Tissue Analysis After Thermal Ablation for Colon Cancer Liver Metastases Leading to Immediate Retreatment

Inclusion Criteria:

Diagnosis of colorectal cancer liver metastases (CLM)
Confined liver disease or limited extrahepatic disease stable/controlled for at least 4 months (extrahepatic disease amenable to treatment is allowed)
Lesions of ≤3 cm in maximum diameter
At least one FDG-avid lesion to be treated***
Any patient with CLM treated with Microwave ablation (as per clinical IR Guidelines)*
INR < 1.5*
Platelet count ≥ 50,000

Exclusion Criteria:

Age < 18
Less than 5 mm distance to a structure (GI or biliary tract), that cannot be protected from ablation injury with technical modifications such as hydro or air dissection
INR > 1.5 that cannot be corrected with fresh frozen plasma **
Platelet count of <50,000 that cannot be corrected with transfusion
More than 3 tumors in the liver
More than 5 tumors of extrahepatic disease (including mediastinal nodes and pulmonary nodules, abdominal or other lymph nodes, and bone metastasis)

Presence of any peritoneal Carcinomatosis

Institutional IR guidelines:

https://one.mskcc.org/sites/pub/radiology/lptestapp/Split%20Dose%20PET%20Ablation%20Liver%20tumors.pdf

For patients on Coumadin, general clinical guidelines for IR ablation will be followed.

For patients with no FDG-PET avid tumors aim 2 of the protocol will not be assessed