Advanced Bone Tumor Treatment;

Radiofrequency Ablation (RFA) of Osteoid Osteoma

At Dr. Ziauddin Hospital

Radiofrequency ablation (RFA) is a treatment that uses imaging guidance to place a needle electrode through the skin into a tumor. High-frequency electrical currents are passed through the electrode, creating heat that destroys the tumor cells. RFA is an effective treatment option for patients who might have difficulty with surgery .The success rate for completely eliminating small tumors is greater than 90 percent. Dr. Ziauddin hospital is offering this latest treatment at its two interventional radiology suits. Dr. M. Kashif Shazlee, HOD radiology, among two other interventional radiologist, Dr. I. A Lutfi& Dr. M. Ali, offers this minimally invasive curative treatment.

What is RFA?

Radiofrequency ablation, sometimes referred to as RFA, is a minimally invasive treatment for cancer. It is an image-guided technique that heats and destroys tumor cells.

In radiofrequency ablation, imaging techniques such as ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) are used to help guide a needle electrode into a bone tumor. High-frequency electrical currents are then passed through the electrode, creating heat that destroys the abnormal cells.

What are indications for RFA of Bone?

Radiofrequency ablation is used to treat few types of bone lesions especially osteoid osteoma. Osteoid osteoma is a benign tumor of the bone. This tumor is most frequently found in the legs but may occur also at other bones in nearly any part of the body. Osteoid osteoma is a tumor of children and young adults, it is very rare in older adults over the age of 50.​In general, radiofrequency ablation is most effective treating this tumor.

How does the procedure works?

Radiofrequency ablation works by passing electrical currents in the range of radiofrequency waves between the needle electrode and the grounding pads placed on the patient’s skin. These currents create heat around the electrode, which when directed into the tumor, heats and destroys the tumor cells. At the same time, heat from radiofrequency energy closes small blood vessels and lessens the risk of bleeding. The dead tumor cells are gradually replaced by scar tissue that shrinks over time.

How the procedure is performed?

Image-guided, minimally invasive procedures such as radiofrequency ablation are most often performed by a specially trained interventional radiologist in an interventional radiology suite or occasionally in the operating room. Dr. M. Kashif Shazlee & his dedicated specialized team is one of the fewer physicians who are specialized in this advanced technique.

Radiofrequency ablation is often done on an outpatient basis.

The area where the electrodes are to be inserted will be sterilized and covered with a surgical drape.

Your physician will numb the area with a local anesthetic if the procedure is to be done while you are awake. If general anesthesia is used, you will have a breathing tube placed through your mouth and into your trachea after you are asleep. The breathing tube will be connected to a breathing machine while you are asleep.

A very small nick may be made in your skin to make it easier to pass the RFA electrode into in the effected bone.

Using imaging-guidance, your physician will insert the needle electrode through the skin and advance it to the site of the tumor.

At the end of the procedure, the needle electrode will be removed and pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. No sutures are needed.

What are benefits & risks involved?

Benefits

• Rapid pain relief usually apparent within the first 2-3 days after the procedure,
• No overnight hospital stay,
• Return to work, school and other normal activities usually within the first week after the procedure, but no vigorous sports for 3 months,
• Minimal damage to bones and muscle with no significant structural weakness,
• Lower cost.
• Treatment-related serious complications are infrequent and discomfort is minimal.
• No surgical incision is needed—only a small nick in the skin that does not have to be stitched closed.

Risks

• Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
• Less than one percent of patients may develop a localized infection (abscess) at the site of the tumor ablation three to four weeks after the treatment.
• Severe pain after RFA is uncommon, but may last a few days and require a narcotic to provide relief.