Background Information:

What are the other Names for the Procedure?

• Lung Tumor Radiofrequency Ablation
• Lung Tumor RFA
• RFA of Lung Tumor

What is Radiofrequency Ablation of Lung 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 Lung Tumor is used to treat tumors of the lungs and small metastatic lung tumors
• 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 Lung Tumor involves the lungs.

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

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

• In treatment of early lung cancer and lung cancer that has metastasized from other cancers such as intestine, kidneys, or breasts
• It is especially useful in patients who are not candidates for surgery, due to age or other medical complications
• Generally, lung metastasis that are smaller in size are more responsive to RFA treatment than large-sized metastasis
• RFA is also useful in treating tumors that are hard to reach through surgery
• RFA can also help reduce the tumor size so that they may be treated by chemotherapy, radiation therapy, or surgery
• This procedure is also employed in pain relief due to tumor invasion in the chest wall

What is the Equipment used? (Description of Equipment)

Following equipment is used in Radiofrequency Ablation of Lung 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 Lung Tumor procedure.

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

The cost of Radiofrequency Ablation of Lung 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/25546668 (accessed on 07/20/2015)

http://www.ncbi.nlm.nih.gov/pubmed/25329865 (accessed on 07/20/2015)

http://www.ncbi.nlm.nih.gov/pubmed/25300878 (accessed on 07/20/2015)

Prior to Radiofrequency Ablation of Lung Tumor radiology procedure:

How does the Radiofrequency Ablation of Lung 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 Lung Tumor radiology procedure Performed?

The Radiofrequency Ablation of Lung 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
• If general anesthesia is used, an endotracheal tube (breathing tube) is inserted into the patient’s trachea and removed after the procedure is complete
• 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

Where is the Procedure Performed?

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

Who Performs the Procedure?

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

How long will the Procedure take?

• The Radiofrequency Ablation of Lung 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
• The entire procedure may take about 1-3 hours

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
• 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 Lung 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 Lung Tumor procedure:

• It is a minimally invasive procedure
• RFA has quick recovery period and it is a quick procedure. Thus, chemotherapy can be used immediately (without too much time delay), if needed
• Side effects and complications from RFA are much less than with other procedures
• After the procedure, RFA preserves most of the lung functions than a surgery would
• The procedure treats primary and metastasized lung tumors very effectively
• It is much safer, cheaper, and much less invasive than surgical procedures

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

• Since a small incision is made during the RFA procedure, there is a slight risk of infection
• Insertion of radiofrequency electrode may cause pneumothorax, a condition where air gets collected in the chest cavity (space between lung and chest wall) and collapses the lung. In cases of pneumothorax, patient may need a chest tube inserted into the chest to remove air
• RFA may rarely cause severe pain for a few days, which may require the use of narcotic painkillers
• Fluid collection may occur during this procedure between the lung and the membrane covering the lung; if this is severe, it may require the removal of fluid by using a needle
• There is a slight chance of cancer, if excessive radiation is used

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

• Radiofrequency Ablation of Lung Tumor is mostly effective for small tumors of the lungs. Larger tumors may require multiple RFA, or surgical treatment may be a better option in such cases
• RFA cannot be used if the lung tumor is close to the blood vessels, heart, or central airways, as it can damage these critical organs

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 Lung 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 Lung Tumor radiology procedure:

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

The following may be expected during the Radiofrequency Ablation of Lung 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
• If general anesthetics are used with a breathing tube, the patient may have sore throat for a couple of days
• Patient may feel pain immediately after the RFA procedure, and it is mostly relieved by administering IV pain medications
• After two hours of the procedure, a chest x-ray may be taken to check the lungs for pneumothorax (collapse of lungs). If the patient has pneumothorax and they require a chest tube, then the patient may have to be admitted in the hospital
• 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 or general anesthetics 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 Lung Tumor radiology procedure?

• Insertion of radiofrequency electrode may cause pneumothorax where air gets collected in chest cavity and collapses the lung. In such cases, it may be necessary to insert a chest tube to remove the air
• During this procedure, fluid collection between the lung and lung membrane may occur. If it is severe, then the fluid may have to be removed using a needle

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

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

After the Radiofrequency Ablation of Lung Tumor radiology procedure:

What is to be expected after the Radiofrequency Ablation of Lung 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

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
• Patient has trouble breathing, or worsening of breathing, after the procedure

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

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