Skip to main content
SpringerLink
Log in

Radiofrequency Tumor Ablation: Principles and Techniques

  • Chapter
Multi-Treatment Modalities of Liver Tumours

Abstract

The purpose of this article is to review the basic principles of radiofrequency [RF] thermal ablation with the goal of providing insights into achieving optimal results (i.e. reproducible large volume tissue coagulation) in the safest possible manner. This article will attempt to provide a better understanding of radiofrequency ablation that can hopefully be applied to clinical practice with favorable results.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  1. Gazelle GS, Goldberg SN, Solbiati L and Livraghi T. Tumor Ablation with Radio-frequency Energy. Radiology 2000; 217:633–646

    PubMed  CAS  Google Scholar 

  2. Goldberg SN, Gazelle GS, and Mueller PR. Thermal ablation therapy for focal malignancy: A unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR 2000 174:323–331

    PubMed  CAS  Google Scholar 

  3. Dodd GD 3rd, Soulen MC, Kane RA, Livraghi T, Lees WR, Yamashita Y, Gillams AR, Karahan OI, Rhim H. Minimally invasive treatment of malignant hepatic tumors: at the threshold of a major breakthrough. Radiographics 2000; 20:9–27.

    PubMed  Google Scholar 

  4. McGahan, JP, Dodd, GD, Radiofrequency ablation of the liver: Current status AJR 2001 (in press)

    Google Scholar 

  5. Rossi S, Buscarini E, Garbagnati F, et al. Percutaneous treatment of small hepatic tumors by an expandable RF needle electrode. AJR 1998; 170:1015–1022

    PubMed  CAS  Google Scholar 

  6. Solbiati L, Goldberg SN, Ierace T, Livraghi T, Sironi S, and Gazelle GS. Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes. Radiology 1997; 205:367–374

    PubMed  CAS  Google Scholar 

  7. Livraghi T, Goldberg SN, Meloni F, Solbiati L, and Gazelle GS. Hepatocellular carcinoma: comparison of efficacy between percutaneous ethanol instillation and radiofrequency. Radiology 1999; 210:655–661

    PubMed  CAS  Google Scholar 

  8. Livraghi T, Goldberg SN, Meloni F, Solbiati L, and Gazelle GS. Radiofrequency of large hepatocellular carcinomas. Radiology 2000; 214:761–768

    PubMed  CAS  Google Scholar 

  9. Curley SA, Izzo F, Delrio P, et al. Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients. Ann Surg 1999; 230:1–8

    Article  PubMed  CAS  Google Scholar 

  10. Birdwell RL, Jefferey SS, Kermit EL, Ikeda DM, Nowells KW. Preliminary experience with intraoperative radiofrequency breast tumor ablation. Radiology 1998; 209(P):198

    Google Scholar 

  11. Anzai Y, Lufkin R, DeSalles A, Hamilton DR, Farahani K, Black KL. Preliminary experience with MR-guided thermal ablation of brain tumors. AJNR 1995; 16:39–48

    PubMed  CAS  Google Scholar 

  12. Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gephart MC, Mankin HJ. Changes in the management of osteoid osteoma. J Bone Joint Surg (Am) 1998; 80:815–821

    CAS  Google Scholar 

  13. Dupuy DE, Hong R, Oliver BS, and Goldberg SN. Radiofrequency Ablation of Spinal Tumors: Temperature Distribution in the Spinal Canal. AJR 2000; 175:1263–1266.

    PubMed  CAS  Google Scholar 

  14. Zlotta AR, Wildschutz T, Raviv G, et al. Radiofrequency interstitial tumor ablation (RITA) is a possible new modality for treatment of renal cancer: ex vivo and in vivo experience. J Endourol 1997; 11:251–8

    Article  PubMed  CAS  Google Scholar 

  15. McGovern FJ, Wood BJ, Goldberg SN, Mueller PR. Radiofrequency ablation of renal cell carcinoma via image guided needle electrodes. J Urol 1999;161:599–600.

    Article  PubMed  CAS  Google Scholar 

  16. Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WW, Kavanaugh PV, Safran H. Percutaneous RF ablation of malignancies in the lung. AJR 2000. 174:57–60

    PubMed  CAS  Google Scholar 

  17. Lewin JS, Connell CF, Duerk JL, et al. Interactive MRI-guided radiofrequency interstitial thermal ablation of abdominal tumors: clinical trial for evaluation of safety and feasibility. JMRI 1998; 8:40–47

    Article  PubMed  CAS  Google Scholar 

  18. Livraghi T, Giorgio A. Marin G, et al. Hepatocellular carcinoma and cirrhosis in 746 patients: Long-term results of percutaneous ethanol injection. Radiology 1995; 197:101–8

