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Principles of Thermal Ablation

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Radiation Therapy for Liver Tumors

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Abstract

Within the field of local–regional hepatic therapies, the area of thermal ablation plays an important role. First conceptualized in the 1840s, thermal ablation greatly expanded after the advent of cross-sectional imaging. These techniques are generally used for patients with unresectable and borderline resectable disease, which may be due to the size, number, or location of the liver tumors, or for patients judged inoperable due to the patient’s poor health. These methods have thus become an integral part of the treatment armamentarium for liver-directed therapy. All techniques presented in this chapter can be used for either primary or metastatic hepatic malignancies, and can also be used in combination with other therapies to maximize effectiveness. Thermal ablation methods are divided into hyper- and hypothermic techniques, depending on the temperature delivered. They are further divided based on the method used for developing a temperature differential. Hyperthermic techniques include radiofrequency ablation (RFA), microwave ablation (MWA), interstitial laser photocoagulation (ILP), and high-intensity focused ultrasound (HIFU), whereas cryoablation is the sole technique that uses hypothermia. Below is a description of each of these ablation methods and how they ablate tumor, along with a review of the technical and clinical considerations that must be made when deciding to employ one of these modalities.

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Authors and Affiliations

  1. Department of Surgery, University of Colorado School of Medicine, 12605 E. 16th Ave, Aurora, CO, 80045, USA

    Camille L. Stewart MD

  2. Department of Surgery, University of Colorado Hospital, 12631 E. 17th Ave, 6th Floor MS-C313, Aurora, CO, 80045, USA

    Barish H. Edil MD

  3. Division of Interventional Radiology, University of Colorado Anschutz Medical Campus, 12401 E. 17th Avenue, Leprino 954, Suite 526, Aurora, CO, 80045, USA

    Robert K. Ryu MD, FSIR

  4. Radiology, University of Colorado, 12605 E 16th Ave, Aurora, CO, 80045, USA

    M. Reza Rajebi MD

Authors
  1. Camille L. Stewart MD
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  2. Barish H. Edil MD
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  3. Robert K. Ryu MD, FSIR
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  4. M. Reza Rajebi MD
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Correspondence to Camille L. Stewart MD .

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Editors and Affiliations

  1. Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA

    Jeffrey Meyer

  2. Department of Radiation Oncology, University of Colorado Comprehensive Cancer Center, Aurora, Colorado, USA

    Tracey Schefter

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Stewart, C.L., Edil, B.H., Ryu, R.K., Reza Rajebi, M. (2017). Principles of Thermal Ablation. In: Meyer, J., Schefter, T. (eds) Radiation Therapy for Liver Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-54531-8_8

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  • DOI: https://doi.org/10.1007/978-3-319-54531-8_8

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