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Figure 1: Proposed algorithm for thermal ablation of single nodule. HCC: hepatocellular carcinoma; LM: liver metastases; MWA: microwave ablation;
LTA: laser thermal ablation; RF: radiofrequency

Figure 2: Proposed algorithm for thermal ablation of multiple nodules. HCC: hepatocellular carcinoma; LM: liver metastases; MWA: microwave ablation; LTA: laser thermal
ablation; RFA: radiofrequency ablation

tumor is close to large vessels, as MWA is not affected by three fibers should be used for LTA. Conversely, LM 2-3 cm in
the heat-sink effect. In addition, LTA could be more feasible size can take advantage of MWA because the safety margin
and safe when the nodule has a difficult or risky location, as has to be greater than for HCC. Likewise, both single HCC and
the needles used to insert the fibers are considerably finer LM ≥ 3 cm should be treated with MWA.
than RFA electrodes. Single HCC 2-3 cm in size could be
ablated following the same indications, even though multiple Multiple small lesions (maximum 2.5-3 cm in diameter),
overlapping insertions can be needed for RFA, and at least especially if they vary in size, should preferably be treated

Hepatoma Research | Volume 1 | Issue 2 | July 15, 2015 55