Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000068.xml
Download PDF
Semin intervent Radiol 2010; 27(3): 285-295
DOI: 10.1055/s-0030-1261787
© Thieme Medical PublishersDOI: 10.1055/s-0030-1261787
Complications of Radiofrequency Ablation of Hepatic, Pulmonary, and Renal Neoplasms
Further Information
Publication History
Publication Date:
20 August 2010 (online)
ABSTRACT
Percutaneous thermal ablation has emerged as a viable technique for treatment of numerous solid organ malignancies. As the number of these procedures increases, so do the complications that are seen. Most common complications are generally related to bleeding from the target organ during or after the procedure and from thermal injury to adjacent structures. The nature of these injuries depends on the particular organ being treated, therefore it it best to categorize them this way. We will review the more common complications seen following the ablation of tumors in the liver, kidney, and lung, discuss the clinical presentation associated with each, and suggest precautions to help avoid them in the future. Understanding the potential risks associated with this procedure is critical for treatment planning and fundamental for performing these procedures safely.
KEYWORDS
Complication - radiofrequency - ablation - liver - tumor
REFERENCES
- 1 Nahum Goldberg S, Dupuy D E. Image-guided radiofrequency tumor ablation: challenges and opportunities—part I. J Vasc Interv Radiol. 2001; 12(9) 1021-1032
- 2 Dodd III G D, Soulen M C, Kane R A et al.. Minimally invasive treatment of malignant hepatic tumors: at the threshold of a major breakthrough. Radiographics. 2000; 20(1) 9-27
- 3 Gazelle G S, Goldberg S N, Solbiati L, Livraghi T. Tumor ablation with radio-frequency energy. Radiology. 2000; 217(3) 633-646
- 4 Goldberg S N, Grassi C J, Cardella J F Society of Interventional Radiology Technology Assessment Committee et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol. 2005; 16(6) 765-778
- 5 Sacks D, McClenny T E, Cardella J F, Lewis C A. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol. 2003; 14(9 Pt 2) S199-S202
- 6 Dupuy D E, Goldberg S N. Image-guided radiofrequency tumor ablation: challenges and opportunities—part II. J Vasc Interv Radiol. 2001; 12(10) 1135-1148
- 7 Nemcek A A. Complications of radiofrequency ablation of neoplasms. Semin Intervent Radiol. 2006; 23 177-187
- 8 Livraghi T, Solbiati L, Meloni M F, Gazelle G S, Halpern E F, Goldberg S N. Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology. 2003; 226(2) 441-451
- 9 Choi H, Loyer E M, DuBrow R A et al.. Radio-frequency ablation of liver tumors: assessment of therapeutic response and complications. Radiographics. 2001; 21(Spec No, Spec No) S41-S54
- 10 Rhim H, Yoon K H, Lee J M et al.. Major complications after radio-frequency thermal ablation of hepatic tumors: spectrum of imaging findings. Radiographics. 2003; 23(1) 123-134 discussion 134-136
- 11 Rhim H, Dodd III G D, Chintapalli K N et al.. Radiofrequency thermal ablation of abdominal tumors: lessons learned from complications. Radiographics. 2004; 24(1) 41-52
- 12 Akahane M, Koga H, Kato N et al.. Complications of percutaneous radiofrequency ablation for hepato-cellular carcinoma: imaging spectrum and management. Radiographics. 2005; 25(Suppl 1) S57-S68
- 13 de Baère T, Risse O, Kuoch V et al.. Adverse events during radiofrequency treatment of 582 hepatic tumors. AJR Am J Roentgenol. 2003; 181(3) 695-700
- 14 Curley S A, Marra P, Beaty K et al.. Early and late complications after radiofrequency ablation of malignant liver tumors in 608 patients. Ann Surg. 2004; 239(4) 450-458
