Lesson 1Adjunctive Techniques: Track Ablation, Artificial Ascites, and Adjunct Embolisation to Reduce Heat SinkThis part reviews extra techniques that boost safety and success, like track ablation to stop bleeding and seeding, artificial ascites or fluid in chest for moving organs, and extra embolisation to cut heat loss effects.
Track ablation to prevent bleeding and seedingCreating artificial ascites: indications and methodArtificial pleural effusion for dome lesionsAdjunct transarterial embolization for heat sinkCombining ablation with portal vein embolizationDocumentation and follow-up of adjunctive measuresLesson 2Tumour Assessment: Size, Segmental Location, Proximity to Vessels/Bile Ducts, and Surgical CandidacyThis part handles tumour checks before ablation, including measuring size, segment and subsegment spots, nearness to vessels and bile ducts, and checking if surgery fits and other cure choices.
Measuring tumor size and multiplicitySegmental and Couinaud-based localizationProximity to major vessels and bile ductsAssessing heat sink risk from large vesselsEvaluating surgical and transplant candidacySelecting ablation versus other local therapiesLesson 3Ablation Modality Selection: Principles, Advantages, and Limitations of Radiofrequency, Microwave, Cryoablation, and Irreversible ElectroporationThis part compares ablation types, like radiofrequency, microwave, cryoablation, and irreversible electroporation, focusing on how they work, good points, limits, best uses, and safety notes for devices.
Biophysics of thermal and nonthermal ablationRadiofrequency ablation: strengths and limitsMicrowave ablation: power and speed advantagesCryoablation: ice ball dynamics and risksIrreversible electroporation: niche indicationsChoosing modality by tumor size and locationLesson 4Needle Path Planning: Safe Trajectories, Avoidance of Pleura, Bowel, and Major Vessels, and Hydrodissection TechniquesThis part explains designing safe needle paths for liver ablation, stressing avoiding pleura, bowel, and big vessels, and using hydrodissection and extra moves to guard nearby key parts.
Analyzing cross‑sectional imaging for safe accessPlanning trajectories to avoid pleura and lung basesStrategies to protect bowel and stomach loopsAvoiding and traversing near major hepatic vesselsHydrodissection: indications, agents, and techniqueUse of patient positioning to optimize needle pathLesson 5Patient Selection and Preprocedural Optimisation: Liver Function (Child-Pugh), Coagulation, and Anaesthesia ConsiderationsThis part covers picking patients and improving before ablation, including liver work with Child-Pugh and MELD, coagulation state, other health issues, anaesthesia plans, and ways to lower risks around procedure.
Oncologic indications and contraindicationsChild-Pugh and MELD scoring for liver reserveCoagulation assessment and correction strategiesRenal function and contrast-related considerationsAnesthesia choice: local, MAC, or generalPreprocedural fasting, medications, and consentLesson 6Imaging Guidance Options: Real-Time Ultrasound, CT-Guidance, CT-Fluoroscopy, MRI Guidance, and Image Fusion WorkflowsThis part looks at imaging guide choices for liver ablation, like live ultrasound, CT, CT-fluoroscopy, MRI guide, and image mixing steps, stressing picking methods, accuracy, and radiation notes.
Conventional and contrast-enhanced ultrasoundCT and CT-fluoroscopy guidance techniquesMRI-guided ablation: logistics and benefitsImage fusion of US with CT or MRI datasetsNavigation systems and needle tracking toolsRadiation dose optimization during CT guidanceLesson 7Intra-Procedure Monitoring of Ablation Zone and Immediate Technical Success CriteriaThis part details watching the ablation area during with ultrasound, CT, or MRI, rules for good coverage and edges, checking quick success, and ways to change or redo ablations right away.
Real-time imaging of probe position and angleMonitoring ablation zone growth over timeAssessing minimal ablative margin requirementsUse of contrast-enhanced US or CT intra-procedureCriteria for immediate technical success or failureDecision-making for repeat or extended ablationLesson 8Imaging for Planning: Multiphase Liver CT, Contrast-Enhanced MRI, and PET When IndicatedThis part reviews imaging types for ablation plans, stressing multiphase liver CT, contrast MRI, and PET if needed, noting lesion clearness, staging, and mapping blood and bile layouts.
Multiphase CT protocols and timing optimizationMRI sequences for lesion detection and marginsUse of hepatobiliary contrast agents in MRIRole of PET and PET/CT in lesion characterizationImaging-based staging and resectability assessmentMapping vascular and biliary anatomy pre-ablationLesson 9Ablation Procedural Steps: Patient Positioning, Sterile Setup, Probe Insertion, Energy Delivery Parameters, Overlapping Ablations for MarginThis part describes step-by-step liver ablation, from placing patient and clean prep to putting probe, energy settings, overlapping ablations for good edges, and recording procedure details.
Optimal patient positioning by segment locationSterile field setup and antibiotic prophylaxisSkin entry planning and local anesthesiaProbe insertion, adjustment, and confirmationEnergy delivery settings and cycle durationOverlapping ablations to secure tumor marginsLesson 10Complications: Haemorrhage, Bile Leak, Thermal Injury to Adjacent Structures, Abscess — Recognition and ManagementThis part talks complications of liver ablation, like bleeding, bile leak, heat harm to nearby parts, abscess, and needle track seeding, stressing early spotting, imaging signs, and step-by-step handling.
Risk factors for major and minor complicationsRecognition and treatment of hemorrhageDiagnosis and management of bile leakThermal injury to bowel, diaphragm, and skinHepatic abscess: prevention and drainageNeedle-track seeding and long-term outcomesLesson 11Post-Ablation Imaging Protocols and Follow-Up Schedule to Confirm Complete AblationThis part outlines imaging after ablation, including timing and method picks, standard reports of ablation areas, rules for full response vs leftover disease, and organised follow-up times.
Immediate post-procedure imaging objectivesFirst follow-up scan timing and modality choiceImaging criteria for complete ablationDetection of residual or recurrent tumorStandardized reporting of ablation findingsLong-term surveillance intervals and duration
