Ablation, NanoKnife®, and Other Minimally Invasive Techniques for Liver Cancer

Ablation, NanoKnife®, and Other Minimally Invasive Techniques for Liver Cancer

MSK interventional radiologist Joseph Erinjeri (left) and fellow Noor Ahmad performing an ablation procedure on a patient.

Interventional radiologist Joseph Erinjeri (left) and fellow Noor Ahmad use minimally invasive techniques to perform an ablation procedure. The monitors above allow them to monitor what's happening inside the patient's body.

When it comes to surgery, precision matters. We’re experienced in minimally invasive therapies involving imaging techniques — such as CT scans, ultrasound, and MRI — to guide the delivery of treatments directly to liver tumors. Our interventional radiologists help with this in the operating room.

When it’s an option that might work well for you, we’ll offer minimally invasive laparoscopic or robotic surgery to remove your tumor. Laparoscopic procedures involve inserting a laparoscope (a thin, lighted tube with a camera on its tip) through a tiny incision in your abdomen. This approach can remove tumors or, in some cases, part of the liver.

Our interventional radiologists are skilled in the following minimally invasive approaches to destroy liver tumors. These techniques can be used alone or in combination with other minimally invasive therapies before surgery or in addition to chemotherapy.

  • Ablation destroys a tumor by cutting, vaporizing, melting, or using intense heat or cold.
  • NanoKnife uses electrical currents to make holes in the cancer cells and eliminate them.
  • Embolization, including chemoembolization, involves blocking or lessening blood flow to the main source of blood for liver tumors
Thermal Ablation for Liver Cancer

We usually recommend ablation only if you have three or fewer tumors. Using image guidance, we deliver the therapy through a probe and directly into the tumor.

There are several types of thermal ablation, including:

  • radiofrequency ablation, which uses radio waves to superheat the tumor
  • cryoablation, which freezes the tumor

Other types of thermal ablation use lasers, microwaves, and focused ultrasound waves to kill tumor cells.

Typically, we deliver these therapies using image guidance and don’t need to make a surgical incision. We can deliver the therapy through a laparoscope, for example, or in some cases during open surgical procedures. Whether we choose heat or cold depends on the size, location, and shape of your tumor.

Chemical Ablation for Liver Cancer

If thermal ablation isn’t a good option, we may also be able to destroy tumors by injecting cancer-killing chemicals, such as pure alcohol (ethanol) or acid, directly into them. We reserve this approach for people with three or fewer liver tumors.

NanoKnife for Liver Cancer

We can destroy a primary liver tumor with a minimally invasive NanoKnife®  that uses electrical currents (called irreversible electroporation) to punch holes in cancer cell membranes and eliminate them.

Embolization for Liver Cancer

The hepatic artery is a short blood vessel that delivers oxygenated blood to the liver as well as parts of the stomach, small intestine, and pancreas. It’s also the main source of blood for most liver tumors.

With a procedure called embolization, we block or reduce this flow and deprive the tumor of the nutrients and oxygen it needs to survive by injecting tiny particles through a catheter (a tube) that we thread into the artery.

We can also use chemotherapy-loaded spherical particles (called chemoembolization) or radio-embolization to deliver embolization. With this second method, we inject small microspheres carrying the radioisotope Y90, which delivers internal radiation therapy to the tumor.

Embolization can be done again to treat cancer that comes back after treatment (recurs).

We’re determined to measure how effective these minimally invasive approaches are and what conditions should exist to make them a good option for avoiding the complications that can occur with traditional, open surgery.


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