Abstract

Percutaneous image-guided ablation is now a fairly well established first-line treatment modality for eligible hepatocellular carcinomas (HCCs). However, it is interesting that world-side,the adoption of ablation for HCC has had a checkered history with relatively slow acceptance. In retrospect several factors were likely contributary. Despite early attempts at standardization starting with the International Working Group on Image-guided Tumor Ablation,1-2 published outcomes were initially widely discrepant and highly heterogeneous in ablation device, imaging guidance methods, patient selection, provider's medical specialty, and training background and experience. Now that percutaneous ablation is generally accepted as a potential first-line treatment for HCC, it is important to establish basic guidelines and continue to update such guidelines, across specialties and physician organizations. Therefore, it is commendable that in this is-sue, an expert panel consisting of both hepatologists and radiologists has reached and published an updated consensus practice guideline document for the performance of image-guided per-cutaneous ablation of HCCs.3

An interesting component of this document is that in addition to reviewing published literature, the consensus panel also incorporated survey data from existing practitioners, therefore recommendations took into account actual practice patterns of experienced providers. The following are selected recommendations and discussion points.

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