Beebe Medical Center Radiologist destroys Liver Cancer through Nonsurgical Radiofrequency Procedure

a. The first image shows the tumor mass before any electrode is inserted.

b. The second image shows the tumor mass with the electrode inside. The radiofrequency procedure has started and micro bubbling from the heat is starting to form at the periphery.

It is not unusual for a radiologist in a major, medical research center to use imaging-guided, radiofrequency technology to destroy a liver cancer without the need for surgery. The procedure takes a skilled radiologist, a consulting surgical oncologist, an experienced team of interventional radiology technologists, and highly specialized medical equipment. So, when Beebe Medical Center radiologist Michael Ramjattansingh, MD, recently destroyed a cancerous tumor in the liver of a local patient working in the interventional radiology lab at the hospital and without a surgeon’s touch, a sense of accomplishment spread amongst those at Beebe who treat cancer patients. “This is a huge accomplishment and revolutionizes the way we at Beebe take care of patients with tumors of the liver and biliary system,” says surgical oncologist James E. Spellman, MD, of the Division of Surgical Oncology at Beebe Physician Network. “It allows us to continually expand the medical treatment options for cancer and to improve the care that we bring to this community.” Surgically removing cancers of the liver is one of the many complex cancer surgical procedures that Dr. Spellman and surgical oncologist Chia-Chi Wang, DO, perform at Beebe Medical Center. Dr. Ramjattansingh, a skilled radiologist, is experienced in interventional radiology procedures, as well as reading and assessing the variety of images taken at the hospital. He has performed imaging-guided radiofrequency ablations of cancers in the operating room. In those situations, the surgeons were operating and the patients were under general anesthesia and surgically open, with their internal organs exposed. But this recent procedure was different. Surgical oncologist Dr. Wang had determined that the patient was not a candidate for surgery, even though the cancerous tumor needed to be removed from the liver. The patient had serious breathing problems and other health complications that made it a considerable risk for general anesthesia to be used. Dr. Ramjattansingh and Beebe’s interventional radiology team had been educated in the latest radiofrequency ablation system, which would allow the nonsurgical procedure to be performed with a local pain killer, much like what is used in a dental office for a routine procedure. “The patient was able to talk to me throughout the procedure,” Dr. Ramjattansingh recalled. “I wanted to make sure that he was comfortable. I told him exactly what to expect. He had no pain and went home the next day.” Once the patient’s abdomen was numb, Dr. Ramjattansingh inserted a probe through the skin, into the liver and into the cancerous tumor itself. He was able to follow the route of the probe by watching the image on an ultrasound screen. At the end of the probe was a needle electrode. Once he positioned the electrode within the tumor, the electrode delivered a radiofrequency that created so much heat that the tumor tissue was destroyed (ablated). The healthy tissue of the liver was not affected by the heat generated within the tumor. During the procedure, interventional radiology team members monitored the imaging and radiofrequency equipment. Dr. Ramjattansingh then carefully removed the probe and sealed the small incision. “We are extremely pleased to be able to bring this technology to our community, and to have the skilled and quality medical team to be able to perform this procedure,” says Dan Mapes, Director of Imaging at Beebe Medical Center. Beebe Medical Center continues to grow the minimally invasive procedures it offers the community. These procedures, as well as the minimally invasive surgeries, generally have shown to improve patient outcomes. The Beebe Medical Center Board of Directors approved the new Minimally Invasive Surgery Department in December 2011. The Medical Center also has continued to improve and expand the procedures and surgeries it offers for the treatment of cancer.