Isfort P, Penzkofer T, Mahnken A H
Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
Radiologe. 2012 Jan;52(1):29-37. doi: 10.1007/s00117-011-2209-8.
Primary and secondary liver tumors often limit patient outcome and only a minority of patients are eligible for potential curative surgery. Minimally invasive treatments, such as radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation are alternative treatment options in a curative and palliative setting. One major limitation of RFA and MWA is the limited size of tumor ablation. Furthermore during the procedure the ablation size can only be roughly estimated using RFA and MWA.
RFA is the standard modality of minimally invasive tumor therapy. In comparison cryoablation is rarely used despite its advantages.
Argon-helium-based cryoablation systems of the newest generation combine the advantage of small diameter applicators comparable with those of RFA and MWA systems with intrinsic advantages.
Cryoablation is a minimally invasive treatment option with advantages, such as virtually unlimited ablation size, real-time visualization using computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound and intrinsic analgesic effects. On the other hand it is not very time-efficient in comparison to MWA. Especially in liver metastases RFA is the preferred treatment option.
Cryoablation is a fascinating treatment option in minimally invasive tumor treatment. It demonstrates good results in hepatocellular carcinoma within the Milan criteria and T1a renal cell carcinoma. Furthermore it is a well-established treatment modality for palliative pain management in bone tumors.
原发性和继发性肝肿瘤常常限制患者的预后，只有少数患者适合进行可能治愈性的手术。微创治疗，如射频消融（RFA）、微波消融（MWA）和冷冻消融，是治愈性和姑息性治疗中的替代治疗选择。RFA和MWA的一个主要局限性是肿瘤消融的大小有限。此外，在手术过程中，使用RFA和MWA只能大致估计消融大小。
RFA是微创肿瘤治疗的标准方式。相比之下，冷冻消融尽管有其优势，但很少使用。
最新一代基于氩氦的冷冻消融系统结合了与RFA和MWA系统相当的小直径施源器的优势以及自身优势。
冷冻消融是一种微创治疗选择，具有诸多优势，如消融大小几乎不受限制、可使用计算机断层扫描（CT）、磁共振成像（MRI）和超声进行实时可视化以及具有内在镇痛效果。另一方面，与MWA相比，它的时间效率不高。特别是在肝转移瘤中，RFA是首选的治疗选择。
冷冻消融是微创肿瘤治疗中一种引人关注的治疗选择。它在符合米兰标准的肝细胞癌和T1a期肾细胞癌中显示出良好效果。此外，它是骨肿瘤姑息性疼痛管理中一种成熟的治疗方式。
