IHA). Patients with APA are usually treated with unilateral adrenalectomy, and patients with IHA are treated medically. The subtype evaluation may require one or more tests, the first of which is imaging the adrenals with computerized tomography (CT). When a solitary unilateral macroadenoma (> 1 cm) and normal contralateral adrenal morphologic pattern are found on CT in a young patient with primary aldosteronism, unilateral laparoscopic adrenalectomy is a reasonable therapeutic option. However, in many cases, CT imaging may reveal normal-appearing adrenals or ambiguous findings. Adrenal venous sampling helps to resolve these clinical dilemmas.

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Microwave ablation of the adrenal gland: experimental study and clinical application

Abstract: Microwave ablation of the adrenal gland may be clinically applicable in the treatment of adrenal tumours.

Cited by 11 publications

References 1 publication

In vitrothermal therapy of AT-1 Dunning prostate tumours

In vitrothermal therapy of AT-1 Dunning prostate tumours

Hemodynamic Changes During Laparoscopic Radiofrequency Ablation of Normal Adrenal Tissue in Dogs

Primary Aldosteronism

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