- 15 Choi D, Lim H K, Rhim H et al.. Percutaneous radiofrequency ablation for early-stage hepatocellular carcinoma as a first-line treatment: long-term results and prognostic factors in a large single-institution series. Eur Radiol. 2007; 17(3) 684-692
- 16 Wong S L, Mangu P B, Choti M A et al.. American Society of Clinical Oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer. J Clin Oncol. 2010; 28(3) 493-508
- 17 Buscarini L, Buscarini E, Di Stasi M, Vallisa D, Quaretti P, Rocca A. Percutaneous radiofrequency ablation of small hepatocellular carcinoma: long-term results. Eur Radiol. 2001; 11(6) 914-921
- 18 Cha J, Rhim H, Lee J Y et al.. Percutaneous radiofrequency ablation of hepatocellular carcinoma: assessment of safety in patients with ascites. AJR Am J Roentgenol. 2009; 193(5) W424–W429
- 19 Chen M H, Wei Y, Yan K et al.. Treatment strategy to optimize radiofrequency ablation for liver malignancies. J Vasc Interv Radiol. 2006; 17(4) 671-683
- 20 Poon R T, Ng K K, Lam C M et al.. Learning curve for radiofrequency ablation of liver tumors: prospective analysis of initial 100 patients in a tertiary institution. Ann Surg. 2004; 239(4) 441-449
- 21 Smith E H. Complications of percutaneous abdominal fine-needle biopsy. Review. Radiology. 1991; 178(1) 253-258
- 22 Llovet J M, Vilana R, Brú C Barcelona Clínic Liver Cancer (BCLC) Group et al. Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma. Hepatology. 2001; 33(5) 1124-1129
- 23 Uña E, Trueba J, Montes J M. Unexplained liver laceration after metastasis radiofrequency ablation. World J Gastroenterol. 2009; 15(40) 5103-5105
- 24 Rao M P, Bell R. Pulmonary hemorrhage after radioablation of liver metastases. Anesth Analg. 2003; 97(3) 684-686
- 25 Kim Y S, Rhim H, Lim H K, Choi D, Lee W J, Kim S H. Hepatic infarction after radiofrequency ablation of hepatocellular carcinoma with an internally cooled electrode. J Vasc Interv Radiol. 2007; 18(9) 1126-1133
- 26 Shibata T, Yamamoto Y, Yamamoto N et al.. Cholangitis and liver abscess after percutaneous ablation therapy for liver tumors: incidence and risk factors. J Vasc Interv Radiol. 2003; 14(12) 1535-1542
- 27 Kim W, Clark T WI, Baum R A, Soulen M C. Risk factors for liver abscess formation after hepatic chemoembolization. J Vasc Interv Radiol. 2001; 12(8) 965-968
- 28 Bessoud B, Doenz F, Qanadli S D, Nordback P, Schnyder P, Denys A. Enterobiliary fistula after radiofrequency ablation of liver metastases. J Vasc Interv Radiol. 2003; 14(12) 1581-1584
- 29 Kim Y S, Rhim H, Sung J H et al.. Bronchobiliary fistula after radiofrequency thermal ablation of hepatic tumor. J Vasc Interv Radiol. 2005; 16(3) 407-410
- 30 Park B J, Byun J H, Jin Y H et al.. CT-guided radiofrequency ablation for hepatocellular carcinomas that were undetectable at US: therapeutic effectiveness and safety. J Vasc Interv Radiol. 2009; 20(4) 490-499
- 31 Shibata T, Shibata T, Maetani Y et al.. Transthoracic percutaneous radiofrequency ablation for liver tumors in the hepatic dome. J Vasc Interv Radiol. 2004; 15(11) 1323-1327
- 32 Meloni M F, Goldberg S N, Moser V, Piazza G, Livraghi T. Colonic perforation and abscess following radiofrequency ablation treatment of hepatoma. Eur J Ultrasound. 2002; 15(1-2) 73-76
- 33 Novellas S, Karimdjee B S, Caramella T, Benchimol D, Chevallier P. Perforation of a subhepatic retrocecal appendix after radiofrequency ablation of a hepatic metastasis. J Vasc Interv Radiol. 2007; 18(10) 1334-1336
- 34 Livraghi T, Lazzaroni S, Meloni F, Solbiati L. Risk of tumour seeding after percutaneous radiofrequency ablation for hepatocellular carcinoma. Br J Surg. 2005; 92(7) 856-858
- 35 Jaskolka J D, Asch M R, Kachura J R et al.. Needle tract seeding after radiofrequency ablation of hepatic tumors. J Vasc Interv Radiol. 2005; 16(4) 485-491
