Thermal Ablation in the Liver: Heat versus Cold—What Is the Role of Cryoablation?

IF 1 4区医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in Interventional Radiology Pub Date : 2024-01-24 DOI:10.1055/s-0043-1777845

Donna L. D'Souza, Ranjan Ragulojan, Chunxiao Guo, Connie M. Dale, Christopher J. Jones, Reza Talaie

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Abstract

Cryoablation is commonly used in the kidney, lung, breast, and soft tissue, but is an uncommon choice in the liver where radiofrequency ablation (RFA) and microwave ablation (MWA) predominate. This is in part for historical reasons due to serious complications that occurred with open hepatic cryoablation using early technology. More current technology combined with image-guided percutaneous approaches has ameliorated these issues and allowed cryoablation to become a safe and effective thermal ablation modality for treating liver tumors. Cryoablation has several advantages over RFA and MWA including the ability to visualize the ice ball, minimal procedural pain, and strong immunomodulatory effects. This article will review the current literature on cryoablation of primary and secondary liver tumors, with a focus on efficacy, safety, and immunogenic potential. Clinical scenarios when it may be more beneficial to use cryoablation over heat-based ablation in the liver, as well as directions for future research, will also be discussed.

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肝脏热消融：热与冷--低温消融的作用是什么？

冷冻消融常用于肾脏、肺部、乳腺和软组织，但在肝脏却不常用，因为肝脏主要是射频消融（RFA）和微波消融（MWA）。这在一定程度上是历史原因造成的，因为使用早期技术进行开放式肝脏冷冻消融时曾发生过严重的并发症。当前的技术与图像引导的经皮方法相结合，改善了这些问题，使冷冻消融术成为治疗肝脏肿瘤的一种安全有效的热消融方式。与 RFA 和 MWA 相比，冷冻消融术具有多项优势，包括冰球可视化、手术疼痛轻微、免疫调节作用强等。本文将回顾目前有关原发性和继发性肝肿瘤冷冻消融的文献，重点关注其疗效、安全性和免疫原性。文章还将讨论在哪些临床情况下使用冷冻消融术比使用热消融术对肝脏更有利，以及未来的研究方向。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Interventional Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

1.90

自引率

7.10%

发文量

期刊介绍： Seminars in Interventional Radiology is a review journal that publishes topic-specific issues in the field of radiology and related sub-specialties. The journal provides comprehensive coverage of areas such as cardio-vascular imaging, oncologic interventional radiology, abdominal interventional radiology, ultrasound, MRI imaging, sonography, pediatric radiology, musculoskeletal radiology, metallic stents, renal intervention, angiography, neurointerventions, and CT fluoroscopy along with other areas. The journal''s content is suitable for both the practicing radiologist as well as residents in training.