Interventional radiologists use ablative technologies to treat a tumor through small incision in the skin. Thermal ablation involves controlled heating or cooling to destroy cancer cells and tissue of a known volume leaving behind a scar. This is performed using image guidance with CT or US.
Thermal Ablation: How does it work?
The goal of heat-based therapy is to destroy the entire tumor with a margin of at least 5 mm using heat to kill the malignant cells without damaging adjacent vital structures. To accomplish this, the tissue must be heated to temperatures between 60-100°C to break down the proteins in the cells, a process known as coagulative necrosis. There are many ways to create this thermal energy.
For radiofrequency ablation, radio waves generated by alternating current travel from the non insulated tip of the probe to the grounding pad resulting in resistive forces that generate heat. This technology has been studied and employed extensively and has been shown to be safe and effective. Limitations occur in heat conduction when adjacent to large vessels, which rapidly cool the lesion causing a heat sink effect. In less than 1% of cases there has been evidence of seeding along the ablation tract. This has been addressed with new technology to burn the tract as the needle is withdrawn.
For microwave ablation, the probe functions as an antennae generating heat by friction as polar (water) molecules attempt to align with the electromagnetic field. There is no charring around the tip of the probe or need for a grounding pad. While there is less experience with this technology, initial work has shown that microwave ablation generates higher temperatures, treating large tumor volumes, in less time, and is less susceptible to heat sink.
For cryoablation, by freezing and thawing and refreezing the tumor cells the cell membrane ruptures causing cell death. This is accomplished by allowing the expansion of argon gas from high to low pressure through a narrow port which cools the gas to temperatures as low as -1608°C. This forms an “ice ball” around the probe that can be seen on imaging allowing active monitoring and control of the ablation zone as it approaches critical structures. Helium gas is then use to warm the probe to remove it. There is no need for grounding pads and larger volumes may be ablated with multiple probes.
- Bone cancer
- Kidney or renal cancer
- Liver cancer
- Lung cancer
Treat painful metastases that do not response to radiation or surgical care for palliation of pain
Treat renal carcinoma in patients who cannot or do not wish to undergo resection
Treat primary hepatocellular carcinoma as bridge to liver transplant.
Treat primary hepatocellular carcinoma in patients who are not candidates for surgical resection.
Treat patients with oligometastatic disease to the liver from other primary malignancies.
Treat primary lung carcinoma in patients who are not candidates for surgical resection.
Treat patients with oligometastatic disease to the lung from other primary malignancies.
The interventional radiology experts at the University of Miami Health System use imaging technology to perform this procedure and ensure only cancerous tissue is harmed, while keeping healthy tissue intact.
Why Choose Sylvester Comprehensive Cancer Center?
Multidisciplinary approach. Cancer treatment at the University of Miami Health System has evolved to emphasize individualized care provided in a coordinated effort by multiple specialties. This includes oncologists, surgeons, radiation oncologists and interventional radiologists. Interventional radiologists treat cancer from a loco-regional approach focusing on a specific organ or target lesion using minimally invasive intra-arterial or percutaneous techniques.
Expert care from highly trained interventional radiologists. Our interventional radiologists and radiology specialists are experts in a variety of minimally invasive procedures — everything from treatments to clear blocked blood vessels to advanced cancer therapies like NanoKnife®.
Leading-edge imaging care in South Florida. Our doctors are also researchers discovering new ways to improve diagnosis and treatment. That means you can get some of today’s most promising advancements through clinical trials. You benefit from the latest developments that are fast-tracked from the lab to the bedside.