A review of radiofrequency ablation: Large target tissue necrosis and mathematical modelling

•We review the state-of-the-art of RFA specifically for tumours ⩾3 cm in diameter.•We review the tissue charring, one of the reasons for the so-called “3-cm” problem.•We discuss the state-of-the-art of mathematical modelling of RFA.•We propose the temperature control of target tissue in RFA for the “3-cm” problem.

Radiofrequency ablation (RFA) is an effective clinical method for tumour ablation with minimum intrusiveness. However, the use of RFA is mostly restricted to small tumours, especially those <<3 cm in diameter. This paper discusses the state-of-the-art of RFA, drawn from experimental and clinical results, for large tumours (i.e. ⩾⩾3 cm in diameter). In particular, the paper analyses clinical results related to target tissue necrosis (TTN) and mathematical modelling of the RFA procedure to understand the mechanism whereby the TTN is limited to under 3 cm with RFA. This paper also discusses a strategy of controlling of the temperature of target tissue in the RFA procedure with the state-of-art device, which has the potential to increase the size of TTN. This paper ends with a discussion of some future ideas to solve the so-called 3-cm problem with RFA.