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Cooking a tumour from the inside through a needle. Radiofrequency current was the first method and is proven for small liver cancers; microwave energy heats faster, makes larger zones and is less troubled by nearby blood vessels carrying the heat away, so it is now the more common choice.
Radiofrequency ablation passes alternating current from a needle electrode through the tissue to grounding pads; ionic friction heats the tissue around the tip to coagulation. It was the first widely used percutaneous ablation and remains a curative option for hepatocellular carcinoma up to about three centimetres, where trials found survival similar to resection for small tumours, and it is used for colorectal liver metastases, small kidney tumours, lung metastases, thyroid nodules and osteoid osteoma. Microwave ablation uses an antenna radiating at microwave frequencies to agitate water molecules directly, heating a larger volume faster and less dependent on tissue conductivity, so charring and the heat-sink effect of vessels matter less and no grounding pads are needed. The COLLISION randomised trial reported in 2024 that ablation was not inferior to surgery for small colorectal liver metastases. Medtronic (Emprint microwave, Cool-tip RF), Johnson & Johnson (NeuWave) and AngioDynamics (Solero microwave, StarBurst RF) are the main vendors, and robotic needle guidance is being added.
Both methods are limited by tumour size and by proximity to bowel, bile ducts and large vessels, and the ablation zone is harder to see during treatment than an ice ball; irreversible electroporation and stereotactic radiotherapy compete for tumours next to critical structures.
Radiofrequency current or a microwave antenna at the needle tip heats tissue to coagulative necrosis; microwave heating is faster, reaches larger volumes and is less affected by tissue conductivity and vascular heat sink.
Query for this technology: (TITLE:"Microwave and radiofrequency ablation systems" OR ABSTRACT:"Microwave and radiofrequency ablation systems") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Microwave and radiofrequency ablation systems, not a curated reading list.
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