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Techniques in Interventional Radiology
Other titles in this Series
Handbook of Angioplasty and Stenting Procedures
Transcatheter Embolization and Therapy
Interventional Radiology Procedures in Biopsy and Drainage
Interventional Neuroradiology
Paediatric Interventional Radiology
Timothy Clark • Tarun Sabharwal
Editors
Michael J. Lee • Anthony F. Watkinson
Series Editors
Interventional Radiology
Techniques in Ablation
Editors
Timothy Clark, MD, FSIR
Department of Radiology
Section of Vascular
and Interventional Radiology
University of Pennsylvania
Philadelphia, PA
USA
Tarun Sabharwal, MB,ChB, FRCSI, FRCR
Department of Radiology
St Thomas’ Hospital
London
UK
Series Editors
Michael J. Lee, MSc, FRCPI, FRCR,
FFR(RCSI), FSIR, EBIR
Department of Radiology
Beaumont Hospital
Dublin
Ireland
Anthony F. Watkinson, BSc, MSc(oxon),
MBBS, FRCS, FRCR, EBIR
Department of Radiology
The Royal Devon and Exeter Hospital
and Peninsula Medical School
Exeter
UK
ISBN 978-0-85729-093-9 ISBN 978-0-85729-094-6 (eBook)
DOI 10.1007/978-0-85729-094-6
Springer Dordrecht Heidelberg New York London
Library of Congress Control Number: 2012948088
© Springer-Verlag London 2013
Whilst we have made considerable efforts to contact all holders of copyright material contained in this
book, we may have failed to locate some of them. Should holders wish to contact the Publisher, we will
be happy to come to some arrangement with them.
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfilms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection
with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and
executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this
publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s
location, in its current version, and permission for use must always be obtained from Springer. Permissions
for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to
prosecution under the respective Copyright Law.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the date of
publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for
any errors or omissions that may be made. The publisher makes no warranty, express or implied, with
respect to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
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v
Preface from the Series Editors
Interventional radiology treatments now play a major role in many disease pro-
cesses and continue to mushroom with novel procedures appearing almost on a
yearly basis. Indeed, it is becoming more and more dif fi cult to be an expert in all
facets of interventional radiology. The interventional trainee and practising inter-
ventional radiologist will have to attend meetings and read extensively to keep up to
date. There are many IR textbooks that are disease speci fi c, but incorporate inter-
ventional radiology techniques. These books are important to understand the natural
history, epidemiology, pathophysiology, and diagnosis of disease processes.
However, a detailed handbook that is technique-based is a useful addition to have in
the Cath Lab, of fi ce, or at home where information can be accessed quickly, before,
or even during a case. With this in mind we have embarked on a series of books
which will provide technique-speci fi c information on IR procedures. Initialy, tech-
nique handbooks on angioplasty and stenting, transcatheter embolization, biopsy
and drainage and ablative techniques will comprise the series. In the future we hope
to add books on pediatric and neurointervention.
We have chosen two editors, who are expert in their fi elds, for each book. One
editor is an European and the other is an American so that the knowledge of detailed
IR techniques is balanced and representative. We have tried to make the information
easy to access using a consistent bullet point format with sections on clinical fea-
tures, anatomy, tools, patient preparation, technique, aftercare, complications, and
key points at the end of each chapter.
These technique-speci fi c books will be of bene fi t to those residents and fellows
who are training in interventional radiology and who may be taking subspeciality
certi fi cate examinations in interventional radiology. In addition, these books will be
of help to most practicing interventional radiologists in academic or private prac-
tice. We hope that these books will be left in the interventional lab where they
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vi
Preface from the Series Editors
should also be of bene fi t to ancillary staff, such as radiology technicians, radiogra-
phers, or nurses who are specializing in the care of patients referred to interven-
tional radiology.
We hope that you will use these books extensively and that they will be of help
during your working IR career.
Dublin, Ireland Michael J. Lee
Exeter, UK Anthony F. Watkinson
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vii
Preface
In preparing Interventional Radiology Techniques in Ablation we sought to develop
a practical and concise guide to contemporary techniques in image-guided tumor
ablation. This handbook is intended to serve as a quick reference for physicians in
interventional radiology training as well as a resource for IR technologists, nurses,
nurse practitioners, and physician assistants.
To avoid duplicate descriptions of ablation technologies within multiple clinical
applications, we have divided the book into a Technology Overview section address-
ing current ablation technologies followed by chapters addressing speci fi c clinical
applications. We have utilized the expertise of contributors from the USA, Europe,
and Asia to provide broad and international perspectives on tumor ablation. This
includes chapters on well-established applications such as liver ablation to more
recent developments in breast and endocrine ablation. We have retained the style of
this series, with consistent headings across chapters to provide organization for gen-
eral reading and enable rapid access to key points. Each chapter is supplemented
with a short list of up-to-date references to serve as the basis for further reading.
Selected fi gures are provided to illustrate important concepts.
We are grateful to Professors Lee and Watkinson for their vision and guidance in
the development of this unique series. We are also very appreciative of the patience
and support of Springer-Verlag, particularly Maureen Alexander.
Timothy Clark
Tarun Sabharwal
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ix
Contents
1 Introduction ............................................................................................. 1
Timothy Clark
Part I: Technology Assessment
2 Overview of Thermal Ablation Devices:
Radiofrequency Ablation ....................................................................... 5
Miltiadis Krokidis and Irfan Ahmed
3 Overview of Thermal Ablation Devices:
Cryoablation ............................................................................................ 13
Joseph P. Erinjeri
4 Overview of Thermal Ablation Devices: Microwave ........................... 21
Jeffrey A. Klein, Fred T. Lee Jr., J. Louis Hinshaw,
Meghan G. Lubner, and Chris L. Brace
5 Overview of Thermal Ablation Devices: HIFU,
Laser Interstitial, Chemical Ablation.................................................... 29
Julien Garnon, Georgia Tsoumakidou, Iulian Enescu,
Xavier Buy, and Afshin Gangi
6 Overview of Thermal Ablation: Plasma-Mediated Ablation .............. 43
Konstantinos Katsanos
Part II: Clinical Applications
7 Radiofrequency Ablation of Thyroid and Parathyroid Nodules ........ 53
Jung Hwan Baek
8 Breast Ablation: Breast Carcinoma, Fibroadenomas .......................... 73
Rachel R. Bitton, Bruce L. Daniel,
and Kim Butts Pauly
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