Radiofrequency ablation (RFA) is a medical procedure in which part of the electrical conduction system of the heart, tumor or other dysfunctional tissue is ablated using the heat generated from medium frequency alternating current (in the range of 350–500 kHz). RFA is generally conducted in the outpatient setting, using either local anesthetics or conscious sedation anesthesia.
Two important advantages of RF current (over previously used low frequency AC or pulses of DC) are that it does not directly stimulate nerves or heart muscle and therefore can often be used without the need for general anesthetic, and that it is very specific for treating the desired tissue without significant collateral damage.
In radiofrequency ablation, imaging techniques such as ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) are used to help guide a needle electrode into a cancerous tumor. High-frequency electrical currents are then passed through the electrode, creating heat that destroys the abnormal cells. Sometimes, to be sure the treatment is aimed at the right place it may be done during surgery.
Common Uses of Radiofrequency Ablation
Radiofrequency ablation is used to treat many types of liver cancer, most common types are:
- Hepatocellular Carcinoma, which is a primary liver cancer, originating in the liver.
- Colon cancer that metastasizes or spreads from the colon to the liver.
Radiofrequency ablation is a viable and effective treatment option if the patient:
Radiofrequency ablation is performed using one of three methods:
- Patient is not a good candidate for surgery because his tumor is difficult to reach.
- Patient would not have enough liver tissue left for the organ to function adequately following the surgical removal of a tumor.
- Patient has liver tumors that have not responded to chemotherapy or that have recurred after being removed surgically.
- Patient has several small liver tumors that are too spread out to be removed surgically.
Procedure of Radiofrequency Ablation
Image-guided, minimally invasive procedures such as radiofrequency ablation are most often performed by a specially trained interventional radiologist in an interventional radiology suite or occasionally in the operating room.
Radiofrequency ablation is often done on an outpatient basis. Liver tumors small in size can be treated with one ablation. The patient is positioned on the examining table. The monitors track the patient’s heart rate, blood pressure and pulse during the procedure. A nurse then insert an intravenous (IV) line into a vein in the hand or arm so that sedation medication can be given intravenously. The area where the electrodes are to be inserted are sterilized and covered with a surgical drape. A very small nick may be made in the skin to make it easier to pass the RFA electrode into the liver.
- Surgically.
- Percutaneous, in which needle electrodes are inserted through the skin and into the site of the tumor.
- Laparoscopic, in which needle electrodes within a thin, plastic tube is threaded through a small hole in the skin in a procedure called a laparoscopy.
For a large tumor, it may be necessary to do multiple ablations by repositioning the needle electrode into different parts of the tumor to ensure no tumor tissue is left behind. At the end of the procedure, the needle electrode will be removed and pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. No sutures are needed.
Each radiofrequency ablation takes about 10 to 30 minutes, with additional time required if multiple ablations are performed. The entire procedure is usually completed within one to three hours.
Benefits of RFA
Proven technology - Since the RFA program began in 1999, hundreds of patients have received this form of therapy at the Liver Cancer Center.
Minimal Invasive:A major advantage of RFA is that the procedure can often be done using minimally invasive surgery. Only a small nick in the skin that does not have to be stitched closed.
Can be repeated if new cancer appears:Radiofrequency ablation may be used repeatedly to treat recurrent liver tumors.
Rapid Recovery:RFA is a relatively quick procedure and recovery is rapid so that chemotherapy may be resumed almost immediately in patients who need it.
Less Expensive: Radiofrequency ablation is less expensive than other treatment options.
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