- 36 Goldberg S N, Solbiati L. Tumor dissemination after radiofrequency ablation of hepatocellular carcinoma. Hepatology. 2001; 34(3) 609-611, author reply 610–611
- 37 Livraghi T. Tumor dissemination after radiofrequency ablation of hepatocellular carcinoma. Hepatology. 2001; 34(3) 608-609, author reply 610–611
- 38 Espinoza S, Briggs P, Duret J S, Lapeyre M, de Baère T. Radiofrequency ablation of needle tract seeding in hepatocellular carcinoma. J Vasc Interv Radiol. 2005; 16(5) 743-746
- 39 Steinke K, Gananadha S, King J, Zhao J, Morris D L. Dispersive pad site burns with modern radiofrequency ablation equipment. Surg Laparosc Endosc Percutan Tech. 2003; 13(6) 366-371
- 40 Goldberg S N, Solbiati L, Halpern E F, Gazelle G S. Variables affecting proper system grounding for radiofrequency ablation in an animal model. J Vasc Interv Radiol. 2000; 11(8) 1069-1075
- 41 Sawada M, Watanabe S, Tsuda H, Kano T. An increase in body temperature during radiofrequency ablation of liver tumors. Anesth Analg. 2002; 94(6) 1416-1420
- 42 Goodman E J, Johnson P A. Radiofrequency ablation of hepatic tumors can cause elevation of the patient's temperature. Anesth Analg. 2003; 97(4) 1203-1204
- 43 Frich L, Halvorsen P S, Skulstad H, Damås J K, Gladhaug I P. Microbubbles in the pulmonary artery generated during experimental hepatic radiofrequency ablation is correlated with increased pulmonary arterial pressure. J Vasc Interv Radiol. 2007; 18(3) 437-442
- 44 Sweesy M W, Holland J L, Smith K W. Electromagnetic interference in cardiac rhythm management devices. AACN Clin Issues. 2004; 15(3) 391-403
- 45 Donohoo J H, Anderson M T, Mayo-Smith W W. Pacemaker reprogramming after radiofrequency ablation of a lung neoplasm. AJR Am J Roentgenol. 2007; 189(4) 890-892
- 46 Tong N Y, Ru H J, Ling H Y, Cheung Y C, Meng L W, Chung P C. Extracardiac radiofrequency ablation interferes with pacemaker function but does not damage the device. Anesthesiology. 2004; 100(4) 1041
- 47 Hayes D L, Charboneau J W, Lewis B D, Asirvatham S J, Dupuy D E, Lexvold N Y. Radiofrequency treatment of hepatic neoplasms in patients with permanent pacemakers. Mayo Clin Proc. 2001; 76(9) 950-952
- 48 Asensio E L, López T G, Guerrero M H et al.. Radiofrequency ablation of a hepatic neoplasm in a patient with an abdominal pacemaker. Cardiol J. 2009; 16(3) 264-268
- 49 Dodd III G D, Napier D, Schoolfield J D, Hubbard L. Percutaneous radiofrequency ablation of hepatic tumors: postablation syndrome. AJR Am J Roentgenol. 2005; 185(1) 51-57
- 50 Dupuy D E, Mayo-Smith W W, Abbott G F, DiPetrillo T. Clinical applications of radio-frequency tumor ablation in the thorax. Radiographics. 2002; 22 S259-S269
- 51 Dupuy D E, Zagoria R J, Akerley W, Mayo-Smith W W, Kavanagh P V, Safran H. Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol. 2000; 174(1) 57-59
- 52 Rose S C, Thistlethwaite P A, Sewell P E, Vance R B. Lung cancer and radiofrequency ablation. J Vasc Interv Radiol. 2006; 17(6) 927-951, quiz 951
- 53 Fernando H C. Radiofrequency ablation to treat non-small cell lung cancer and pulmonary metastases. Ann Thorac Surg. 2008; 85(2) S780-S784
- 54 Steinke K, King J, Glenn D W, Morris D L. Percutaneous radiofrequency ablation of lung tumors with expandable needle electrodes: tips from preliminary experience. AJR Am J Roentgenol. 2004; 183(3) 605-611
- 55 Simon C J, Dupuy D E, DiPetrillo T A et al.. Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology. 2007; 243(1) 268-275
- 56 Sano Y, Kanazawa S, Gobara H et al.. Feasibility of percutaneous radiofrequency ablation for intrathoracic malignancies: a large single-center experience. Cancer. 2007; 109(7) 1397-1405
