[Clinical strategies and indication expansion of interventional ultrasonography ablative therapy for hepatic tumors].

Thermal ablation has become an important treatment option for early-stage hepatocellular carcinoma with the development of interventional ultrasound technology. However, in the treatment of medium-to-large-volume tumors, intrahepatic cholangiocarcinoma, and high-risk anatomical sites, it still faces clinical bottlenecks such as high recurrence rates and difficulties with margin control. This article discusses current clinical difficulties and explores indication expansion and coping strategies for various ablation techniques. The "no touch" strategies of radiofrequency ablation and microwave ablation have shown an overall survival period that is comparable to that of surgery for medium or multiple tumors that are 3 to 5 cm in size. Microwave ablation and repeated surgical resection that meets the Milan criteria have similar overall and disease-free survival rates in patients with intrahepatic cholangiocarcinoma. Non-thermal ablation techniques such as irreversible electroporation offer safe alternatives for refractory lesions adjacent to large blood vessels or bile ducts due to their characteristics of no heat-sink effect and preservation of collagen scaffolds. Image fusion navigation and synergistic "ablation plus immunotherapy" may be key directions for overcoming local control bottlenecks and improving long-term prognosis in the future.