Article

Abdominal Imaging

, Volume 36, Issue 6, pp 635-647

First online:

The current role of minimally invasive therapies in the management of liver tumors

  • Hansjörg RemppAffiliated withDepartment on Diagnostic and Interventional Radiology, Eberhard Karls University Hospital of Tübingen Email author 
  • , Andreas BossAffiliated withDivision of Diagnostic and Interventional Radiology, University Hospital Zurich
  • , Thomas HelmbergerAffiliated withInstitute of Diagnostic and Interventional Radiology and Nuclear Medicine, Klinikum Bogenhausen
  • , Philippe PereiraAffiliated withClinic for Radiology, Minimally Invasive Therapies and Nuclear Medicine, SLK-Kliniken

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Abstract

This is a review of minimally invasive therapy options for liver tumors, such as highly focused ultrasound, microwave ablation, and irreversible electroporation, as well as new aspects of radiofrequency ablation. Radiofrequency ablation is recommended for patients with early-stage HCC with up to 3 lesions with a tumor diameter within 3 cm and for patients with non-resectable liver metastasis. Indications and contraindications to treatment are designated, and different modalities for image-based therapy guidance are compared. Options for therapy monitoring and controlling are reviewed, namely intraprocedural tools, imaging and functional parameters and their evolution during therapy. Prevention and control of local recurrences is discussed. We also present a short review of current clinical results in treating liver metastasis and primary liver tumors.

Key words

Ablative therapies Microwave ablation Radiofrequency ablation Highly focused ultrasound Irreversible electroporation MR functional imaging MR thermometry Hepatocellular carcinoma Liver metastasis