Tumor Ablation with Radio-frequency Energy

Gazelle, G. Scott; Goldberg, S. Nahum; Solbiati, Luigi; Livraghi, Tito

doi:10.1148/radiology.217.3.r00dc26633

Cited by 666 publications

(381 citation statements)

References 77 publications

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“…Recent studies have shown the cost effectiveness [1], relatively low complication rates [2] and short hospital stays associated with thermal ablation. Early results suggest a high rate of local control of small or isolated liver lesions [3,4]. Local application of radiofrequency to tissue can create a controlled and predictable area of coagulation necrosis with little collateral damage.…”

Section: Introductionmentioning

confidence: 99%

“…Proximity of tumor to adjacent structures often influences the treatment plan. Although no controlled clinical studies have directly assessed the risk of cholecystitis after ablations adjacent to the gallbladder, reports of post-ablative cholecystitis have been influential in planning the treatment of liver tumors [3,4]. Some have noted that when treating tumors adjacent to the gallbladder and bowel, an open or laparoscopic technique provides the ability to mobilize adjacent vital structures away from the treatment area, thus decreasing the risk [4][5][6].…”

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confidence: 99%

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Radiofrequency Ablation Treatment in Proximity to the Gallbladder Without Subsequent Acute Cholecystitis

Patti

Neeman

Wood

2003

CardioVascular and Interventional Radiology

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Initial reports have suggested that proximity of liver tumors to the gallbladder may increase the risk for cholecystitis after radiofrequency ablation. A colon adenocarcinoma metastasis to the liver in contact with the gallbladder was successfully treated with radiofrequency ablation without subsequent cholecystitis. KeywordsCholecystitis; Radiofrequency ablation; RFA; Gallbladder; Liver Radiofrequency ablation is quickly becoming a valuable option in the treatment of certain unresectable liver tumors. Recent studies have shown the cost effectiveness [1], relatively low complication rates [2] and short hospital stays associated with thermal ablation. Early results suggest a high rate of local control of small or isolated liver lesions [3,4]. Local application of radiofrequency to tissue can create a controlled and predictable area of coagulation necrosis with little collateral damage. Currently, pre-procedural imaging studies are used to determine the spatial relationship of the tumor to organs such as gallbladder, diaphragm, major vessels and bowel. Proximity of tumor to adjacent structures often influences the treatment plan. Although no controlled clinical studies have directly assessed the risk of cholecystitis after ablations adjacent to the gallbladder, reports of post-ablative cholecystitis have been influential in planning the treatment of liver tumors [3,4]. Some have noted that when treating tumors adjacent to the gallbladder and bowel, an open or laparoscopic technique provides the ability to mobilize adjacent vital structures away from the treatment area, thus decreasing the risk [4][5][6]. A more recent report by Chopra et al. [5], demonstrated in 8 patients who were followed for a mean of 8 months, that radiofrequency ablation near the gallbladder is feasible and appears to be safe. Case ReportA 58-year-old man with a history of T3N1M1 adenocarcinoma of the colon presented with metastases to the liver 10 months after diagnosis and subsequent right hemicolectomy. Surgical history included a left thoracotomy for the repair of a hiatal hernia and duodenal ulcer 33 years prior to admission. The patient had no history of liver disease or alcoholism. MRI and CT of the liver revealed a small (1 cm) hypervascular enhancing lesion adjacent to the gallbladder within the right lobe of the liver (Fig. 1) and a smaller (>1 cm) lesion in the posterior aspect of the right lobe of the liver.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Radiofrequency Ablation Treatment in Proximity to the Gallbladder Without Subsequent Acute Cholecystitis

Patti

Neeman

Wood

2003

CardioVascular and Interventional Radiology

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“…With the beginning 1990 s, several working groups reported on successful experimental and clinical RF ablation of the liver [5,6]. Based on the experiences with large patient studies in the second half of the 1990 s [5] percutaneous RFablation is now a clinically established method of percutaneous treatment of primary and secondary liver tumors. However, it is not only restricted to the liver.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is not only restricted to the liver. In few and foremost preliminary reports the feasibility of percutaneous RF ablation of the bone, lung, brain, spleen and parathyroids was shown [5].…”

Section: Discussionmentioning

confidence: 99%

Nephron-sparing percutaneous ablation of a 5 cm renal cell carcinoma by superselective embolization and percutaneous RF-ablation

