Learning Objectives:

For radiofrequency and microwave ablation and trans-arterial chemo- and radioembolization we will:

1.	Describe the indications, pre-procedural imaging, and clinical work-up.
2.	Describe procedural technique using intra-procedural fluoroscopic, ultrasound, and CT images.
3.	Recognize common and significant intra- and post-procedural complications and their management.
4.	Detail post-procedural follow-up and ongoing imaging surveillance to assess for disease recurrence and/or progression.
5.	Describe the Interventional Radiologist’s role as a member of the multidisciplinary oncology team.


Background:

Historically non-metastatic renal and hepatic malignancies were treated with surgical resection but increasingly both early stage and non-resectable lesions are being managed in part using image-guided interventions including radiofrequency ablation, microwave ablation, trans-arterial chemoembolization, and trans-arterial  radioembolization.  As the indications for these techniques expand, radiologists interpreting diagnostic, staging, and follow- up studies must understand which hepatic and renal tumours are amenable to these interventions, imaging findings of procedural complications, and signs of disease recurrence on post-procedural surveillance imaging. 

Conclusion:

Radiologist understanding of interventional therapies for renal and hepatic malignancies will help streamline patient referral and work-up at the diagnostic stage and ensure timely and accurate post-procedural diagnosis of complications and cancer recurrence.

Image-guided interventions for the treatment of renal and hepatic malignancies