While RFA uses heat to destroy tumors, cryoablation uses freezing temperatures to the same end. It has been less studied than RFA, but the method is showing promise in treating tumors that may not be ideal candidates for heat treatment.

Pros of Cryoablation

• Cryoablation can be used in situations where heat-based ablation methods risk causing thermal stricture, such as in the prostate or kidney.

• It is not vulnerable to the heat sink effect.

• It may be less painful.

• Intraprocedural imaging is easier—no water vapor obscures the image. The treatment margin is clear during the procedure.

• There are CPT codes for cryoablation in the prostate.

Cons of Cryoablation

• Cryoablation is not as well tested as RFA.

• It may carry an increased risk of bleeding, because blood vessels are not cauterized as they would be with RFA or other heat ablation methods.

• No CPT codes exist for cryoablation outside the prostate.

Microwave Ablation

Microwave ablation is relatively new and rare in the U.S. Like RFA, microwave ablation is a heat-based ablative method. Unlike RFA, the technique heats the tissue by using electromagnetic fields, not conductive heating methods.

Pros of Microwave Ablation

• Microwave ablation provides more even heating of the tissue, reducing the risk of charring.

• It may be less vulnerable to the heat-sink effect.

• It may be able to treat a larger volume of tissue.

• It may cause less pain.

• It heats tissue faster than RFA.

Cons of Microwave Ablation

• Microwave ablation is not clinically available.

• It is not as well tested as RFA.