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Semin intervent Radiol 2023; 40(06): 491-496
DOI: 10.1055/s-0043-1777845
Review Article

Thermal Ablation in the Liver: Heat versus Cold—What Is the Role of Cryoablation?

Donna L. D'Souza
1   Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota
,
Ranjan Ragulojan
1   Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota
,
Chunxiao Guo
1   Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota
,
Connie M. Dale
1   Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota
,
Christopher J. Jones
1   Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota
,
Reza Talaie
1   Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota
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Abstract

Cryoablation is commonly used in the kidney, lung, breast, and soft tissue, but is an uncommon choice in the liver where radiofrequency ablation (RFA) and microwave ablation (MWA) predominate. This is in part for historical reasons due to serious complications that occurred with open hepatic cryoablation using early technology. More current technology combined with image-guided percutaneous approaches has ameliorated these issues and allowed cryoablation to become a safe and effective thermal ablation modality for treating liver tumors. Cryoablation has several advantages over RFA and MWA including the ability to visualize the ice ball, minimal procedural pain, and strong immunomodulatory effects. This article will review the current literature on cryoablation of primary and secondary liver tumors, with a focus on efficacy, safety, and immunogenic potential. Clinical scenarios when it may be more beneficial to use cryoablation over heat-based ablation in the liver, as well as directions for future research, will also be discussed.

Keywords

cryoablation - radiofrequency ablation - microwave ablation - hepatocellular carcinoma - liver metastases - interventional radiology


Publication History

Article published online:
24 January 2024

© 2023. Thieme. All rights reserved.

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