Tacke¹,

Mahnken²,

Bücker³

et al. 2001

Rofo

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Schlüsselwörter: Radiofrequenzablation (RF-Ablation) ± Embolisation (arteriell) ± Nierenzellkarzinom ± Therapie Abstract. Purpose: To report on the nephron-sparing, percutaneous ablation of a large renal cell carcinoma by combined superselective embolization and percutaneous radiofrequency ablation. Materials and Methods: A 5 cm renal cell carcinoma of a 43-year-old drug abusing male with serologically proven HIV, hepatitis B and C infection, who refused surgery, was superselectively embolized using microspheres (size: 500 ± 700 m) and a platinum coil under local anesthesia. Percutaneous radiofrequency ablation using a 7 F LeVeen probe (size of expanded probe tip: 40 mm) and a 200 Watt generator was performed one day after transcatheter embolization under general anesthesia. Results: The combined treatment resulted in complete destruction of the tumor without relevant damage of the surrounding healthy renal tissue. The patient was discharged 24 hours after RF ablation. No complications like urinary leaks or fistulas were observed and follow up CT one day and 4 weeks after the radiofrequency intervention revealed no signs of residual tumor growth. Conclusion: The combined transcatheter embolization and percutaneous radiofrequency ablation of renal cell carcinoma has proved technically feasible, effective, and safe in this patient. It may be offered as an alternative treatment to partial or radical nephrectomy under certain circumstances. Abbreviations: RF = radiofrequency ablation; CT = computed tomography; HIV = human immunodeficiency virus.

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“…Percutaneous radiofrequency ablation can be performed with the patient under local anesthesia and conscious sedation in the outpatient setting. Radiofrequency ablation has promising early results for the treatment of primary and secondary hepatic tumors and carries minimal risk [3]. Radiofrequency ablation has been described for the treatment of metastatic bone tumors and has been used for more than a decade for the treatment of osteoid osteoma.…”

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confidence: 99%

Percutaneous Radiofrequency Ablation of Chordoma

Neeman

Patti²,

Wood³

2002

American Journal of Roentgenology

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Chordomas originate in the notochord remnants and are difficult to manage with surgery and radiation therapy because of morbidity to collateral structures, such as nerves, and the high radiation doses that are required. We used percutaneous imaging-guided radiofrequency ablation to treat a patient whose chordoma had metastasized to the pararectal region and was causing local and sciatic pain. To our knowledge, radiofrequency ablation of a chordoma has not been previously reported.Chordomas are the most commonly occurring primary malignant spinal tumor. This infrequent tumor represents 1−4% of primary bone tumors. Chordomas arise within the axial skeleton, most commonly in the sacrococcygeal region (50−66%) and the base of the skull (approximately 35%); they have a metastatic rate of 5−43% [1]. Patient age at detection is between 30 and 70 years; chordomas are found more often in men than in women (ratio, 2 −3:1).A chordoma usually presents as an expansile, midline bone lesion with marked soft-tissue involvement. Intratumoral calcification is seen on CT in most patients. MR imaging shows a low or intermediate signal intensity on T1-weighted images and very high signal intensity on T2-weighted images, indicating high water content in the tumor. Contrast enhancement is typically seen on CT and MR imaging.The mainstay of treatment for chordomas is maximal debulking by surgery followed by adjuvant radiation or proton radiation treatment. Unfortunately, chordomas have a relatively high recurrence rate, low disease-free survival rates, and high rate of morbidity from conventional treatments. Surgery to debulk the tumor and reduce local pain can also be considered for palliation [2].Radiofrequency ablation is a well-established, minimally invasive technique for unresectable liver tumors. Percutaneous radiofrequency ablation can be performed with the patient under local anesthesia and conscious sedation in the outpatient setting. Radiofrequency ablation has promising early results for the treatment of primary and secondary hepatic tumors and carries minimal risk [3]. Radiofrequency ablation has been described for the treatment of metastatic bone tumors and has been used for more than a decade for the treatment of osteoid osteoma. Although this technique has been given clearance for soft-tissue ablation under section 510(k) regulations of the United States Food and Drug Administration, it has not been validated for the treatment of chordomas. We describe the successful application of radiofrequency ablation in a patient with a chordoma. TechniqueA 62-year-old woman presented with a slowly enlarging pararectal tumor. She had a 16-year history of recurrent sacral chordomas, despite having undergone multiple surgical re-sections,

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Tumor Ablation with Radio-frequency Energy

Cited by 666 publications

References 77 publications

Radiofrequency Ablation Treatment in Proximity to the Gallbladder Without Subsequent Acute Cholecystitis

Radiofrequency Ablation Treatment in Proximity to the Gallbladder Without Subsequent Acute Cholecystitis

Nephron-sparing percutaneous ablation of a 5 cm renal cell carcinoma by superselective embolization and percutaneous RF-ablation

Percutaneous Radiofrequency Ablation of Chordoma

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