- 57 Nomura M, Yamakado K, Nomoto Y et al.. Complications after lung radiofrequency ablation: risk factors for lung inflammation. Br J Radiol. 2008; 81(963) 244-249
- 58 Yamakado K, Hase S, Matsuoka T et al.. Radiofrequency ablation for the treatment of unresectable lung metastases in patients with colorectal cancer: a multicenter study in Japan. J Vasc Interv Radiol. 2007; 18(3) 393-398
- 59 Steinke K, Sewell P E, Dupuy D et al.. Pulmonary radiofrequency ablation—an international study survey. Anticancer Res. 2004; 24(1) 339-343
- 60 Steinke K, King J, Glenn D, Morris D L. Radiologic appearance and complications of percutaneous computed tomography-guided radiofrequency-ablated pulmonary metastases from colorectal carcinoma. J Comput Assist Tomogr. 2003; 27(5) 750-757
- 61 Gillams A R, Lees W R. Radiofrequency ablation of lung metastases: factors influencing success. Eur Radiol. 2008; 18(4) 672-677
- 62 Hiraki T, Gobara H, Iishi T et al.. Percutaneous radiofrequency ablation for clinical stage I non-small cell lung cancer: results in 20 nonsurgical candidates. J Thorac Cardiovasc Surg. 2007; 134(5) 1306-1312
- 63 Jin G Y, Han Y M, Lee Y S, Lee Y C. Radiofrequency ablation using a monopolar wet electrode for the treatment of inoperable non-small cell lung cancer: a preliminary report. Korean J Radiol. 2008; 9(2) 140-147
- 64 Lee J M, Jin G Y, Goldberg S N et al.. Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report. Radiology. 2004; 230(1) 125-134
- 65 Akeboshi M, Yamakado K, Nakatsuka A et al.. Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response. J Vasc Interv Radiol. 2004; 15(5) 463-470
- 66 Hiraki T, Gobara H, Iishi T et al.. Percutaneous radiofrequency ablation for pulmonary metastases from colorectal cancer: midterm results in 27 patients. J Vasc Interv Radiol. 2007; 18(10) 1264-1269
- 67 Herrera L J, Fernando H C, Perry Y et al.. Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates. J Thorac Cardiovasc Surg. 2003; 125(4) 929-937
- 68 Yamagami T, Kato T, Hirota T, Yoshimatsu R, Matsumoto T, Nishimura T. Pneumothorax as a complication of percutaneous radiofrequency ablation for lung neoplasms. J Vasc Interv Radiol. 2006; 17(10) 1625-1629
- 69 Yamakado K, Akeboshi M, Nakatsuka A et al.. Tumor seeding following lung radiofrequency ablation: a case report. Cardiovasc Intervent Radiol. 2005; 28(4) 530-532
- 70 Hiraki T, Mimura H, Gobara H et al.. Two cases of needle-tract seeding after percutaneous radiofrequency ablation for lung cancer. J Vasc Interv Radiol. 2009; 20(3) 415-418
- 71 Vaughn C, Mychaskiw II G, Sewell P. Massive hemorrhage during radiofrequency ablation of a pulmonary neoplasm. Anesth Analg. 2002; 94(5) 1149-1151
- 72 Sakurai J, Hiraki T, Mukai T et al.. Intractable pneumothorax due to bronchopleural fistula after radiofrequency ablation of lung tumors. J Vasc Interv Radiol. 2007; 18(1 Pt 1) 141-145
- 73 Gobara H, Hiraki T, Mukai T et al.. Abstract No. 330: Thermal nerve injury after percutaneous radiofrequency ablation for lung tumor. J Vasc Interv Radiol. 2008; 19 S121-S122
- 74 Le T X, Andrews R T. Thermal osteonecrosis of the rib after radiofrequency ablation in the thorax. J Vasc Interv Radiol. 2008; 19(6) 940-944
- 75 Aberle D R, Gamsu G, Golden J A. Fatal systemic arterial air embolism following lung needle aspiration. Radiology. 1987; 165(2) 351-353
- 76 Yamamoto A, Matsuoka T, Toyoshima M et al.. Assessment of cerebral microembolism during percutaneous radiofrequency ablation of lung tumors using diffusion-weighted imaging. AJR Am J Roentgenol. 2004; 183(6) 1785-1789
- 77 Rose S C, Fotoohi M, Levin D L, Harrell J H. Cerebral microembolization during radiofrequency ablation of lung malignancies. J Vasc Interv Radiol. 2002; 13(10) 1051-1054
