Radiofrequency ablation (RFA) is a procedure used to treat certain tumors in certain parts of the body. A special needle is placed through the skin into the tumor. A generator sends radiofrequency energy through the needle; the energy heats the tissue around the needle; killing tumor cells in the area. Cryoablation is a similar procedure in which a needle is inserted to kill tissue by freezing.

Radiofrequency ablation is most commonly used for treatment of the following types of tumors.

• Liver tumors: Hepatocellular carcinoma, which is a tumor that originates in the liver from abnormal liver cells. Metastases from colon and rectal cancer. Metastases from cancers of other organs are rarely treated with RFA.
• Bone tumors: Most commonly metastases to bone from cancers of other organs. RFA can be used to treat bone tumors that are causing significant pain that does not respond well to pain medications.
• Other tumors: RFA can be used to treat tumors in a variety of locations when those tumors are causing pain that does not respond well to pain medications. Certain lung cancers and other tumors are occasionally treated with RFA.

Radiofrequency ablation is only appropriate for a small percentage of patients with cancer. When tumors are potentially curable, surgical resection of the tumor is generally the preferred method of treatment. However, some patients may not be able to have surgery due to illnesses that make surgery too risky or due to tumor locations. In these cases, RFA may be a good option for treatment of the tumor. Likewise, tumors that are causing pain may be treated with surgery, radiation or chemotherapy. However, in some cases, RFA can be used to rapidly shrink the tumor and reduce the pain caused by the tumor.

Clinical Radiologists has been performing radiofrequency ablations at Memorial Medical Center since 1999. We have physicians with advanced training in imaging guided procedures who can evaluate patients prior to the procedure, perform the procedure and help to follow patients after the procedure. We have used RFA to treat a variety of liver tumors, kidneys tumors as well as painful tumors elsewhere in the body.

How do I know whether I am a candidate for RFA?

Your oncologist, surgeon or primary physician should know whether RFA may be an appropriate treatment option for your tumor or condition. If so, you will receive an appointment to meet with a radiologist who performs radiofrequency ablations. The radiologist will discuss the procedure with you and answer questions you have. Together you can decide whether RFA is appropriate and whether to proceed with RFA. (Radiologists have additional means of treating some tumors, including chemoembolization and injection of cell-killing substance into tumors. If appropriate, we may recommend an alternative treatment or a combination of two approaches.)

How is the RFA procedure performed?

RFA will be performed either under general anesthesia or a combination of local anesthesia and IV sedation (a combination of anti-anxiety medicines and narcotic pain relievers given through an intravenous line). Using either ultrasound or CT for guidance, the radiologist will advance a special needle into the tumor. This part of the procedure is the same as a biopsy. Once the needle has been positioned, the generator will be activated and the tissue heated. Depending upon the size and location of the tumor, one burn or several burns may be needed. For larger tumors, the radiologist will position the needle in different parts of the tumor to try to kill the entire tumor. In some cases, more than one tumor can be treated during a given session.

      View how this procedure is performed >>

This video may be viewed using Windows Media Player, or QuickTime

What happens the day of the procedure?

The radiofrequency ablations are generally performed as outpatient procedures. You will report to the hospital very early in the morning, a couple hours prior to the scheduled start of the procedure. You will be checked into the same day care ward, have an IV line placed, and be prepared for the procedure. After the procedure you will return to the same day care ward to be observed for the remainder of the day. (If the procedure is performed with general anesthesia, you will go to the recovery room first, then back to the same day care area.) You will be at bed rest for several hours while being observed and having vital signs monitored. Any pain resulting from the procedure can be treated. Most patients will be discharged to home late in the afternoon. Some patients may be admitted overnight if they have significant pain, complications or any other medical problems.

Are there potential complications from RFA?

RFA is a generally safe and minimally invasive means of treating appropriate tumors. It is often a less risky alternative to surgery. However, like any invasive procedure, it does carry some risks.

• There is a risk of pain from the procedure and patients are rarely admitted overnight for pain control. Most patients are discharged with some pain medicines to take at home.
• There is a small risk of bleeding. Bleeding that requires hospitalization, blood transfusion or that is life threatening, is quite rare.
• Depending upon tumor location, there may be a risk of damage to the organ being treated, or to adjacent organs. This will vary from patient to patient and can be addressed during your pre-procedure appointment with the radiologist.
• The tissue that is heated and killed remains in the body. The body’s natural response to this tissue can leave you feeling “punky” and with a low-grade fever for several days. Rarely the necrotic tissue can become infected.
• Although the needle is placed into the tumor and then withdrawn, the chance of spreading the tumor with the needle is extremely low since the heat should kill tumor cells near the needle.

How will I know whether the procedure was successful?

The goal of RFA will vary from patient to patient. If the procedure is performed to treat a painful lesion, we will know within several days whether the procedure was a success. In some cases, the goal may be to shrink a tumor, which is usually relatively easy to accomplish. In some cases, the goal will be to completely eliminate a particular tumor, as if it had been removed surgically. This can be difficult to accomplish, and unfortunately, it is usually not possible to know at the time of the procedure whether a particular tumor has been completely eradicated. We generally recommend that a patient have a follow-up CT scan about a month after the procedure. The CT scan will usually allow us to determine whether the treatment was completely successful. In some cases, a portion of the tumor which was not successfully ablated with the initial procedure can be retreated. Even in cases where the tumor is not entirely eradicated, patients may benefit from partial treatment; shrinking the tumor, or “reducing the tumor burden on the body” may help patients to feel better and may help chemotherapy agents to work better.

An image from a CT scan of the liver shows a 1.5 cm spot that represents colon cancer that has spread to the liver.	An image from a CT scan over month after RFA shows a “hole” in the liver where the tumor was.  The “hole” is bigger than the tumor and no residual tumor is seen.
An image from a CT scan is months after RFA shows the “hole” in the liver has gotten smaller.  No residual tumor is seen.

Back To Top