History of the Tumor Ablation Program
Cross-Sectional Interventional Radiology (CSIR)
Go to Tumor Ablation Program Introduction
Image-guided percutaneous tumor ablation is a growing field world-wide. There are ongoing increases in the number of procedures and advances in both the technologies of imaging and the ablation devices. Our tumor ablation program uses a full array of several imaging techniques [ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) 
and positron emission tomography (PET)] and therapeutic ablative modalities (alcohol, radiofrequency, cryotherapy). Our program is unique in this respect as compared against other centers that typically use one ablative modality and one or two imaging techniques; we use all of them.
Our interest and research efforts in image-guided tumor ablation have arisen from developments in the field of medical imaging that have made image-guided percutaneous interventions feasible. These developments include both improved image acquisition and advanced computer visualization of image data. In 1988, our group presented and published the first research on the use of MRI to visualize therapeutic thermal events in tissue. The initial focus was on MRI of experimental interstitial laser tissue coagulation and cryotherapy. These were pioneering efforts of MRI image-guided thermal therapies and established a foot-hold in the history of the field.
The Tumor Ablation Program (TAP) was born out of the Department of Radiology’s Cross-Sectional Interventional Radiology (CSIR) that officially commenced clinical operations in 1990 as a departmental commitment to interventional radiology. The general interventional practice expanded steadily through the 1990’s with an increasing role in patient care, mirroring a 
nationwide trend.
The research efforts in MRI both fueled a growing interest in clinical applications and research of percutaneous thermal ablation of tumors. Technical developments and physical resources have always played vital roles for CSIR and TAP from the acquisition of a dedicated US system to the advent of CT fluoroscopy. However, a key development for TAP was the opening of the interventional MRI suite in 1994. The centerpiece of this suite was the first-of-its-kind, a “vertically open” interventional 0.5 Tesla scanner. After performing the first-ever fully MRI-guided needle biopsy, the principles and techniques of targeting and navigating with MRI were established and extended to percutaneous tumor ablations in 1996.
The first image-guided ablation performed in the open MRI scanner targeted a liver metastasis with interstitial laser thermal photocoagulation. In 1998, the range of treatment modalities was extended to include cryotherapy for tumor ablation. The ablation service extended further (and provided for the treatment of larger large liver metastases) with the addition of interstitial radiofrequency (RF) coagulation - done percutaneously under CT guidance. In 2000 and 2001, cryotherapy and RF ablation (RFA) were applied outside the liver in the kidney under MRI and CT, respectively. Tumor ablation in the adrenal gland was added in 2001. The program’s first CT-guided RFA in the lung was first performed in 2001. Currently 2-4 patients are treated each week. 
MILESTONES
1990 CIS opens: US, CT-guided interventions offered to patients
1994 Interventional MRI suite opens
1994 First percutaneous MRI-guided procedure performed:
MRI-guided abdominal mass biopsy (the first MR-
guided biopsy in which entire procedure was performed
under MRI-guidance)
1995 CIS patient volume increases steadily through the 1990s
1996 First percutaneous MRI-guided tumor ablation: MRI-guided laser ablation of a liver metastasis: TAP launched
1997 CT fluoroscopy (a.k.a. “real-time” CT) used to guide interventions, one of the first sites to use such device
1998 First percutaneous MRI-guided cryo-ablation of a liver tumor (one of the first performed in the world)
1998 First percutaneous MRI-guided musculoskeletal tumor ablation: cryotherapy (one of the first performed
in the world)
1999 CIS patient volume grows by 30% per year
1999 First percutaneous CT-guided liver tumor ablation: RFA (cooled tip device)
2000 First percutaneous MRI-guided kidney tumor ablation: cryotherapy
2000 CIS Nurse Coordinator position created
2001 First percutaneous CT-guided RFA in the lung (array-style device)
2001 First percutaneous MRI-guided cryo-ablation of an adrenal tumor
2001 First percutaneous CT-guided RFA of an adrenal tumor using a RF needle electrode with cooled tip
2001 First percutaneous CT-guided RFA in a kidney (array-style device)
2002 100th ablation procedure in May, 2002; 150th in December, 2002
2002 First percutaneous CT-guided alcohol ablation of a pancreatic tumor
2003 Apply cryo-probe template for multi-probe cryotherapy
2003 First MRI-guided RFA of a kidney tumor
2003 First MRI-guided RFA of a liver tumor
2003 230th ablation procedure in December, 2003
Send Feedback to: 
