The growing armamentarium of image-guided tumor ablation in interventional oncology

Minimally invasive image-guided tumor ablation techniques have been established as safe, effective methods to treat a variety of unresectable soft tissue tumors. Standard thermal ablation methods include radiofrequency ablation, microwave ablation, and cryoablation. However, newer non-thermal and/or non-invasive ablation techniques are now available as alternative options to treat soft tissue tumors, particularly those that are near critical structures or otherwise susceptible to thermal energy sink effects. The 4 types of emerging ablation techniques discussed in this review are as follows: irreversible electroporation, pulsed electric field, high-intensity focused ultrasound, and histotripsy. While the clinical trials evaluating the safety and efficacy of these ablation techniques are in their early stages, initial results are promising in the treatment of various cancers at different stages. These include potential synergistic effects when combined with chemotherapy and immunotherapy.