77013 Computed tomography guidance for, and monitoring of, parenchymal tissue ablation

Name of the Procedure:

Computed tomography (CT) guidance for, and monitoring of, parenchymal tissue ablation. Also known as CT-guided ablation.

Summary

CT-guided ablation involves using computed tomography imaging to precisely locate and destroy abnormal tissue within an organ, such as a tumor, using heat, cold, or chemical methods. This minimally invasive procedure allows for targeted treatment with minimal damage to surrounding tissue.

Purpose

CT-guided ablation is used to treat various conditions, including cancerous tumors in organs such as the liver, lungs, and kidneys. The goal is to eradicate the abnormal tissue while preserving as much healthy tissue as possible.

Indications

• Liver, kidney, or lung tumors that are small and localized.
• Patients who are not ideal candidates for surgical removal of tumors.
• Recurrent tumors that have been previously treated.

Preparation

• Fasting for a specific period before the procedure.
• Stopping certain medications, such as blood thinners, as instructed by the healthcare provider.
• Pre-procedural imaging tests, such as MRI or CT scans, to map out the target area.
• Blood tests to ensure proper clotting and kidney function.

Procedure Description

1. The patient lies on a CT scanning table.
2. An initial CT scan is performed to locate the target tissue.
3. Local anesthesia or sedation is administered to ensure patient comfort.
4. A needle or probe is guided to the abnormal tissue using real-time CT imaging.
5. The abnormal tissue is ablated using one of the following methods:
   • Radiofrequency ablation (RFA): Uses heat.
   • Cryoablation: Uses extreme cold.
   • Microwave ablation: Uses microwave energy.
   • Chemical ablation: Uses chemicals to destroy tissue.
6. Additional CT scans monitor the procedure and ensure the entire target area is treated.

Duration

The procedure typically takes 1 to 3 hours, depending on the complexity and the size/location of the target tissue.

Setting

Performed in a hospital or specialized outpatient clinic with access to CT imaging equipment.

Personnel

• Radiologist or interventional radiologist.
• Radiologic technologist.
• Nursing staff.
• Anesthesiologist or nurse anesthetist, if sedation is used.

Risks and Complications

• Common risks: Mild pain or discomfort, bruising, and temporary changes in blood pressure.
• Rare risks: Infection, bleeding, damage to surrounding tissues or organs, and adverse reactions to anesthesia.

Benefits

• Minimally invasive with a shorter recovery time compared to surgery.
• Effective local control of tumors.
• Minimal damage to surrounding healthy tissue.
• Can be repeated if necessary.

Recovery

• Patients may need to stay in a recovery area for a few hours post-procedure.
• Pain management with prescribed medications.
• Monitoring of vital signs and the treated area.
• Avoiding strenuous activities for a few days.
• Follow-up imaging tests to assess the effectiveness of the ablation.

Alternatives

• Surgical resection: More invasive, longer recovery time, but may be required for larger or multiple tumors.
• Radiation therapy: Non-invasive but requires multiple sessions and has potential long-term side effects.
• Chemotherapy: Systemic treatment with broader effects on the body, often used in combination with other treatments.

Patient Experience

• During the procedure: Patients may feel pressure or slight discomfort at the insertion site.
• After the procedure: Some mild pain or cramping at the treatment site is possible, managed with pain relievers.
• Follow-up care involves monitoring for any signs of complications, such as fever or increased pain, and ensuring the treated tissue is effectively ablated.