When it comes to treating cancer, many options exist. While chemotherapy and radiation therapy have long been the primary go-to treatments, more targeted and less invasive procedures have emerged in recent years. One such alternative is imaging-guided tumor ablation, which uses advanced imaging technology to precisely destroy tumors.
What is Imaging-Guided Tumor Ablation?
Imaging-guided tumor ablation is a minimally invasive treatment that destroys cancerous tissue with high-frequency heat or extreme cold. The procedure is performed using imaging techniques like CT, MRI, or ultrasound, which guide the ablation device directly to the site of the tumor for precise destruction.
While traditional cancer treatments like chemotherapy and radiation therapy can damage healthy cells along with cancerous ones, imaging-guided tumor ablation targets cancer cells directly. By using heat or cold to destroy the tumor, the surrounding healthy tissue remains undamaged.
The most commonly used ablation techniques are radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation, each with its unique benefits and drawbacks.
Radiofrequency Ablation (RFA)
RFA is the most commonly used technique for tumor ablation and is often used to treat liver, lung, and kidney cancers. During the procedure, a needle is inserted directly into the tumor under imaging guidance. The needle is then heated to high temperatures using radiofrequency waves, destroying the cancer cells in the process.
The use of radiofrequency ablation has several benefits, including reduced discomfort, a quick recovery time, and significantly less blood loss than traditional surgical treatments. Additionally, the procedure can be repeated multiple times if necessary, making it an attractive option for patients with recurring tumors or those not responding to other treatment methods.
However, RFA does have drawbacks. The size and location of the tumor can be limiting factors for successful ablation. Also, RFA is not suitable for large tumors or those close to critical blood vessels or organs.
Microwave Ablation (MWA)
Microwave ablation, like RFA, uses a needle to deliver high-frequency energy to the tumor under imaging guidance. Unlike RFA, which uses radiofrequency waves, MWA uses microwaves to destroy cancer cells.
Microwave ablation is especially useful for larger tumors compared to RFA, which has size limitations. The higher energy output of MWA devices allows it to create larger ablation zones, making it more effective in treating larger or more invasive tumors.
Like RFA, MWA has drawbacks, including the potential to damage surrounding healthy tissue, particularly in organs that are sensitive to heat. Additionally, not many devices currently exist to perform microwave ablation, which may limit its global availability as a treatment option.
Cryoablation
Cryoablation is a technique that uses extreme cold to kill cancerous cells. During the procedure, a needle is inserted into the tumor under imaging guidance, and a liquid or gas is delivered to freeze the surrounding tissue. This process creates a ball of ice that engulfs the malignant tissue, causing it to die and ultimately be absorbed by the body.
Like radiofrequency and microwave ablation, cryoablation is minimally invasive and can be performed on an outpatient basis. Unlike other ablation techniques, cryoablation is well-suited for tumors in sensitive areas, including nerves and spinal cords, where excessive heat could cause damage.
However, cryoablation has some limitations, including the potential need for multiple procedures, as it may not be effective on larger tumors. Additionally, the extreme cold can cause pain or discomfort in some patients.
How Imaging-Guided Tumor Ablation Works
Imaging-guided tumor ablation is a safe and effective way of treating cancer. The procedure typically involves the following steps:
Step 1: Patient Preparation
Prior to the procedure, the patient undergoes imaging scans like CT or MRI so the physician can get a clear view of the tumor’s location, size, and shape. The patient is then sedated, and the area around the tumor is numbed.
Step 2: Insertion of Ablation Device
The physician inserts a needle into the tumor using imaging guidance, such as CT or ultrasound. The type of device will depend on the type of ablation being performed.
Step 3: Ablation
The physician activates the ablation device, resulting in the destruction of the malignant tissue via heat or cold. Monitoring of the treatment area is done with frequent imaging scans during the procedure.
Once the ablation is complete, the needle is removed, and the patient can go home on the same day.
Benefits of Imaging-Guided Tumor Ablation
Imaging-guided tumor ablation offers several benefits to patients, including:
1. Minimally Invasive
Unlike traditional cancer treatment methods like surgery, imaging-guided tumor ablation is minimally invasive. The procedure involves only a small needle puncture and patients can often return home the same day.
2. Less Pain and Discomfort
Imaging-guided tumor ablation often involves less pain and discomfort than traditional surgical procedures. Patients report a lower incidence of post-operative pain and a faster return to normal activities compared to other treatment methods.
3. Increased Precision
The use of advanced imaging technology like CT or MRI allows physicians to achieve a high level of precision when delivering ablation therapy. This results in better cancer cell destruction and a reduced likelihood of complications.
4. Fewer Side Effects
Imaging-guided tumor ablation typically results in fewer short and long-term side effects compared to other treatments. Because of its minimally invasive nature, patients experience less pain and require less healing time. This results in fewer complications related to anesthesia, fewer blood transfusions, and less scarring compared to traditional treatments.
Real-Life Examples of Imaging-Guided Tumor Ablation
Imaging-guided tumor ablation has been used successfully to treat a wide range of cancers, including:
Liver Cancer
Liver cancer is one of the most common cancers worldwide, affecting over 20,000 people in the United States annually. In many cases, surgery or transplantation is the best treatment option. In others, imaging-guided tumor ablation can be an option depending on the size of the tumor and the health of the patient.
Liver cancer specialists at Washington University School of Medicine in St. Louis used imaging-guided ablation to treat liver cancer in a 47-year-old man. The patient had several small tumors that were too small to operate on using traditional surgery. As a result, the experts used radiofrequency ablation under the guidance of CT. The procedure was performed multiple times over several months, and follow-up scans confirmed the successful removal of all cancerous tissue.
Lung Cancer
Lung cancer is the leading cause of cancer death worldwide, with an estimated 1.4 million deaths annually. Early detection is essential for successful treatment, and imaging-guided tumor ablation is emerging as a promising option for patients with small lung tumors.
One successful example is the story of a 59-year-old woman who was discovered to have a 1.7 cm lung nodule during a routine chest x-ray. Imaging-guided ablation was performed using radiofrequency ablation, and post-procedure scans confirmed complete destruction of the tumor. The patient returned to normal activities the next day and has remained free of recurrence for over 4 years.
Renal Cancer
Renal cancer, or kidney cancer, is the eighth most common cancer in men and the tenth most common cancer in women. For small tumors located on the kidneys, imaging-guided ablation is becoming an increasingly popular treatment option.
One example is the story of a 78-year-old man with a small renal mass that was detected during an abdominal CT scan. After evaluating multiple treatment options, the patient preferred minimally invasive methods. The tumor was successfully ablated using microwave ablation under ultrasound guidance, and follow-up imaging confirmed complete destruction of the tumor.
Conclusion
Imaging-guided tumor ablation is becoming an increasingly popular treatment option for cancer patients worldwide. The precision, lack of significant side effects, and minimal invasiveness make it an attractive alternative to traditional surgical treatments. With continuous advances in technology, the options for ablation will only continue to expand, offering hope to cancer patients who have exhausted other available treatments. See you again in another interesting article.
