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5 - Image-guided Interventions: Fundamentals of Radiofrequency Tumor Ablation

from PART II - PRINCIPLES OF IMAGE-GUIDED THERAPIES

Published online by Cambridge University Press:  18 May 2010

By
Andrew Hines-Peralta  and
S. Nahum Goldberg
Edited by
Jean-François H. Geschwind  and
Michael C. Soulen
Andrew Hines-Peralta
Affiliation:
Radiologist, Beth Israel Deaconess Medical Center Department of Radiology Boston, MA
S. Nahum Goldberg
Affiliation:
Professor in Radiology, Department of Radiology Beth Israel Deaconess Medical Center Boston, MA
Jean-François H. Geschwind
Affiliation:
The Johns Hopkins University School of Medicine
Michael C. Soulen
Affiliation:
University of Pennsylvania School of Medicine
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Summary

KEY POINTS

  • Radiofrequency (RF) ablation is a viable alternative for the treatment of many solid focal malignancies, especially in the non-surgical candidate.

  • Benefits of RF ablation include low morbidity and mortality, low cost, non-surgical patient inclusion, and same-day discharge.

  • Successful treatment is a balance between complete tumor destruction and minimizing damage to surrounding normal parenchyma and adjacent structures.

  • The bio-heat equation states: coagulation necrosis = energy deposited × local tissue interactions – heat loss. This forms the foundation of RF ablation.

  • Widespread adoption of RF ablation will rely upon improving and increasing tumor ablation volume. Adjuvant therapies such as antiangiogenetics, chemotherapeutics, embolization, and radiation in this capacity hold great promise.

INTRODUCTION

Minimally invasive RF ablation continues to gain attention as a viable option for the treatment of multiple solid malignancies given continued favorable outcome studies coupled with scarce complications (1–4). Advantages of RF ablation include a wider spectrum of patients, including non-surgical candidates and outpatients, along with lower immediate morbidity and mortality, and lower cost (5–6). For these reasons and impressive initial outcomes, the indications continue to broaden to include multiple tumor types, multiple locations and ever-expanding patient selection criteria. Currently, the most commonly ablated tumor worldwide is focal hepatic cell carcinoma (HCC), but rapid acceptance of renal cell carcinoma (RCC) has been shown in many parts of the world, including the United States (7–12).

Type
Chapter
Information
Interventional Oncology
Principles and Practice
 , pp. 55 - 66
Publisher: Cambridge University Press
Print publication year: 2008

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