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Image-Guided Tumor Ablative Therapies

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Demystifying Interventional Radiology

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Abstract

The development of intra-arterial and percutaneous endovascular methods to access and treat pathologic lesions in the body has led to an increased role for interventional radiologists within multidisciplinary oncology treatment teams. There are multiple techniques that can be used for image-guided tumor ablation: non-thermal ablation techniques include chemical ablation and irreversible electroporation, whereas thermal ablation techniques for tumor treatment include radiofrequency ablation, cryoablation, and microwave ablation (MWA).

Non-thermal ablative therapy techniques utilize chemical and physical properties of compounds, such as the cell membrane, in order to cause protein denaturation and vascular occlusion of the tumor blood supply or to create permanent nanopores in the cell membrane that alters cell homeostasis leading to cell death. Thermal ablative therapy techniques utilize heat to destroy tumors, though the mechanisms differ; for example, microwave ablation [MWA] utilizes continuous realignment of water molecules to generate energy leading to tissue heating, while cryoablation utilizes conduction to remove heat and cause rapid tissue cooling leading to the formation of intracellular ice crystals (Hickey et al., J Vasc Interv Radiol 24:1167–88, 2013). Regardless of type, be it thermal or non-thermal ablative therapy, image-guided tumor ablation is deemed successful when a circumferential margin measuring 0.5 to 1.0 cm of healthy tissue surrounding the lesion is ablated (Hickey et al., J Vasc Interv Radiol 24:1167–88, 2013). This is termed a A0 ablation and is similar to how surgical resection seeks to achieve a certain margin of healthy tissue when a cancerous mass is resected (Hickey et al., J Vasc Interv Radiol 24:1167–88, 2013).

Thermal and non-thermal ablation techniques provide a unique clinical benefit separate from medical, surgical, and radiation therapy in the treatment of cancer (Hickey et al., J Vasc Interv Radiol 24:1167–88, 2013). This chapter outlines the current landscape of image-guided tumor ablative therapies.

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Authors and Affiliations

  1. Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada

    Ashis Bagchee-Clark, Anna Hwang & Lazar Milovanovic

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  1. Ashis Bagchee-Clark
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  2. Anna Hwang
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  3. Lazar Milovanovic
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Correspondence to Anna Hwang .

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Editors and Affiliations

  1. Interventional Radiology, McMaster University, Hamilton, ON, Canada

    Sriharsha Athreya

  2. Interventional Radiology, McMaster University, Hamilton, ON, Canada

    Mahmood Albahhar

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Bagchee-Clark, A., Hwang, A., Milovanovic, L. (2022). Image-Guided Tumor Ablative Therapies. In: Athreya, S., Albahhar, M. (eds) Demystifying Interventional Radiology. Springer, Cham. https://doi.org/10.1007/978-3-031-12023-7_10

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  • DOI: https://doi.org/10.1007/978-3-031-12023-7_10

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