Learning objectives
With the use of extensive images,
this poster will review the use of pulmonary RFA,
including indications,
patient selection,
practical technique and useful tips,
follow-up imaging appearances and complications.
Background
Radiofrequency ablation is an image guided,
minimally invasive technique used to destroy tumour tissue.
Current is passed from an electrode through the patient’s tissues and is grounded via skin pads.
Ionic agitation in the tissues adjacent to the needle tip produces heating.
Cell death occurs if heating of over 50 degrees is achieved for 5 minutes.
Current applications include local treatment of lung,
liver,
renal and bone tumours.
There is growing evidence of its efficacy and in recent published guidance the Royal College of Radiologists...
Findings and procedure details
Tip 1: Staffing
Dedicated team of nurses and radiographers familiar with the procedure.
Prospective data base of patients.
Tip 2: Careful patient selection
True oligometastatic disease (<3 lesions per organ fare better than those with more lesions).
Lesions less than 4 cm in diameter have a better outcome.
Period of at leat 12 months between primary diagnosis and presentation of metastases.
PET prior to RFA is very useful to exclude more widespread disease.
Tip 3: Use Conscious sedation whenever possible
RFA is generally very well...
Conclusion
RFA is generally a safe procedure.
There is a steep learning curve in both performing ablation and assessing follow up imaging.
This poster shares our experience of performing over 200 lung ablation procedures.
References
(1) Standards for Radiofrequency Ablation,
RCR,
2009.
(2) N076 NICE guidance 2004.