    PubMed  CAS  Google Scholar 

  19. Shiina S., Tagawa K., Niwa Y et al. Percutaneous ethanol injection therapy for hepatocellular carcinoma: Results in 146 patients. AJR 1993;160: 1023–1028

    PubMed  CAS  Google Scholar 

  20. Mueller PR, Charboneau JW, Chezmar IL, et al. North American experience with percutaneous alcohol ablation in 141 patients: Complications and overview. Radiology 1995; 197:P200

    Google Scholar 

  21. Hahn PF, Gazelle GS, Jiang DY, Compton CC, Goldberg SN, Mueller PR. Liver tumor ablation: Real-time monitoring using dynamic CT imaging. Acad Radiol 1997; 4:634–8

    Article  PubMed  CAS  Google Scholar 

  22. Ohnishi K, Ohyama N, Ito S, Fujiwara K. Small hepatocellular carcinoma: treatment with US-guided intratumoral injection of acetic acid. Radiology 1994; 193:747–52

    PubMed  CAS  Google Scholar 

  23. Seki T, Wakabayashi M, Nakagawa T, et al. Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma. Cancer 1994; 74:817825

    Google Scholar 

  24. Murakami R, Yoshimatsu S, Yamashita Y, et al. Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation. AJR 1995; 164:1159–1164

    PubMed  CAS  Google Scholar 

  25. Cline HE, Hynynen K., Watkins RD, Adams WJ, Schenck JF, Ettinger RH, Freund WR, Vetro JP, Jolesz FA. Focused US system for MR imaging-guided tumor ablation. Radiology 1995; 194:731–7

    PubMed  CAS  Google Scholar 

  26. Amin Z, Brown SG, Lees WR. Liver tumor ablation by intersitial laser photocoagulation: review of experimental and clincial studies. Semin Int Rad 1993; 10:88–100

    Article  Google Scholar 

  27. Vogl TJ, Muller PK, Hammerstingl R, et al. Malignant liver tumors treated with MR imaging-guided laser-induced thermotherapy: technique and prospective results. Radiology 1995; 196:257–65

    PubMed  CAS  Google Scholar 

  28. Zevas NT, Kuwayama A. Pathological characteristics of experimental thermal lesions: comparison of induction heating and radiofrequency electrocoagulation. J Neurosurg 1972; 37:418–422

    Article  Google Scholar 

  29. Goldberg SN, Gazelle GS, Halpern EF, Rittman WJ, Mueller PR, and Rosenthal DI. Radiofrequency tissue ablation: Importance of local temperature along the electrode tip exposure in determining lesion shape and size. Acad Radiol 1996; 3:212–218

    Article  PubMed  CAS  Google Scholar 

  30. Cosman ER, Nashold BS, Ovelman-Levitt J. Theoretical aspects of radiofrequency lesions in the dorsal root entry zone. Neurosurg 1984; 15:945–950

    Article  CAS  Google Scholar 

  31. Organ LW. Electrophysiologic principles of radiofrequency lesion making. Appl Neurophysiol 1976; 39:69–76

    PubMed  Google Scholar 

  32. Goldberg SN, Gazelle GS, Compton CC, Mueller PR, Tanabe KK. Treatment of intrahepatic malignancy with radiofrequency ablation: Radiologic-pathologic correlation. Cancer 2000 88:2452–2463

    Article  PubMed  CAS  Google Scholar 

  33. Pennes, HH. Analysis of tissue and arterial blood temperatures in the resting human forearm. J Applied Physiology 1948; 1:93–122

    CAS  Google Scholar 

  34. Seegenschmiedt MH; Brady LW; Sauer R. Interstitial thermoradiotherapy: review on technical and clinical aspects. Am J Clin Oncol 1990; 13:352–63

    Article  PubMed  CAS  Google Scholar 

  35. Trembley BS, Ryan TP, Strohbehn JW. Interstitial Hyperthermia: physics, biology and clinical aspects. In: Urano M, Douple E (eds), Physics of Microwave Hyperthermiai. In: Hyperthermia and Oncology. Vol 3, VSP, Utrecht, the Netherlands, 1992, pp. 11–98

    Google Scholar 

  36. Larson TR, Bostwick DG, Corcia A. Temperature-correlated histopathologic changes following microwave thermoablation of obstructive tissue in patients with benign prostatic hyperplasia. Urology 1996; 47:463–469

    Article  PubMed  CAS  Google Scholar 

  37. Thomsen S. Pathologic analysis of photothermal and photomechanical effects of laser-tissue interactions. Photochem Photobiol 1991; 53:825–35

    PubMed  CAS  Google Scholar 

  38. van Kleef M, Liem L, Lousberg R, Barendse G, Kessels F, Sluijter M. Radiofrequency lesion adjacent to the dorsal root ganglion for cervicobrachial pain: a prospective double blind randomized study. Neurosurgery 1996; 38:1127–3

