Image-guided percutaneous radiofrequency ablation and incidence of post-radiofrequency ablation syndrome: prospective survey
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Published on: August 25, 2022
Tze M Wah1, Ronald S Arellano, Debra A Gervais
1Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, 55 Fruit St, White Bldg 270, Boston, MA 02114-2696, USA.
Purpose:
To evaluate prospectively the incidence of post-radiofrequency (RF) ablation syndrome and determine its impact on the quality of life in the 10 days after percutaneous RF ablation.
Materials And Methods:
This study was approved by the institutional review board and was HIPAA compliant. Informed consent was obtained for this survey in all patients by the interventional nurse coordinators. Thirty-six patients (20 men, 16 women; mean age, 69.3 years; range, 40-88 years) underwent RF ablation for 26 liver tumors and 17 renal tumors. Twenty control patients (11 men, nine women; mean age, 60.8 years; range, 35-76 years) underwent biopsy of focal liver lesions or renal lesions. With a standardized questionnaire, a telephone survey was conducted on days 1, 3, 5, and 10 after RF ablation or biopsy. The symptoms and interference with lifestyle were documented prospectively with a numeric intensity scale by using grades 0-10. Statistical analysis with Fisher exact test and analysis of variance was performed.
Results:
After RF ablation, 15 (42%) patients developed low-grade fever (P < .001), 29 (81%) had flulike symptoms (P < .001), and four were asymptomatic. Symptoms peaked on day 3 and mainly resolved by day 10. Twelve (33%) patients had complete post-RF ablation syndrome: fever and flulike symptoms (P = .005). Flulike symptoms were more prolonged when they were accompanied with fever, peaked on day 5, and resolved more quickly for patients with renal lesions than they did for patients with liver lesions. Four patients had persistent fever caused by pneumonia (n = 2), pleural effusion and atelectasis (n = 1), or liver abscess (n = 1). No control patients developed both fever and flulike symptoms. Post-RF ablation patients with symptoms experienced significantly greater pain and interference with general and work activities, which peaked on day 1, than did control patients (P = .01 [pain], P < .001 [general and work activities]).
Conclusion:
Complete post-RF ablation syndrome occurs in approximately one-third of patients but is self-limiting within 10 days after the procedure. Persistent or late-onset fever may indicate concurrent infection elsewhere or possible abscess formation.
Supplemental Material:
radiology.rsnajnls.org/cgi/content/full/237/3/1097/DC1
