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Interventional oncology · London

Microwave liver tumour ablation, private in London.

Percutaneous microwave ablation for HCC, colorectal liver metastases and selected secondaries - done by a consultant interventional radiologist with a high liver case volume, in a unit with a full hepatobiliary MDT.

A stethoscope on a clinical desk

Indicative pricing

What private microwave liver ablation costs in London.

Indicative ranges across UK units.

In short

£6,500 to £12,000, home same day or one night.

Procedure Indicative range
MDT case review and imaging opinion £450 to £850
Single lesion MWA (up to 3 cm) £6,500 to £8,500
Single lesion MWA (3 to 5 cm) £8,000 to £10,500
Multi-lesion or multi-antenna MWA £9,500 to £12,000
Combined MWA plus TACE (bridge to transplant) £11,000 to £15,500
Second-opinion review of imaging and MDT plan £300 to £550

Prices are all-inclusive of guidance imaging, general anaesthesia and disposable microwave probes. They vary by unit, by which interventional radiologist does the case, by tumour size and by the number of antennae required.

What it is

A minimally invasive way to destroy a liver tumour with heat.

A thin microwave antenna is placed through the skin into the tumour under ultrasound or CT guidance, then a 2.45 GHz field heats the tissue above 100C in a few minutes.

  • Percutaneous antenna placement

    A 14 to 16 gauge microwave antenna is passed through the skin into the tumour under real-time ultrasound or CT guidance - no incision, no scar of note.

  • 2.45 GHz electromagnetic energy

    The generator drives a high-frequency electromagnetic field around the antenna tip. Water molecules in the tumour oscillate rapidly, producing heat above 100C.

  • Coagulative necrosis in minutes

    A 5 to 15 minute cycle creates a predictable ellipsoid ablation zone that destroys the tumour and a safety margin of surrounding liver.

Why microwave over radiofrequency

Larger, faster, less heat-sink limited.

Microwave is the newer generation of thermal ablation and has largely replaced radiofrequency for liver work in most UK HPB centres.

  • Larger ablation zone per session

    A single microwave antenna produces a bigger, more spherical ablation zone than a comparable radiofrequency probe - fewer overlapping burns for a 3 to 5 cm lesion.

  • Less heat-sink from adjacent vessels

    Radiofrequency is cooled by flowing blood in nearby portal or hepatic veins, leaving residual tumour. Microwave heats past this effect for more complete kill next to vessels.

  • Faster cycle time

    Typical MWA cycles run 5 to 10 minutes versus 15 to 20 minutes for radiofrequency - a shorter anaesthetic and a shorter time on the CT table.

When it helps

When MWA is the right step - and when it is not.

The liver tumours we see most, plus the anatomical situations where cryoablation, IRE or SBRT is safer.

  • Hepatocellular carcinoma (HCC) under 3 cm

    BCLC very early or early stage HCC in patients unsuitable for resection or transplant, or as a bridge on the transplant list.

  • HCC 3 to 5 cm in selected patients

    Solitary lesions where MWA gives a larger, more predictable ablation zone than radiofrequency, often with one antenna.

  • Colorectal liver metastases under 3 cm

    Oligometastatic disease with a limited number of small lesions - MWA can be curative or extend chemotherapy holidays.

  • Neuroendocrine liver metastases

    Symptom control and cytoreduction for functional NETs, or local control of a dominant lesion alongside somatostatin analogues.

  • Recurrence after resection

    A new lesion in a remnant liver after hepatectomy - MWA avoids the morbidity of a second open operation.

  • Other secondaries: breast, renal, sarcoma

    Selected solitary or oligometastatic secondaries in a controlled systemic disease context, agreed at MDT.

  • Lesion abutting a major bile duct

    A hilar or central lesion within 5 mm of a major bile duct is safer with IRE or cryo - MWA risks a biliary stricture.

  • Red flag: decompensated cirrhosis or ascites

    Child-Pugh C liver disease, uncontrolled ascites or coagulopathy needs medical optimisation and MDT review, not a private booking.

