TACE / Liver Ablation (RFA, MWA, Y-90)
Image-guided treatment of hepatocellular carcinoma and liver metastases. Transarterial chemoembolization (TACE) delivers chemotherapy-loaded beads into tumor-feeding hepatic arteries. Radiofrequency (RFA) and microwave ablation (MWA) thermally destroy tumors under CT or ultrasound guidance. Y-90 radioembolization delivers yttrium-90 microspheres transarterially for larger or more diffuse disease.
Clinical pathway
TACE: femoral access, selective hepatic arteriography, cone-beam CT to confirm tumor-feeding vessels, superselective microcatheter delivery of drug-eluting beads or lipiodol + doxorubicin, post-embolization angiogram.
RFA/MWA: CT or ultrasound-guided percutaneous probe placement, ablation cycles per vendor protocol, post-ablation CT to confirm coverage.
Y-90: pre-treatment mapping angiogram + MAA scan for lung-shunt fraction, second visit for Y-90 delivery.
Typical systems
- Philips Azurion 7 (TACE + Y-90)
- Siemens Artis Q with CBCT
- GE Innova 2100-IQ
- Siemens SOMATOM Force (RFA/MWA guidance)
Room + procedure characteristics
- Procedure time: TACE 60–180 min, RFA 45–90 min per lesion, Y-90 30–60 min
- Team: interventional radiologist + IR tech + RN; nuclear medicine tech for Y-90
- Imaging: cone-beam CT on the IR system is near-mandatory for modern TACE