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BackTable / Tumor Board / Podcast / Episode #4
Curative Intent Therapies for HCC: Today & Tomorrow
with Dr. Kirema Garcia-Reyes, Dr. Kevin Burns, Dr. Sabeen Dhand and Dr. Zach Berman
For hepatocellular carcinoma (HCC) patients who are not candidates for liver transplant or resection, lesion ablation can be a curative treatment. With multiple ablation options available and still under investigation, it can be challenging to navigate the differences between them. In this episode, Dr. Tyler Sandow hosts a discussion with interventional radiologists Dr. Kirema Garcia-Reyes, Dr. Sabeen Dhand, and Dr. Kevin Burns on the various ablation options for HCC and when to use each one.
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BackTable, LLC (Producer). (2025, January 17). Ep. 4 – Curative Intent Therapies for HCC: Today & Tomorrow [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Kirema Garcia-Reyes
Dr. Kirema Garcia-Reyes is an interventional radiologist and assistant professor with Mount Sinai in New York City.
Dr. Kevin Burns
Dr. Kevin Burns is the chief of interventional radiology at Mission Hospital in Mission Viejo, California.
Dr. Sabeen Dhand
Dr. Sabeen Dhand is a practicing interventional radiologist with PIH Health in Los Angeles.
Dr. Zach Berman
Dr. Zachary Berman is an interventional radiologist at the University of California San Diego in San Diego, California.
Dr. Tyler Sandow
Dr. Tyler Sandow is an interventional radiologist with Ochsner Health in New Orleans, Louisiana.
Synopsis
The doctors first discuss Barcelona-Clinic Liver Cancer (BCLC) Stage A patients, where lesion size and location are key factors in deciding between ablation and transarterial therapies. They then compare cryoablation and microwave ablation, highlighting that cryoablation offers better visualization and control of the ablation zone, while microwave ablation is more effective for treating larger lesions.
Dr. Burns introduces histotripsy, a noninvasive treatment that uses ultrasound energy to mechanically ablate tumors. He shares his experiences as an early adopter of this technology and discusses how intraoperative cone beam CT can help treat lesions located near critical structures or those poorly visualized on ultrasound. Finally, Dr. Garcia-Reyes and Dr. Berman provide insights into patient selection, pre-procedural imaging, and technical tips for Y90.
Timestamps
00:00 - Introduction
02:04 - Ablation vs Y90 in BCLC A Patients
05:58 - Same-Day Y90
15:55 - Y90 for Large Tumors
17:51 - Ideal Cases for Cryoablation
19:38 - Explanation of Histotripsy
32:09 - Procedural Specifics for Histotripsy
38:21 - Technical Tips for Y90
Resources
Including the Hollow Viscera (Stomach or Bowel) within the Ice Ball during Cryoablation: A Review of Adverse Events (Abramyan et al, 2024):
https://www.jvir.org/article/S1051-0443(24)00681-X/abstract
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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