BackTable Vascular & Interventional

Ep. 613 Microwave Ablation in Renal Tumors with Dr. Steven Huang

38 snips
Feb 3, 2026
Dr. Steven Huang, an interventional oncologist at MD Anderson specializing in liver and kidney interventions, discusses building an efficient renal biopsy and ablation service. He covers referral pathways, imaging and workflow tips, and when to combine biopsy with ablation. The conversation compares cryo, microwave, and RFA, tackles challenging lesions and heat-sink management, and looks ahead to AI, robotics, and novel technologies.
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ANECDOTE

Bleeding During Biopsy Taught A Hard Lesson

  • Michael Barraza recounts a case where a biopsy caused bleeding and obscured the lesion, forcing him to ablate afterward.
  • He now inserts ablation probes first, then biopsies with probes in place to guarantee tumor treatment.
ADVICE

Use 3‑Plane Guidance For Off‑Angle Paths

  • Use Siemens interventional guidance or similar iterative-plane guidance to simplify off-plane trajectories and triangulation.
  • Verify needle position in all three dimensions as you advance to improve targeting accuracy.
ADVICE

Use Intraop Imaging Or Contrast For Confirmation

  • Image during the ablation (or after) to confirm coverage, using contrast if lesion is endophytic or landmarks are poor.
  • For tricky lesions, use nephrographic-phase contrast to map tumor before or after ablation.
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