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Digestive Disease Interventions 2019; 03(02): 107-116
DOI: 10.1055/s-0039-1691813
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ablation in Primary Liver Tumors

D. Putzer
1   Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
,
P. Schullian
1   Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
,
R. Bale
1   Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
› Institutsangaben
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Publikationsverlauf

22. Dezember 2018

16. April 2019

Publikationsdatum:
03. Juni 2019 (online)

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Abstract

Minimal invasive thermal ablation techniques have a key role in the treatment regimen of primary liver tumors. These relatively low-risk procedures are established in nonresectable liver tumors and even challenge the surgical approach, which is regarded as first-line treatment in eligible patients.

The location and size of the liver tumor, the applied ablation, and guidance technique are crucial for treatment outcome. The confirmation of an adequate ablation zone including sufficient tumor overlap and a safety margin (A0 ablation analogous to R0 resection) is crucial to minimize local recurrence rates and improve survival. A variety of different ablation devices is available. The outcome of conventional computed tomography- or ultrasound-guided thermal ablation in small lesions is well comparable to surgery. However, in liver lesions with large diameter overlapping ablation zones are required to ensure an adequate ablation margin. Therefore, stereotactic techniques in combination with a multiple needle approach, three-dimensional trajectory planning, and image fusion for intraoperative treatment evaluation have been successfully introduced.

Keywords

radiofrequency ablation - liver tumor treatment - percutaneous tumor treatment - interventional oncology - stereotaxy