    PubMed  Google Scholar 

  39. Taha JM, Tew JM Jr, Buncher CR. A prospective 15-year follow up of 154 consecutive patients with trigeminal neuralgia treated by percutaneous stereotactic radiofrequency thermal rhizotomy. JNeurosurg 1995; 83:989–93

    Article  CAS  Google Scholar 

  40. Wagshal AB, Pires LA, Huang SK. Management of cardiac arrhythmias with radiofrequency catheter ablation. Arch Intern Med 1995; 155:137–47

    Article  PubMed  CAS  Google Scholar 

  41. Kay GN and Plumb VJ. The present role of radiofrequency catheter ablation in the management of cardiac arrhythmias. Am J Med 1996; 100:344–56

    Article  PubMed  CAS  Google Scholar 

  42. McGahan JP, Browning PD, Brock JM, Tesluk H. Hepatic ablation using radiofrequency electrocautery. Invest Radiol 1990; 25:267–270

    Article  PubMed  CAS  Google Scholar 

  43. Rossi S. Fornari F, Pathies C, Buscarini L. Thermal lesions induced by 480 KHz localized current field in guinea pig and pig liver. Tumori 1990; 76:54–57

    PubMed  CAS  Google Scholar 

  44. Goldberg SN, Gazelle GS, Dawson SL, Mueller PR, Rosenthal DI, and Rittman W. Tissue ablation with radiofrequency: Effect of probe size, ablation duration, and temperature on lesion volume. Academic Radiology 1995; 2:399–404

    Article  PubMed  CAS  Google Scholar 

  45. Sanchez R, vanSonnnenberg E, D’Agostino H, Goodacre B, Esch O. Percutaneous tissue ablation by radiofrequency thermal energy as a preliminary to tumor ablation. Min Invasive Therapy 1993; 2:299–305.

    Article  Google Scholar 

  46. Goldberg SN, Gazelle GS, Compton C, and McLoud TC. Radiofrequency tissue ablation in the lung: A safe, minimally invasive procedure. Academic Radiology 1995; 2:776–784

    Article  PubMed  CAS  Google Scholar 

  47. Rossi S, DiStasi M, Buscarini E, Quaretti P, Garbagnati F, Squassante L, Paties CT, Silverman DE, and Buscarini L. Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. AJR 1996; 167:759–768

    PubMed  CAS  Google Scholar 

  48. Solbiati L, lerace T, Goldberg SN, Livraghi T, Rizzatto G, Mueller PR, and Gazelle GS. Percutaneous US-guided radio-frequency tissue ablation of liver metastases: treatment and follow-up in 16 patients. Radiology 1997; 202:195–203

    PubMed  CAS  Google Scholar 

  49. Goldberg SN, Gazelle GS, Dawson SL, Mueller PR, Rittman WJ and Rosenthal DI. Radiofrequency tissue ablation using multiprobe arrays: Greater tissue destruction than multiple probes operating alone. Academic Radiology 1995; 2:670–674

    Article  PubMed  CAS  Google Scholar 

  50. LeVeen RF, Laser hyperthermia and radiofrequency ablation of hepatic lesions. Semin Intern Radiol 1997;14:313–324

    Google Scholar 

  51. McGahan JP, Wei-Zhong G, Brock JM, Tesluk H, and Jones CD. Hepatic ablation using bipolar radiofrequency electrocautery. Acad Radiology, 1996; 3:418–422

    Article  CAS  Google Scholar 

  52. Desinger K, Stein T, Muller G, Mack M, Vogl TJ. Interstitial bipolar RF-thermotherapy (REITT) Therapy planning by computer simulation and MRI-monitoring - A new concept for minimally invasive procedures. Proc SPIE Vol. 3249. 147–160

    Article  Google Scholar 

  53. Lorentzen T. A cooled needle electrode for radiofrequency tissue ablation: Thermodynamic aspects of Improved performance compared with conventional needle design. Acad Radiol 1996; 3:556–563

    Article  PubMed  CAS  Google Scholar 

  54. Goldberg SN, Gazelle GS, Solbiati L, Rittman WJ, and Mueller PR. Radiofrequency tissue ablation: Increased lesion diameter with a perfusion electrode. Acad Radiology 1996; 3:636–644

    Article  CAS  Google Scholar 

  55. Goldberg SN, Gazelle GS, Solbiati L, Mullin K, Rittman WJ, and Mueller PR. Large volume radiofrequency tissue ablation: Increased coagulation with cooled-tip electrodes. Radiology 1996; 201:P387

    Google Scholar 

  56. Goldberg SN, Solbiati L, Hahn PF, et al. Large-volume tissue ablation with radiofrequency by using a clustered, internally cooled electrode technique: Laboratory and clinical experience in liver metastases. Radiology 1998; 209:371–379

