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Combined Therapy with Transarterial Embolization Utilizing Radiopaque LUMI Beads and Percutaneous Microwave Ablation for Liver Tumors

Cornish N, Igonkin D, Birney A and Sarkar D

Transarterial Embolization (TAE) and Microwave Ablation (MWA) are efficacious minimally invasive therapies for loco regional treatment of Hepato-Cellular Carcinoma (HCC) and Colorectal Liver Metastases (CRLM). Newer data suggest that combination therapy with TAE and MWA provides better tumor response and survival than with monotherapy alone, but further investigation is warranted. In addition, contrast agents such as Lipiodol are traditionally used during TAE to improve efficacy by allowing direct visualization of the completeness of the embolization. Newer radiopaque embolic beads, LC LUMI beads, are now available in the United States but have not yet been studied. We aim to discuss two cases performing combined TAE/MWA using LC LUMI beads for the treatment of HCC and CRLM. Compared to lipiodol alone, LC LUMI beads cause a larger degree of ischemic necrosis via particle embolization, thus resulting in a higher potential for complete response and successful thermal ablation.