Mass General Hospital - Department of Radiology - RFA

IS RFA SAFE?
IS RFA EXPERIMENTAL?
WHAT EQUIPMENT IS USED?
HOW IS THE HEATING OF THE TUMOR MONITORED?
HOW DO I KNOW IF I AM A CANDIDATE FOR THIS TREATMENT?
WHAT HAPPENS THE DAY OF THE PROCEDURE?

probe and prong IS RFA SAFE?

Since RFA is basically a derivative of a standard biopsy procedure, the risks and complications are similar to those of biopsy. The reported complication rate for this procedure is 3-5 %. However, typical precautions such as those used for any needle procedure are always employed. Patients are screened to make sure their blood clots normally. If the patient is on blood thinners, these are stopped and/or the patient is given blood products to make sure that the blood clots normally during the procedure.

IS RFA EXPERIMENTAL?

The FDA approves the RFA system for soft tissue tumors. The technique is safe based on extensive experience. It is a proven technique for some bone tumors (go to Osteoid Osteoma Treatment Web Site), but also recently RFA has been used for treatment of liver and kidney tumors. Recent reports are optimistic, but no prospective, randomized study has been performed comparing this method to other treatment methods for cancer of the liver and kidney.

WHAT EQUIPMENT IS USED?

The specific equipment used at the Massachusetts General Hospital is designed by Valley Lab (Boulder, Colorado) and RITA (Mountain View, California). The system employs a needle which is manufactured at different lengths. The working portion is an uninsulated tip which also comes in different lengths. This allows the radiologist to pick the best needle to use for individual patients. The uninsulated tip allows the energy to be focused only in the area of the tip of the needle. The radiologist can use either CT or ultrasound to best judge how many treatments are necessary and the correct location of the needle tip. In some cases, microwave energy might be used.

HOW IS THE HEATING OF THE TUMOR MONITORED?

Heating the tumor cells to a temperature over 50 degrees centigrade kills tumors. The machine monitors the temperature of the tissue. The machine automatically controls the temperature so that the heating doesn’t increase too much which would result in charring or burning of the tissues. Charring would result in less energy being deposited and less tumor volume killed.

HOW DO I KNOW IF I AM A CANDIDATE FOR THIS TREATMENT?

At Massachusetts General Hospital, we believe that the patient should have all possible treatment options available and reviewed. To achieve this, we employ the team approach. This means that all patients will have the option of seeing a medical and surgical specialist in addition to the radiologist who performs the procedure. If the patient has a kidney tumor, a urologic surgeon will also see the patient prior to the procedure. Similarly, if the patient has liver tumor, specialists in this area will be made available.

WHAT HAPPENS THE DAY OF THE PROCEDURE?

RFA is an outpatient procedure. Calls regarding questions before the procedure or problems after can be made to Cathy Saltalamacchia, RN in the Interventional Radiology Tumor Ablation Clinic at (617) 724-2239.

The patient should be NPO (no food or drink) after midnight.
The patient will arrive in our nursing area 7:30am the morning of the day of the procedure.
The patient should report to the Ellison 2 nursing area.
The patient will have an I.V. placed to give some fluids and drugs for sedation during the procedure.
The patient will be taken either to Ultrasound or CT (depending on which imaging method has been chosen) for the procedure.
The procedure will take about 1- 2 hours. Much of this time is setting up the equipment and making the patient comfortable. The actual heating time is about 15 minutes. Patients may have several sessions (heating times) in one visit. This is determined based on the findings at time of the procedure.
The patient is taken to the recovery area to be monitored by radiology nurses after the procedure.
The patient will, in most cases, go home that afternoon.
Your doctor will decide what follow-up care is needed. Usually CTs or MRIs are ordered as follow-up imaging studies as they are the best methods to determine if the tumor has been completely treated.