    PubMed  CAS  Google Scholar 

  57. Goldberg SN, Stein M, Gazelle GS, Sheiman RG, Kruskal JB, and Clouse ME. Percutaneous radiofrequency tissue ablation: Optimization of pulsed-RF technique to increase coagulation necrosis. JVIR 1999; 10:907–916

    Article  PubMed  CAS  Google Scholar 

  58. Goldberg SN, Ahmed M, Gazelle GS, Kruskal JB, Huertas JC, Oliver BS, Lenkinski RE. Radiofrequency thermal ablation with adjuvant saline injection: Effect of electrical conductivity on tissue heating and coagulation. Radiology 2001 (in press)

    Google Scholar 

  59. Merkle E, Goldberg SN, Boll DT, Shankaranarayanan A, Boaz T, Jacobs GH, Wendt M, Lewin JS. Effect of supraparamagnetic MR contrast agents on radiofrequency-induced temperature distribution: In vitro measurements in polyacrylamide phantoms and in vivo results in a rabbit liver model. Radiology 1999; 212:459–66

    PubMed  CAS  Google Scholar 

  60. Livraghi T, Goldberg SN, Lazzaroni S, et al. Saline-enhanced radiofrequency tissue ablation in the treatment of liver metastases. Radiology 1997; 202:205–210

    PubMed  CAS  Google Scholar 

  61. Miao Y, Yicheng N, Stefaan M, Wang K, Hoey MF, et al. Ex vivo experiment on radiofrequency liver ablation with saline infusion through a screw-tip cannulated electrode. JSR 1997; 71:19–24

    Article  PubMed  CAS  Google Scholar 

  62. Goldberg SN, Hahn PF, Tanabe KK, et al. Percutaneous radiofrequency tissue ablation: Does perfusion-mediated tissue cooling limit coagulation necrosis ? JVIR 1998; 9:101–11

    Article  PubMed  CAS  Google Scholar 

  63. Goldberg SN, Hahn PF, Halpern E, Fogle R, and Gazelle GS. Radiofrequency tissue ablation: Effect of pharmacologic modulation of blood flow on coagulation diameter. Radiology 1998; 209:761–769

    PubMed  CAS  Google Scholar 

  64. Curley MG and Hamilton PS. Creation of Large Thermal Lesions in Liver using Saline-Enhanced RF Ablation. Proc 19th International Conference IEEE/EMBS 1997; 2516–9

    Google Scholar 

  65. Patterson EJ, Scudamore CH, Owen DA, et al. Radiofrequency ablation of porcine liver in vivo: Effects of blood flow and treatment time on lesion size. Ann Surg 1998; 227:559–565

    Article  PubMed  CAS  Google Scholar 

  66. Ryan TP and Goldberg SN. Comparison of simulation and experimental results for RF thermal treatment devices with or without cooling. Proc SPIE 1999; Vol. 3594 14–25

    Article  Google Scholar 

  67. Rossi S, Garbagnati F, Lencioni R, et al. Percutaneous radio-frequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply. Radiology 2000; 217:119–126

    PubMed  CAS  Google Scholar 

  68. Goldberg SN, Saldinger PF, Gazelle GS, et al. Percutaneous Tumor Ablation: Increased Coagulation Necrosis with Combined Radiofrequency and Percutaneous Doxorubicin Injection. AJR 2000 174: 34 (abstract)

    Google Scholar 

  69. Goldberg SN, Kruskal JB, Oliver BS, Clouse ME and Gazelle GS. Percutaneous Tumor Ablation: Increased Coagulation by Combining Radio-frequency Ablation and Ethanol Instillation in a Rat Breast Tumor Model. Radiology 2000 217:827–831.

    PubMed  CAS  Google Scholar 

  70. Goldberg SN, Solbiati L, Halpem EF and Gazelle GS. Variables Affecting Proper System Grounding for Radiofrequency Ablation in an Animal Model. JVIR 2000 11:1069–1075.

    Article  PubMed  CAS  Google Scholar 

  71. Livraghi T, Solbiati L, Meloni F, Ierce T, Goldberg SN. Complications after Cool-tip RF Ablation of Liver Cancer: Initial Report of the Italian Multicenter Cool-tip RF Study Group. Radiology 2000 217:18 (P)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Laboratory of Minimally Invasive Therapy, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    S. Nahum Goldberg MD

Authors
  1. S. Nahum Goldberg MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Imperial College of Science, Technology, Medicine Hammersmith Hospital, London, UK

    Nagy A. Habib (Faculty of Medicine) (Faculty of Medicine)

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer Science+Business Media New York

About this chapter

Cite this chapter

Goldberg, S.N. (2002). Radiofrequency Tumor Ablation: Principles and Techniques. In: Habib, N.A. (eds) Multi-Treatment Modalities of Liver Tumours. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-0547-1_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-0547-1_9

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-5126-9

  • Online ISBN: 978-1-4615-0547-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation