fig2

Figure 2. Locoregional therapies in the management of HCC. BCLC: Barcelona Clinic Liver Cancer. (A) Radiofrequency ablation generates frictional heat using high frequency alternating current around an active electrode resulting in tissue hyperthermia. (B) Microwave ablation employs electromagnetic energy using an antenna to deliver thermal energy-induced cellular injury. (C) Cryoablation delivers subfreezing temperature via a cryoprobe induced by high-pressure argon gas and the repetitive freeze-thaw cycle leads to tumour necrosis. (D) Irreversible electroporation delivers high-voltage, low-energy direct current pulses to induce irreversible disruption of cell membrane integrity. (E) Transarterial embolization disrupts tumour blood supply resulting in tumour ischaemia/hypoxia. (F) Transarterial chemoembolization delivers high-dose chemotherapy and lipiodol followed by arterial embolization to promote tumour ischaemia/hypoxia. (G) Drug-eluting bead chemoembolization delivers embolic microspheres (beads) loaded with a chemotherapeutic agent providing local, sustained tumour drug delivery combined with tumour ischaemia/hypoxia. (H) Radioembolization delivers Yttrium-90 microspheres providing local, high-dose tumour radiation. (I) Stereotactic body radiotherapy is a form of external beam radiotherapy that accurately delivers high-dose radiation to the target tumour while limiting radiation dose to adjacent non-target liver.