Table 1.
Main potential advantages and disadvantages of each energy-based ablative technology in hepatic tumor treatment
| Technology | Potential Advantages | Potential Disadvantages |
|---|---|---|
| RFA | • High rates of local control in tumors 3 cm or smaller | • High rates of incomplete ablation in tumors larger than 3 cm |
| • Established safety profile | • Heat sink effect in perivascular tumors | |
| • Known limitations | • Potential risk of thermal injury to critical structures | |
| • Experience in combination treatments (HCC) | • Variability in RFA devices | |
| • Widely available | ||
| MWA | • Potential to treat tumors larger than 3 cm more effectively | • Limited efficacy data (predictability and reproducibility) |
| • Less impacted by heat sink effect | • Limited safety data | |
| • Ability to activate multiple probes at the same time | • Potential risk of thermal injury to critical structures (and vessels?) | |
| • No grounding pads required | • Variability in MWA devices | |
| CRYO | • Ability to activate multiple probes at the same time | • Insufficient clinical data |
| • Ability to image the ice-ball formation | • Risk of bleeding | |
| • Risk of cryoshock | ||
| IRE | • Potential to treat tumors located in the vicinity of critical structures | • Insufficient clinical data |
| • Heat sink effect not relevant | • Neuromuscular blockage and cardiac gating required | |