Image-guided thermal ablation with radiofrequency: new approaches and clinical experience

Radiofrequency (RF) tumor ablation is a reliable method for creating thermally induced coagulation necrosis using either percutaneous, image-guidance or direct surgical application of thin electrodes into treated tissues. The technical considerations for RF procedures are reviewed and considerations necessary for optimizing RF ablation are discussed. Strategies to increase the extent of induced coagulation necrosis including: multiprobe and bipolar arrays, saline infusion, and internally-cooled RF electrodes; with or without pulsed-RF or cluster technique are presented. The development and laboratory results for many of these techniques and potential biophysical limitations to RF induced coagulation, such as perfusion mediated tissue cooling (vascular flow) are likewise discussed. Additionally, initial clinical results for liver, bone and other tumors are discussed.