- 78 Jin G Y, Lee J M, Lee Y C, Han Y M. Acute cerebral infarction after radiofrequency ablation of an atypical carcinoid pulmonary tumor. AJR Am J Roentgenol. 2004; 182(4) 990-992
- 79 Ghaye B, Bruyère P J, Dondelinger R F. Nonfatal systemic air embolism during percutaneous radiofrequency ablation of a pulmonary metastasis. AJR Am J Roentgenol. 2006; 187(3) W327-W328
- 80 Stone M J, Venkatesan A M, Locklin J, Pinto P, Linehan M, Wood B J. Radiofrequency ablation of renal tumors. Tech Vasc Interv Radiol. 2007; 10(2) 132-139
- 81 Brown D B. Concepts, considerations, and concerns on the cutting edge of radiofrequency ablation. J Vasc Interv Radiol. 2005; 16(5) 597-613
- 82 Hui G C, Tuncali K, Tatli S, Morrison P R, Silverman S G. Comparison of percutaneous and surgical approaches to renal tumor ablation: metaanalysis of effectiveness and complication rates. J Vasc Interv Radiol. 2008; 19(9) 1311-1320
- 83 Zagoria R J, Traver M A, Werle D M, Perini M, Hayasaka S, Clark P E. Oncologic efficacy of CT-guided percutaneous radiofrequency ablation of renal cell carcinomas. AJR Am J Roentgenol. 2007; 189(2) 429-436
- 84 Zagoria R J. Imaging-guided radiofrequency ablation of renal masses. Radiographics. 2004; 24(Suppl 1) S59-S71
- 85 Farrell M A, Charboneau W J, DiMarco D S et al.. Imaging-guided radiofrequency ablation of solid renal tumors. AJR Am J Roentgenol. 2003; 180(6) 1509-1513
- 86 Hwang J J, Walther M M, Pautler S E et al.. Radio frequency ablation of small renal tumors: intermediate results. J Urol. 2004; 171(5) 1814-1818
- 87 Mayo-Smith W W, Dupuy D E, Parikh P M, Pezzullo J A, Cronan J J. Imaging-guided percutaneous radiofrequency ablation of solid renal masses: techniques and outcomes of 38 treatment sessions in 32 consecutive patients. AJR Am J Roentgenol. 2003; 180(6) 1503-1508
- 88 Mahnken A H, Günther R W, Tacke J. Radiofrequency ablation of renal tumors. Eur Radiol. 2004; 14(8) 1449-1455
- 89 Gervais D A, McGovern F J, Arellano R S, McDougal W S, Mueller P R. Radiofrequency ablation of renal cell carcinoma: part 1, Indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR Am J Roentgenol. 2005; 185(1) 64-71
- 90 Breen D J, Rutherford E E, Stedman B et al.. Management of renal tumors by image-guided radiofrequency ablation: experience in 105 tumors. Cardiovasc Intervent Radiol. 2007; 30(5) 936-942
- 91 Dib R E, Touma N J, Kapoor A. Review of the efficacy and safety of radiofrequency ablation for the treatment of small renal masses. Can Urol Assoc J. 2009; 3(2) 143-149
- 92 Ahrar K, Matin S, Wood C G et al.. Percutaneous radiofrequency ablation of renal tumors: technique, complications, and outcomes. J Vasc Interv Radiol. 2005; 16(5) 679-688
- 93 Clark T W, Malkowicz B, Stavropoulos S W et al.. Radiofrequency ablation of small renal cell carcinomas using multitined expandable electrodes: preliminary experience. J Vasc Interv Radiol. 2006; 17(3) 513-519
- 94 Park B K, Kim C K, Moo H L. Arteriovenous fistula after radiofrequency ablation of a renal tumor located within the renal sinus. J Vasc Interv Radiol. 2007; 18(9) 1183-1185
- 95 Wah T M, Irving H C. Infectious complications after percutaneous radiofrequency ablation of renal cell carcinoma in patients with ileal conduit. J Vasc Interv Radiol. 2008; 19(9) 1382-1385
- 96 Krambeck A E, Farrell M A, Charboneau J W, Frank I, Zincke H. Intraperitoneal drop metastasis after radiofrequency ablation of pararenal tumor recurrences. Urology. 2005; 65(4) 797
Kent T SatoM.D.
Department of Radiology, Northwestern University
251 East Huron Street, Chicago, IL 60611
Email: k-sato@northwestern.edu