Radiology_May04


EDITORIAL

2 SA JOURNAL OF RADIOLOGY • May 2004

The exciting developments in magnetic resonance imaging are leading ustowards the fetus, the female breast and the prostate gland, resulting in a smil-
ing contented look on the face of radiology, not to mention the prospect of regain-
ing imaging of the coronary arteries (that has been the sole and dearly cherished
possession of the cardiologists for decades), with multi-slice computed tomogra-
phy approaching resolution comparable to digital angiography. Despite all the
commotion surrounding the MR and CT consoles we can always rely on the inter-
ventional magicians to invent new fascinating, sometimes frightening and occa-
sionally totally impractical procedures to stimulate the everlasting repressed surgi-
cal pulses in our blood. We have dilated, embolised, occluded, excluded, infiltrat-
ed and biopsied almost everything. With radiofrequency ablation (RFA),‘cooking’
is definitely the new kid on the block. RFA has been employed for some time for
the treatment of primary and metastatic liver tumours. Pancreatic tumours, bone
metastases and intra-pulmonary tumours are being treated similarly and RFA has
recently entered phase 2 clinical trials for the treatment of small renal tumours.

RFA involves the use of high-frequency electrical current to cause heat-based
tissue destruction through needle electrodes of varying diameters depending on
the size of the tumour treated. Limitations include tumours larger than 5 cm in
diameter as well as proximity to vascular structures and other visceral organs.
Treatment of liver tumours can be done percutaneously or as an open procedure
during which the tumour can be visualised with an ultrasound probe placed
directly on the surface of the liver.

RFA is still in its infancy. The initial results are promising and have certainly
caught the imagination of interventional radiologists, surgeons and oncologists.
The length of treatment varies considerably, depending on the size and number of
lesions treated. It would seem that we are facing long sessions of coagulating vari-
ous lesions, hopefully with excellent results, whilst in the process broadening our
musical repertoire, listening to Bach, the Beatles or Britney, depending on the age
of the interventional radiologist hanging on to the end of the electrode.

Radiofrequency ablation

Leonie Scholtz
MB ChB, MMedRad (D) 

Department of Radiology
University of Pretoria

Leonie Scholtz
Editor