title: Current role of microwave ablation in the treatment of small hepatocellular carcinomas.
abstract: Percutaneous radiofrequency ablation (RFA) can be as effective as surgical resection in terms of overall survival and recurrence-free survival rates in patients with small hepatocellular carcinoma (HCC). Effectiveness of RFA is adversely influenced by heat-sink effect. Other ablative therapies could be considered for larger tumors or for tumors located near the vessels. In this regard, recent improvements in microwave energy delivery systems seem to open interesting perspectives to percutaneous ablation, which could become the ablation technique of choice in the near future. Microwave ablation (MWA) has the advantages of possessing a higher thermal efficiency. It has high efficacy in coagulating blood vessels and is a relatively fast procedure. The time required for ablation is short and the shape of necrosis is elliptical with the older systems and spherical with the new one. There is no heat-sink effect and it can be used to ablate tumors adjacent to major vessels. These factors yield a large ablation volume, and result in good local control and fewer complications. This review highlights the most relevant updates on MWA in the treatment of small (<3 cm) HCC. Furthermore, we discuss the possibility of MWA as the first ablative choice, at least in selected cases.
authors.affiliation: Department of Radiology Insubria University, Varese, Italy (Natalie Lucchina, Anna Maria Ierardi, Francesca Giorlando, Edoardo Macchi, Ejona Duka, Federico Fontana), University of Milan, Italy.
authors.forename: Natalie
authors.initials: N
authors.lastname: Lucchina
authors.affiliation: Department of Radiology, University Hospital of Heraklion, Crete, Greece (Dimitrios Tsetis, Elias Kehagias), University of Milan, Italy.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsetis
authors.affiliation: Department of Radiology Insubria University, Varese, Italy (Natalie Lucchina, Anna Maria Ierardi, Francesca Giorlando, Edoardo Macchi, Ejona Duka, Federico Fontana), University of Milan, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ierardi
authors.affiliation: Department of Radiology Insubria University, Varese, Italy (Natalie Lucchina, Anna Maria Ierardi, Francesca Giorlando, Edoardo Macchi, Ejona Duka, Federico Fontana), University of Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Giorlando
authors.affiliation: Department of Radiology Insubria University, Varese, Italy (Natalie Lucchina, Anna Maria Ierardi, Francesca Giorlando, Edoardo Macchi, Ejona Duka, Federico Fontana), University of Milan, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Macchi
authors.affiliation: Department of Radiology, University Hospital of Heraklion, Crete, Greece (Dimitrios Tsetis, Elias Kehagias), University of Milan, Italy.
authors.forename: Elias
authors.initials: E
authors.lastname: Kehagias
authors.affiliation: Department of Radiology Insubria University, Varese, Italy (Natalie Lucchina, Anna Maria Ierardi, Francesca Giorlando, Edoardo Macchi, Ejona Duka, Federico Fontana), University of Milan, Italy.
authors.forename: Ejona
authors.initials: E
authors.lastname: Duka
authors.affiliation: Department of Radiology Insubria University, Varese, Italy (Natalie Lucchina, Anna Maria Ierardi, Francesca Giorlando, Edoardo Macchi, Ejona Duka, Federico Fontana), University of Milan, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Fontana
authors.affiliation: Department of Surgical Sciences, University of Insubria, Varese, Italy (Lorenzo Livraghi), University of Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livraghi
authors.affiliation: Department of Diagnostic and Interventional Radiology, San Paolo Hospital, Department of Health Sciences, University of Milan, Italy.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
keywords: Microwave ablation; radiofrequency ablation; small hepatocellular carcinoma