Role of percutaneous image-guided ablation of malignant liver tumors: global trends and Croatian perspective

percutaneous minimally invasive methods are gaining space in oncologic treatment algorithms. interventional radiology has a leading role in the last twenty years in developing percutaneous curative therapy for tumors of the parenchymal organs of the abdomen due to the precision of image-guided procedures. ablative technology uses thermal energy for tumor tissue destruction. compared to radiofrequency technology, microwave technology shows advantages in size of the liver tumors that can be ablated and the length of the procedure. compared to surgery, both ablative techniques, enable shorter postprocedural time to chemotherapy, hospital stay and recovery time, reduced complication rate, and easier secondary ablation in case of new or residual tumors. comparative advantages make these minimally invasive procedures, often the first choice in the treatment of hepatocellular carcinoma and liver metastases. Even though image-guided ablation is accepted in most european countries as a valid alternative to surgery in patients with unresectable hepatic tumors, currently, there is no algorithm for the use of this minimally invasive therapy in croatia. lack of clinical validation of thermal ablation in croatia is mostly due to a limited number of the interventional radiologist with such focus along with limited patient referrals despite the published data about the potential advantages, efficacy, and safety of this technology.