Ablative Technologies in the Management of Patients with Primary and Secondary Liver Cancer: An Overview Nasir A. Khan, HBSc, Mark O. Baerlocher, MD,

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Ablative Technologies in the Management of Patients with Primary and Secondary Liver Cancer: An Overview Nasir A. Khan, HBSc, Mark O. Baerlocher, MD, Richard J.T. Owen, MD, Stephen Ho, MD, John R. Kachura, MD, Stephen T. Kee, MD, Dave M. Liu, MD Canadian Association of Radiologists Journal Volume 61, Issue 4, Pages 217-222 (October 2010) DOI: 10.1016/j.carj.2009.12.009 Copyright © 2010 Terms and Conditions

Figure 1 Representative, coronal, contrast-enhanced computed tomography images through the upper abdomen in a patient with metastatic liver disease. (A) Preablation image shows a well-demarcated, subscapular (arrows) lesion within the liver. (B) Image that demonstrates the tip of the radiofrequency electrode (arrow), with multiple metal tines situated within this lesion. Canadian Association of Radiologists Journal 2010 61, 217-222DOI: (10.1016/j.carj.2009.12.009) Copyright © 2010 Terms and Conditions

Figure 2 Sonographic images of the liver in a patient with hepatocellular carcinoma taken preradiofrequency (A, B) and postradiofrequency (C) ablation. (A, B) Images that demonstrate a heterogeneous, hypoechoic nodule in segment 7 of the liver (arrows), biopsy proven to be hepatocellular carcinoma. (C) Post–radiofrequency ablation image shows marked increase in echogenicity in the same region (arrow), with minimum posterior dirty shadowing, consistent with gas and coagulation necrosis. Canadian Association of Radiologists Journal 2010 61, 217-222DOI: (10.1016/j.carj.2009.12.009) Copyright © 2010 Terms and Conditions

Figure 3 Representative sonographic (A) and computed tomography (B) images of the liver in a patient with metastatic endometrial cancer who developed recurrent metastases in segments 2 and 3 of her liver. (A) Image shows the appearance of the liver before microwave ablation. (B) Postablation image with a triple antenna approach shows the well-circumcised zone of ablation (arrows). (Images courtesy of Dr Justin McWilliams and Dr David Lu, UCLA Medical Center.) Canadian Association of Radiologists Journal 2010 61, 217-222DOI: (10.1016/j.carj.2009.12.009) Copyright © 2010 Terms and Conditions

Figure 4 Representative, axial, contrast-enhanced computed tomography images through the liver taken pre- (A) and postcryoablation (B) in a patient with hepatocellular carcinoma. (A) Image that demonstrates a large hypoattenuating, hypovascular region (arrow) within segment 7 of the liver with peripheral enhancement. (B) Image shows the zone of ablation (arrows) after cryoablation. Canadian Association of Radiologists Journal 2010 61, 217-222DOI: (10.1016/j.carj.2009.12.009) Copyright © 2010 Terms and Conditions

Figure 5 Sonographic images through the liver in a swine model, before (A) and after (B) irreversible electroporation (IRE) embolization. (A) Image demonstrates the positioning of the probes (arrows). (B) Post-IRE image shows the hypoechoic ablation zone (arrows). (Images courtesy of Dr Edward W. Lee, UCLA Medical Center.) Canadian Association of Radiologists Journal 2010 61, 217-222DOI: (10.1016/j.carj.2009.12.009) Copyright © 2010 Terms and Conditions