Precision oncology: The role of minimally-invasive ablation therapy in the management of solid organ tumors

Table 1 Overview of minimally invasive ablation techniques

Technique	Mechanism	Frequency range	Max temperature	Tumor types treated	Strengths	Limitations	Common complications
Radiofrequency ablation	High-frequency currents to induce coagulative necrosis	460-500 KHz	100 °C	Adrenal gland, bone, breast, kidney, liver, lung, pancreas, thyroid	Oldest technique, low cost, minimal equipment	Requires conductivity, heat sink, less effective over time	Bleeding, pain, infection, tumor seeding, skin burns, post-RFA syndrome
Microwave ablation	Electromagnetic waves to induce coagulative necrosis	300 MHz-300 GHz	150 °C	Adrenal gland, bone, breast, kidney, liver, lung, prostate, spleen, uterus	Higher temps quickly, no conductivity needed, multiple probes for larger ablation	Cables can burn patient, requires cooling, less precise	Bleeding, pain, infection, tumor seeding, skin burns, post-ablation syndrome
Cryoablation	Extreme cold to induce cell death	N/A (cryogenic gases)	-196 °C	Bone, breast, kidney, liver, lung, prostate, skin	No heat, vessel occlusion, minimal damage to nearby tissues, multiple probes for larger ablation	Specialized gases needed, safety hazard with compressed gases	Infection, pain, bleeding, cryoshock, cryoreaction
High-intensity focused ultrasound	High-intensity ultrasound to generate localized heat and necrosis	0.8-3.5 MHz	Exceeds 60 °C rapidly	Bone, breast, desmoid, kidney, liver, pancreas, prostate, uterus	Non-invasive, high precision, lower risk of off-target damage	Requires anesthetics, affected by tissue echogenicity	Skin burn, pain, fistula, local edema, hyperpigmentation
Histotripsy	Cavitation bubbles to mechanically disintegrate tumors	250 KHz-6 MHz	N/A	Brain, breast, kidney, liver, muscle, pancreas, prostate, skin, thymus	Non-invasive, non-thermal, high precision, lowest risk of off-target damage	Requires anesthetics, affected by tissue echogenicity, experimental, low clinical data	Immune-mediated responses

N/A: Not applicable; RFA: Radiofrequency ablation.