Cryoablation of Liver Tumors

Cryoablation refers to the destruction of tissues by rapid freezing and has been used in the treatment of both primary and metastatic hepatic tumors for several decades. With the advent of thin cryoablation applicators and improved technology, percutaneous cryoablation under imaging guidance has essentially replaced open cryosurgery and is safe and effective in the treatment of liver tumors. Cryoablation presents certain distinct advantages relative to heat-based ablative technologies. Most importantly, the intraprocedural effects of cryoablation (iceballs) are well visualized using CT or MRI, enabling monitoring of the size, shape, and extent of the ablation zone. Iceball monitoring can be used to maximize both effectiveness and safety and provides the operator with a degree of intraprocedural confidence that generally surpasses other ablation technologies. Iceball monitoring helps avoid critical structures while achieving a sufficient ablation margin. Cryoablation usually causes less pain than heat-based ablations, allowing for tumors near the diaphragm, or in other high-risk locations, to be treated with lower doses of intraprocedural and postprocedural analgesic medications. Percutaneous cryoablation under CT or MRI guidance is an increasingly utilized minimally invasive treatment option for patients with malignant liver tumors.