Background Information:

What are the other Names for the Procedure?

• Kidney Tumor Radiofrequency Ablation
• Kidney Tumor RFA
• RFA of Kidney Tumor

What is Radiofrequency Ablation of Kidney Tumor radiology procedure? (General Explanation)

• Radiofrequency Ablation (RFA) is an image-guided technique used to destroy cancer cells. It is a minimally invasive treatment for cancer
• Radiofrequency Ablation of Kidney Tumor is used to treat tumors of the kidney
• RFA is uses ultrasound, CT, or MRI to guide needle electrodes close to the tumor cells. These electrodes are used to heat up and destroy the cancer cells

What part of the Body does the Procedure involve?

Radiofrequency Ablation (RFA) of Kidney Tumor involves the mid and lower abdominal region.

Why is the Radiofrequency Ablation of Kidney Tumor radiology procedure Performed?

Radiofrequency Ablation of Kidney Tumor is performed in the following cases:

• For treatment of renal cell carcinomas (kidney tumors)
• It is especially useful in patients who are not candidates for surgery, due to age or other medical complications, and with recurrent tumor condition after surgical resection
• It patients with only one kidney, the procedure is very useful
• RFA is particularly helpful when the tumors are less than 4 centimeters in size
• The procedure is also useful in patients with tumors in both kidneys and those having a family history of multiple kidney tumors

What is the Equipment used? (Description of Equipment)

Following equipment is used in Radiofrequency Ablation of Kidney Tumor procedure:

• Needle electrodes
• Radiofrequency generator which supplies electrical current to the needle electrodes
• CT scan: It is used for image guidance, to help place needle electrodes into the cancerous tumors
  • A CT scanner that appears like a big box with a hole inside
  • The examination table on which the patient lies down; the table slides into the hole during the procedure
  • X-ray tube and electronic x-ray detectors that rotates around the patient
  • Images are taken from a computer       
• MRI scan: It is also used for image guidance
  • An MRI is a large cylinder-shaped tube that is surrounded by a circular magnet
  • The patient lies on the table that slides back and forth in the cylinder tube
  • In some MRI equipment, called short-bore systems, the magnet does not completely surround the patient. This is particularly helpful for patients who are obese or those fearful of being in a closed tube. This is called an open MRI           
• Ultrasound scan - the equipment for ultrasound imaging consists of:
  • An ultrasound transducer
  • A computer monitor
  • A central processing unit
  • A printer            

A transducer is used to send high-frequency sound waves in the body and the computer creates the image based on the echoes of that sound returning from the patient’s body.

What are the Recent Advances in the Procedure?

There have been no recent advances in the RFA of Kidney Tumor procedure.

What is the Cost of performing the Radiofrequency Ablation of Kidney Tumor radiology procedure?

The cost of Radiofrequency Ablation of Kidney Tumor procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding RFA procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.ncbi.nlm.nih.gov/pubmed/25458737 (accessed on 07/20/2015)

http://www.ncbi.nlm.nih.gov/pubmed/25414370 (accessed on 07/20/2015)

http://www.ncbi.nlm.nih.gov/pubmed/25366922 (accessed on 07/20/2015)

Prior to Radiofrequency Ablation of Kidney Tumor radiology procedure:

How does the Radiofrequency Ablation of Kidney Tumor radiology procedure work?

• The RFA procedure uses needle electrodes which are placed into cancerous tumors using image guidance
• Once the needle electrodes are placed into the tumors, electrical currents are passed between these electrodes and grounding pads that are placed on the patient’s skin
• Passing these electrical current, produces heat around the cancer cells that eventually destroys them
• Heat produced from the electrical current also closes-off small blood vessels going into the tumor. This stops the nutrition supply and decreases the risk of bleeding too

How is the Radiofrequency Ablation of Kidney Tumor radiology procedure Performed?

The Radiofrequency Ablation of Kidney Tumor is often performed as an outpatient procedure.

• The patient is positioned on the examination table
• The patient’s vital signs are monitored and an IV line is inserted into the patient’s arm vein to inject sedation medications
• The area of needle electrode insertion is cleaned and sterilized. A local anesthetic is used to numb the area
• A small skin incision is made and needle electrodes are inserted through them
• Needle electrodes are advanced into the cancerous tumor using image guidance such as CT, ultrasound, or MRI. Once the needle electrode is placed in the area of interest, an electrical current is applied
• The needle electrodes may be repositioned, if ablation is needed in different parts of the tumor, or if the tumor is large
• The needle electrodes are removed at the end of the procedure
• No sutures are needed to close the skin incision; only a pressure dressing is applied to stop any bleeding
• In certain cases, when the tumor is located near the ureter or part of kidney collecting urine, a temporary stent is placed into the ureter by an urologist. Cold water is dripped through this stent to avoid heat injuries from ablation
• The stents are removed after the procedure is completed

Where is the Procedure Performed?

Radiofrequency Ablation of Kidney Tumor is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

An interventional radiologist or oncologist performs the RFA of Kidney Tumor procedure.

How long will the Procedure take?

• The Radiofrequency Ablation of Kidney Tumor procedure takes anywhere from 10-30 minutes
• However, if multiple ablation is required, or if the tumor is large, additional time may be required

Who interprets the Result?

