Radiofrequenzablation (RFA) bei Lungentumoren
Radiofrequency
ablation of lung tumours. Primary lung tumour located in the right lower lobe and treated by RFA. The axial CT shows adequate positioning of the needle within the nodule. Multiplanar reformations demonstrate that the needle is not correctly positioned in the centre of the nodule (B,C)
Radiofrequency
ablation of lung tumours. Primary lung tumour located in the right lower lobe (A). The CT control performed immediately after RFA shows a large area of ground glass surrounding the nodule (B); the needle was slightly to the right of centre of the nodule
Radiofrequency
ablation of lung tumours. Subpleural primary lung tumour in the right lower lobe (A). The CT control during RFA demonstrates correct placement of the needle with a minimal area of pneumothorax (B). The CT control performed at the end of the procedure shows a large pneumothorax (C) that required chest tube drainage (D)
Radiofrequency
ablation of lung tumours. Primary lung tumour in the right upper lobe (A). The CT control during RFA demonstrates correct placement of the needle with a limited area of parenchymal haemorrhage (B). The CT control performed at the end of the procedure shows pleural effusion and a consolidation corresponding to parenchyma haemorrhage (C) without haemoptysis. No adjunctive procedures were required and the CT controls performed 3 (D) and 6 months (E) after treatment documented progressive reduction of the consolidation and shrinkage of the tumour nodule
Radiofrequency
ablation of lung tumours. Subpleural lung tumour treated by RFA (A). The CT control performed 9 months after treatment depicted a subcutaneous mass adjacent to the tumour with peripheral enhancement and air bubbles. Under suspicion of a secondary location (tumour seeding), biopsy was performed (C), allowing the final diagnosis of an abscess formation involving the treated lesion with extension to the thoracic wall
Radiofrequency
ablation of lung tumours. Non-small-cell lung carcinoma (NSCLC) located in the right lower lobe, adjacent to a segmental bronchus (A). RFA was successfully performed (B). The 1-month CT control demonstrated a large area of cavitation including the entire nodule, with no significant contrast enhancement (C,D); the findings were considered indicative of complete response. The 6- and 12-month CT examinations (E,F) demonstrated the progressive reduction in size of the cavitation with formation of a fibrotic band, corresponding to a complete response to treatment
Radiofrequenzablation (RFA) bei Lungentumoren
Radiofrequenzablation (RFA) Radiopaedia • CC-by-nc-sa 3.0 • de
Radiofrequency ablation (RFA) is a medical procedure that uses a high-frequency alternating current produced by a radiofrequency generator oscillating in a closed-loop circuit. This current heats a needle to over 60°C, which is used to cause intentional protein denaturation and tissue damage .
Applications
- tumor ablation: established for the local destruction of liver, lung, and bone tumors, e.g. HCC and osteoid osteoma
- cardiac arrhythmia: used in the treatment of an abnormally discharging focus within the heart
- ablation neurotomy and pain management for specific nerve plexuses or Morton neuroma
- varicose veins: an alternative to sclerotherapy, as the produced heat causes closure of the affected vein
Complications
- thermal injuries to the adjacent structures: in liver tumor ablation, this means potential injury to the diaphragm, colon, gallbladder, or bile ducts, which may result in perforation, leakage of secretions, or stricture formation
- pneumothorax and pleural effusion: in lung tumor ablation
- hemorrhage: small vessels are more liable to hemorrhage more than large vessels which are rather protected by "heat sink" effect of flowing blood
- infection is a relatively low risk of radiofrequency ablation
- tumor seeding along the needle tract
- post-ablation syndrome: flu-like symptoms, including low-grade fever, chills, nausea, pain, and malaise. It is a self-limited condition that usually begins three days after ablation
- dysfunction of a cardiac pacemaker or defibrillator due to the use of radiofrequency waves
Siehe auch:
Assoziationen und Differentialdiagnosen zu Radiofrequenzablation (RFA) bei Lungentumoren:
