The Health Services Authority (HSA) has pioneered the use of a unique procedure in the Cayman Islands with the addition of an interventional radiologist to its team of specialists.

The procedure known as ‘Radiofrequency Ablation (RFA)’ was performed, for the first time on island, at the Cayman Islands Hospital in the treatment of a patient with Osteoid Osteoma, a benign bone tumor.

A multi-disciplinary team consisting of Dr. Hesham Sida, Orthopaedic Surgeon, CTMH Doctors Hospital, Dr. Shravana Jyoti, Pathologist, HSA and Dr. Vladimir Sloboda, Interventional Radiologist, HSA, worked to make this case a success.

Radiofrequency ablation (RFA) is a thermal ablation technique that uses electrodes to generate heat and destroy abnormal tissue. It is a minimally invasive technique for treatment of cancer. RFA is routinely used by interventional radiologist who use imaging techniques (CT, US, MRI) to insert the RFA probe/electrode through the skin into a tumor.

The range of diseases and organs amenable to the procedures are constantly evolving. They include, but are not limited to, diseases and elements of the vascular, gastrointestinal, hepatobiliary, genitourinary, pulmonary, musculoskeletal and central nervous system.

“Interventional radiology is a subspecialty of radiology that uses minimally-invasive image-guided techniques to diagnose and treat diseases in nearly every organ system. It has been described as the surgery of the new millennium. It is more effective, has lower risk of complications, is less painful and has quicker recovery times in comparison to open surgery,” noted Dr. Sloboda.

In a Continuing Medical Education (CME) presentation held on Wednesday, 3 May at the George Town Yacht Club, the team of specialists provided an overview of the procedure and the vast array of other interventional radiology procedures now available at the HSA. Approximately 40 clinical professionals attended the event.

During his presentation, Dr. Sida stated that the patient was a minor who sought care at the CTMH Doctor’s Hospital. Upon initial examination and diagnosis, Dr. Sida decided that a multi-disciplinary approach would provide the best outcome for his patient and proceeded to collaborate with Dr. Sloboda and Dr. Jyoti.

Dr. Sida and Dr. Sloboda carried out clinical and radiological diagnoses before sending the abnormal tissue taken from the patient to Dr. Jyoti at the HSA’s pathology laboratory. “In a multi-disciplinary approach there is a loop; the loop is closed when pathology confirms the diagnosis,” said Dr. Sida.

“My role in this case was to look at the tissue at a microscopic level and rule out any other pathological conditions to conclude the final diagnosis,” Dr. Jyoti explained.

Treatment options were discussed with the patient and his family and the interventional radiology procedure, RFA, was selected as the best option for the patient. RFA has been used for bone, liver, kidney, heart, prostate, breast, brain, lymph nodes, nerve ganglia and soft tissue. It has also been applied in the treatment of arrhythmias (abnormal heart rhythms), tumors and nerve ganglion ablation. RFA usually has few complications, and can be repeated if necessary for the same or additional tumors.

“This procedure significantly reduces the recovery time in comparison to the traditional invasive option, which is surgery. With surgery, recovery time for this patient may have taken a minimum of six months; however, this procedure allows the patient to return to sports in about six weeks,” Dr. Sida noted.

“I worked alongside Dr. Sloboda because he is the only interventional radiologist on island with experience performing this procedure. This demonstrates the importance of the private and public sectors collaborating to utilize the skills that are available on island to better meet the needs of the people,” Dr. Sida added.

RFA, along with other IR procedures, have become an integral part of medical care and are now available to doctors and their patients on island at the HSA.