Ep. 621 Techniques for Liver Metastases Ablation: Planning & Execution with Dr. Jonas Redmond

Mar 3, 2026

Dr. Keith Horton, an interventional radiologist and ergonomics educator, shares practical wisdom on procedural technique and workplace safety. He discusses common setup mistakes and simple fixes for posture, monitor placement, and lead fit. Short, actionable strategies for career longevity, AR and robotics to reduce strain, and institutional ergonomics programs are highlighted.

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INSIGHT

Ergonomics Often Begins With Personal Injury

Self-preservation often drives clinicians to adopt ergonomics after experiencing back or neck problems.
Horton first engaged ergonomics research after personal disc injury and concerns about bloodborne pathogen exposure.

ADVICE

Put Displays Directly In Front Of You

Place monitors and ultrasound directly in front of the operator to keep gaze neutral and reduce neck strain.
Keith Horton reroutes ultrasound output to the angio room screen or requests a slave monitor so he doesn't turn backward during cases.

INSIGHT

Ergonomic Strain Threatens Career Longevity

Poor ergonomics is widespread across specialties and contributes to early retirement and lost productivity.
Horton references meta-analyses and surveys showing higher prevalence of back pain in interventionalists compared with other clinicians.

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With data increasingly positioning thermal ablation as a viable alternative to surgery for select liver metastases, the demands on the interventional oncologist have never been higher. Mastering the nuances of patient selection and precise margin assessment is now essential for ensuring effective disease control locally. In this episode of the BackTable Podcast, interventional radiologist Dr. Jonas Redmond of UC San Diego Health joins host Dr. Sabeen Dhand to discuss the current state of microwave ablation (MWA) in the management of oligometastatic liver disease, focusing on tumor assessment, preprocedural planning, and the integration of local and systemic therapies.

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This podcast is supported by:

Varian IntelliBlate
https://www.varian.com/products/interventional-solutions/microwave-ablation-solutions

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SYNPOSIS

The conversation delves into the complexities of timing systemic versus local ablative therapies and explores questions surrounding adequate treatment margins. Dr. Redmond goes on to emphasize the need for operators to approach procedures with a high level of adaptability, advocating for interdisciplinary preprocedural planning and thoughtful modality selection. Exploring the complications that could arise from injury to adjacent viscera, the physicians speak to the critical importance of rigorous intraprocedural reassessment and discuss how modern software and robotics are transforming procedural precision and safety. Framing these MWA pearls within the context of recent clinical trials like COLLISION and ACCLAIM, the episode underscores the transition of interventional oncology from providing palliative services to increasingly curative solutions that may offer better prospects for patients with metastatic disease.

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TIMESTAMPS

00:00 - Introduction
04:30 - Role of Local Therapy in Systemic Disease
09:49 - Patient Selection and Treatment Modalities
13:15 - Challenging Lesion Characteristics and Locations
19:56 - Y-90 Radioembolization versus Microwave Ablation
23:04 - Intraoperative Ablation and Combining Locoregional Modalities
29:36 - Complications of Microwave Ablation in the Liver
36:43 - Future of Ablation and Liver Metastases Treatment
39:25 - Final Thoughts and Closing Remarks

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RESOURCES

UC San Diego Health. Cryoablation and Arterial Infusion of SD-101 in Combination with Durvalumab and Tremelimumab.
https://clinicaltrials.ucsd.edu/trial/NCT06710223

COLLISION trial
https://clinicaltrials.gov/study/NCT03088150

ACCLAIM trial
https://clinicaltrials.gov/study/NCT05265169