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Learn about interventional radiology
Massachusetts General Hospital Imaging provides RFA (radiofrequency ablation), a minimally invasive, image-guided treatment for some types of cancer, on the Mass General main campus in Boston. Performed by specially trained radiologists using real-time image guidance, interventional-radiology procedures such as RFA often require smaller incisions, have fewer risks of complication, and take less recovery time than traditional surgery.
RFA in depth
What is RFA?
Radiofrequency ablation (RFA) is a procedure that destroys tumor cells by heating them using a needle electrode and high-frequency electrical currents. Ultrasound or CT imaging may be used to help the radiologist guide the needle into the tumor.
Over the last few years, developments in tumor ablation have allowed large volume tissue ablation to be performed safely on selected patients. While other minimally invasive methods of tumor ablation have been used, at this point in time, RFA has been the most commonly used method.
When should I consider RFA?
Radiofrequency ablation can be a viable and effective treatment option for patients who wish to avoid conventional surgery or are too ill to undergo surgery. RFA can be an appropriate treatment for cancer of the liver, kidney, lung, and bones, depending on the specifics of each case. RFA may also be used to reduce the size of a tumor so that it can be more easily eliminated by conventional treatment (chemotherapy or radiation) or to provide relief when a tumor invades the chest wall and causes pain.
The interventional radiologists who perform procedures at Mass General Imaging are specialists in the area of the body and the condition under treatment, as well as the procedure itself. In addition to the training that all radiologists receive, these specialists have additional education, plus extensive real-world experience. In many cases, our doctors helped to pioneer many of the interventional treatments that we offer.
Our team of interventional radiologists and nurse practitioners coordinates a patient's complete care—from imaging evaluation to post-procedure followup—maintaining a high level of communication with the patient throughout the process. In addition, Mass General Imaging works in close coordination with experts from across Mass General when necessary.
What should I expect BEFORE RFA?
Prior to your procedure, your blood may be tested to determine how well your kidneys are functioning and whether your blood clots normally. Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy because radiation can be harmful to the fetus. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.
You may be instructed not to eat or drink anything after midnight before your procedure. Your doctor will tell you which medications you may take in the morning. The procedure is usually performed in the morning and is most often done on an outpatient basis. You should plan to have a relative or friend drive you home after your RFA procedure.
What should I expect DURING RFA?
RFA is usually performed under intravenous (conscious) sedation. You will be awake and will be given sedatives to help you relax. Most patients remain comfortable during the procedure and require no pain medication.
The RFA procedure will take one to two hours. Much of this time is spent setting up the equipment and making you comfortable.
The doctor will insert a small needle into the tumor using ultrasound or CT image guidance. The needle sends high-frequency electrical currents into the tumor, causing the tumor cells to heat up and die. By repositioning the needle, the doctor can perform additional ablations. Each heating takes about 15 minutes. Typically, RFA can create a kill area of 3 to 4 cm in size. The killed cells are not removed, but slowly are absorbed and digested by the natural "immune" system of the body, and a scar appears in the treated area.
What should I expect AFTER RFA?
You will remain in the recovery room until you are completely awake and ready to return home. You should be able to resume your usual activities within a few days.
Pain immediately following radiofrequency ablation can be controlled by pain medication given through your IV or by injection. Afterward any mild discomfort you experience can be controlled by oral pain medications. A few patients feel nauseous, but this can also be relieved by medication.
Department of Radiology Chairman Emeritus James H. Thrall, MD, explains how the ability to see deep inside the body has driven the development of minimally invasive methods of treatment—a trend in which Mass General Imaging has played a key role.
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