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Learn about interventional radiology
Massachusetts General Hospital Imaging provides image-guided ablation, a minimally invasive, 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 image-guided ablation often require smaller incisions, have fewer risks of complication, and take less recovery time than traditional surgery.
Image-guided ablation overview
Image-guided ablation in depth
What is image-guided ablation?
Image-guided ablation is a procedure that destroys tumor cells with either extreme heat (radiofrequency and microwave ablation) or extreme cold (cryoablation). Energy is delivered through the skin with a needle. 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 select patients.
When should I consider image-guided ablation?
Image-guided ablation can be a viable and effective treatment option for patients who wish to avoid conventional surgery or are too ill to undergo surgery. Image-guided ablation can be an appropriate treatment for cancer of the liver, kidney, lung, and bones, depending on the specifics of each case. Image-guided ablation 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 follow-up—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 image-guided ablation?
You may want to meet your interventional radiologist and discuss the procedure during a dedicated clinic visit. Your blood may be tested to determine how well your kidneys are functioning and whether your blood clots normally. Women should always inform their doctor 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 procedure.
What should I expect DURING image-guided ablation?
Image-guided ablation 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 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 delivers either extreme heat or cold into the tumor, causing the tumor cells to die. Typically, image-guided ablation can create a “kill area” of 3 to 4 cm in size. The dead cells are not removed but are slowly absorbed and digested by the body’s natural immune system , and a scar appears in the treated area.
What should I expect AFTER image-guided ablation?
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 image-guided 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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