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Cryoablation of Liver Tumors

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Image-Guided Cancer Therapy

Abstract

Cryoablation refers to the destruction of tissues by rapid freezing and has been used in the treatment of both metastatic and primary hepatic tumors for several decades. Historically, cryoablation was performed in an open surgical setting and was shown to be an efficacious and generally safe treatment. However, severe but relatively infrequent complications did occur. These early complications led to a better understanding of the biochemistry and predisposing factors that led to the complications. This improved understanding allowed for better patient selection as well as improved post treatment care in avoiding or managing complications. While certain complications, including thrombocytopenia, hemorrhage and cryoshock, are unique to or more common in cryoablation than other ablative modalities, most of these complications are now readily treatable or can be avoided with proper patient screening. Recent technological advances have allowed for cryoablation to be performed percutaneously under imaging guidance. Cryoablation zones are exceptionally well visualized using MR or CT. The precision of cryoablation zone monitoring afforded by CT or MRI guidance provides the operator a degree of intraprocedural confidence regarding ablation zone margins and safety that is not generally possible with other ablation technologies. The placement and powering of individual cryoprobes allows for greater flexibility in avoiding critical structures as well as creating a sufficient ablation zone margin. Cryoablation also causes less pain than radiofrequency ablation, allowing for tumors near the diaphragm, or in a perihepatic location, to be treated with lower doses of intraprocedural and post-procedural analgesic medications. As the stigma of historical problems associated with surgical cryoablation using old technology recedes, a gradually developing body of experience with newer cryoablation technology applied percutaneously and with optimal imaging guidance is stimulating renewed interest in this minimally invasive treatment option for malignant liver tumors.

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Authors and Affiliations

  1. Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA, 02115, USA

    Michael J. Hutchinson, Paul B. Shyn & Stuart G. Silverman

Authors
  1. Michael J. Hutchinson
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  2. Paul B. Shyn
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  3. Stuart G. Silverman
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Corresponding author

Correspondence to Paul B. Shyn .

Editor information

Editors and Affiliations

  1. The Warren Alpert Medical School of Brown University, Department of Diagnostic Imaging Rhode Island Hospital, Providence, Rhode Island, USA

    Damian E. Dupuy

  2. Department of Surgery and Radiology Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Yuman Fong

  3. McMullen Consulting, LLC, Surprise, Arizona, USA

    William N. McMullen

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© 2013 Springer Science+Business Media New York

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Hutchinson, M.J., Shyn, P.B., Silverman, S.G. (2013). Cryoablation of Liver Tumors. In: Dupuy, D., Fong, Y., McMullen, W. (eds) Image-Guided Cancer Therapy. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0751-6_35

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  • DOI: https://doi.org/10.1007/978-1-4419-0751-6_35

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-0750-9

  • Online ISBN: 978-1-4419-0751-6

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