Liver Ablation

Various hepatic pathologies, including primary hepatocellular carcinoma, metastases, and symptomatic simple cysts, may be treated with liver ablation therapy. There are a variety of Food Drug Administration (FDA)-approved ablation devices such as radiofrequency ablation, microwave ablation, cryoablation, irreversible electroporation, alcohol ablation, and upcoming ablation technologies including pulse electric fields (PEFs), high focused ultrasound (HIFU), and histotripsy. This chapter will discuss the current clinical indications, outcomes, and potential complications of interventional treatment for these hepatic pathologies, with particular emphasis on hepatocellular carcinoma and colorectal metastasis based on inclusion in the National Comprehensive Cancer Network guidelines. Alternative therapies, including recent molecular-based therapies, will also be discussed. Finally, a brief guide will be provided for a typical ablation procedure.