An interventional radiologist interprets the results of the procedure.

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a radiofrequency ablation procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• Lab studies are done prior to the procedure to check kidney function
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
• Women should notify the physician if they are pregnant or breastfeeding their child, as many such procedures may not be performed on pregnant women
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the scan
• The patient may be asked to avoid eating or drinking several hours before the procedure
• Depending on the procedure adopted, the patient may be asked for certain bowel or bladder preparations, before the preparation sessions
• It is recommended to notify the physician about any implants or metal objects in the body, such as a pacemaker, nerve simulators, surgical staples, or artificial heart valves, braces, or dyed tattoos, as they may interfere with the imaging in some cases

What is the Consent Process before the Procedure?

A physician will request your consent for the Radiofrequency Ablation of Kidney Tumor procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the Radiofrequency Ablation of Kidney Tumor procedure:

• It is a minimally invasive procedure
• RFA has quick recovery period and it is a quick procedure
• The RFA procedure allows to preserve the kidney as opposed to surgical treatment that requires removing a part or the entire kidney
• The procedure does not have any adverse effect on blood pressure
• It is much safer, cheaper, and much less invasive than surgical procedures

Following are the risks of the Radiofrequency Ablation of Kidney Tumor procedure:

• Since a small incision is made during the RFA procedure, there is a slight risk of infection
• When the tumor is located close to the ureter, an ablation may cause damage to the ureter, which may lead to leakage of urine or narrowing of the ureter due to scar tissue
• RFA may rarely cause severe pain for a few days, which may require the use of narcotic painkillers
• There is a slight chance of cancer, if excessive radiation is used

What are the Limitations of the Radiofrequency Ablation of Kidney Tumor radiology procedure?

• Radiofrequency Ablation of Kidney Tumor is mostly effective for small kidney tumors, which are less than 4 centimeters
• Larger tumors may require multiple RFA, or surgical treatment may be a better option in such cases

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is a Radiofrequency Ablation of Kidney Tumor procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required after the procedure?
• Is there any medication that needs to be taken for life after the procedure?
• What are the costs involved?

During the Radiofrequency Ablation of Kidney Tumor radiology procedure:

What is to be expected during the Radiofrequency Ablation of Kidney Tumor radiology procedure?

The following may be expected during the Radiofrequency Ablation of Kidney Tumor procedure:

• Patients may feel a slight sting when the IV line is inserted into the patient’s arm vein and when a local anesthetic is injected at the site of needle electrode insertion
• If the patient is sedated during the procedure, they will feel relaxed and sleep and may not remember much of the procedure
• The patient’s vital signs are monitored by using various devices
• Patient may feel pain immediately after the RFA procedure, and it is mostly relieved by administering IV pain medications
• The patient is taken to the recovery room after waking up and kept there, until he/she is ready to return home
• Patients are often prescribed oral narcotic medications, in case they have any pain after their discharge

What kind of Anesthesia is given, during the Procedure?

IV sedatives are used during the RFA procedure.

How much Blood will you lose, during the Procedure?

Since the procedure is a minimally invasive one, the blood loss involved is minimal.

What are the possible Risks and Complications during the Radiofrequency Ablation of Kidney Tumor radiology procedure?

• Ablation on tumors near to the ureter may cause damage to the ureter resulting in urine leakage or narrowing of the ureter due to scar tissue formation
• Normal tissues close to the cancerous tumors may get destroyed during the procedure

What Post-Operative Care is needed at the Healthcare Facility after the Radiofrequency Ablation of Kidney Tumor radiology procedure?

• No specific post-operative care is needed at the healthcare facility after the Radiofrequency Ablation of Kidney Tumor procedure
• Patient may feel pain immediately after the RFA that is mostly relieved through pain medications administered intravenously

After the Radiofrequency Ablation of Kidney Tumor radiology procedure:

What is to be expected after the Radiofrequency Ablation of Kidney Tumor radiology procedure?

• Any pain felt immediately after the RFA procedure may be relieved by giving intravenous pain medications
• The patient is taken to the recovery room after waking up and kept there, until he/she is ready to be discharged
• Oral narcotic medications may be prescribed in case of any pain after discharge
• Some patients may develop fever and flu-like symptoms, which may persist for about a week after the procedure

When do you need to call your Physician?

The patient needs to call their physician after the RFA procedure in the following conditions:

• The patient develops a high fever after the procedure
• Needle insertion site is red, warm, inflamed, and accompanied by high fever
• There is trouble urinating or leakage of urine
• Flu-like symptoms that lasts over 2 weeks

What Post-Operative Care is needed at Home after the Radiofrequency Ablation of Kidney Tumor radiology procedure?

No specific post-operative care is needed at home after Radiofrequency Ablation of Kidney Tumor.

How long does it normally take to fully recover, from the Procedure?

• It may take a few days to completely recover from the radiofrequency ablation procedure
• Patients may resume their normal activities a few days after the RFA procedure

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The radiofrequency ablation procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Radiofrequency Ablation of Kidney Tumor radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Radiofrequency Ablation of Kidney Tumor procedure is performed.