RFA |
• High rates of local control in tumors 3 cm or smaller |
• High rates of incomplete ablation in tumors larger than 3 cm |
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• Established safety profile |
• Heat sink effect in perivascular tumors |
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• Known limitations |
• Potential risk of thermal injury to critical structures |
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• Experience in combination treatments (HCC) |
• Variability in RFA devices |
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• Widely available |
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MWA |
• Potential to treat tumors larger than 3 cm more effectively |
• Limited efficacy data (predictability and reproducibility) |
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• Less impacted by heat sink effect |
• Limited safety data |
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• Ability to activate multiple probes at the same time |
• Potential risk of thermal injury to critical structures (and vessels?) |
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• No grounding pads required |
• Variability in MWA devices |
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CRYO |
• Ability to activate multiple probes at the same time |
• Insufficient clinical data |
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• Ability to image the ice-ball formation |
• Risk of bleeding |
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• Risk of cryoshock |
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IRE |
• Potential to treat tumors located in the vicinity of critical structures |
• Insufficient clinical data |
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• Heat sink effect not relevant |
• Neuromuscular blockage and cardiac gating required |