Thermal Ablation of Liver Lesions

Liver-directed therapies have continuously evolved since their introduction and actually represent a unique and irreplaceable resource in the management of malignant hepatic disease. Specifically, tumor destruction based on thermal damage showed a rapid evolution in the past few decades. The implementation of thermal ablation technology, together with a better understanding of its underlying physical properties, had led to a progressive improvement of the clinical outcomes and security profiles associated with a progressive expansion of treatment indications. Through their own characteristic features, thermic ablative techniques gained a well-established role as effective treatments for patients affected by primary or secondary liver tumors who are deemed not eligible or with contraindications to surgery. This chapter summarizes the main aspects of thermal ablation of primary and metastatic liver malignancies, with a special focus on radiofrequency and microwave ablation modalities.