Liver RFA is the most well-established indication, as reflected by the number of peer-reviewed reports on this topic: more than 50 between 2003 and 2005. One of the studies included 1000 patients. Reports include general reviews but also address survival rates, comparative studies, evaluation of tumor response, complications, combination therapies, imaging strategies, cost evaluations, and variations in technique.
Two dozen peer-reviewed journal articles from 2003 to 2005 address different aspects of renal RFA. General review articles are included, as well as cost comparisons, comparisons of techniques, comparisons with other therapies, and literature reviews.
At 7 a.m., a patient with a small, inoperable liver tumor arrives at a community hospital for a previously scheduled radio-frequency ablation. At 8 a.m., he lies in a CT scanner, sedated but conscious. A few minutes later, the interventional radiologist, guided by CT fluoroscopy, inserts a needle into the patient's abdomen. A probe slides through it and opens up, umbrella-like, within the target lesion. Because the patient seems tense, the physician tries some humor, asking before he turns on the electrode, "Medium rare or well done?"
Over the past 15 years, improvements in biopsy needle design, sampling technique, and expertise of radiologists and cytopathologists have developed in concert with imaging technologies to make percutaneous needle biopsy (PNB) the most common interventional radiologic procedure. With skills refined from performing PNB, radiologists can now use a new and promising outgrowth of this technique—percutaneous tumor ablation—to safely and accurately place needles into a variety of malignant lesions to deliver local treatment.