Procedure options

MWA is a family of techniques - and sits beside other ablations.

What each option on the table actually involves - and which fits which tumour.

  • Percutaneous MWA under CT

    CT guidance for lesions near diaphragm, in segment 7 or 8, or where ultrasound windows are poor. Precise antenna placement and immediate post-ablation check.

  • Percutaneous MWA under ultrasound

    Real-time ultrasound guidance for accessible lesions in the left lobe and anterior right lobe. No ionising radiation and faster set-up.

  • Contrast-enhanced ultrasound (CEUS) fusion

    CEUS or CT-ultrasound fusion for lesions that are conspicuous on CT but hard to see on standard ultrasound. Improves targeting accuracy.

  • Multi-antenna synchronous MWA

    Two or three antennae fired together to create a larger, more spherical ablation zone in one session - useful for 3 to 5 cm lesions.

  • Hydrodissection and bowel displacement

    Sterile fluid instilled between the liver capsule and adjacent bowel or diaphragm to protect them from thermal injury during the ablation cycle.

  • Combined MWA and TACE

    Trans-arterial chemoembolisation followed by MWA for larger HCC - the embolisation reduces heat sink and improves ablation completeness.

  • Laparoscopic or open MWA

    Occasionally the safest route for lesions on the liver surface next to bowel or gallbladder - done with an HPB surgeon in a single-anaesthetic session.

  • Second-opinion imaging review

    A specialist review of your MDT letter, imaging and prior treatments - sometimes the answer is SBRT, Y-90 or systemic therapy, not another ablation.

Outcomes

What the published data show.

Local control and survival vary by tumour type, size and underlying liver function. These are pooled ranges from published series.

  • HCC under 3 cm

    Complete ablation in 90 to 95% of cases at first treatment. 5-year overall survival of 40 to 60%, comparable to surgical resection in very early stage disease.

  • Colorectal liver metastases

    Local tumour control of 80 to 90% at 12 months for lesions under 3 cm with an adequate margin. Best used within a multi-modality plan alongside systemic therapy.

  • HCC 3 to 5 cm

    Complete ablation rates of 70 to 85% with multi-antenna technique or combined MWA plus TACE. Higher local recurrence than smaller lesions but often repeatable.

Safety and recovery

What to expect afterwards - honestly.

MWA is a well-established interventional oncology procedure. The things worth planning are your anaesthetic, the transient post-ablation syndrome, and the follow-up scan.

  • General anaesthesia for most cases

    GA gives a still target and controlled breathing - important for CT-guided punctures near the diaphragm. Deep sedation is used for selected small lesions.

  • Post-ablation syndrome

    A transient flu-like illness with low-grade fever, malaise and right upper quadrant discomfort for 3 to 7 days. Settles with paracetamol and hydration.

  • Transient LFT rise

    Liver enzymes typically rise for 3 to 5 days after ablation as the treated volume undergoes necrosis. Resolves without intervention in most cases.

  • Bleeding is uncommon but real

    Around 1 to 2% risk of clinically significant bleeding needing embolisation or transfusion. Coagulation checked and corrected before the procedure.

  • Biliary injury near central lesions

    Lesions within 5 mm of major bile ducts carry a stricture risk with MWA.

  • Pleural effusion or pneumothorax

    Trans-pleural punctures for high dome lesions can cause a small effusion or pneumothorax - usually managed conservatively, occasionally with a drain.

  • Tumour seeding

    A rare but recognised risk of tumour cells tracking along the antenna path - reduced by track ablation on antenna withdrawal.

  • Recovery and back to work

    Most patients are back to office work within 3 to 5 days. Heavy lifting and vigorous exercise are avoided for two weeks.

  • Red flags after discharge

    Severe abdominal pain, fever over 38.5C, jaundice, or breathlessness - call the unit or attend A&E the same day.

Compared to other options

Where MWA sits alongside cryo, IRE, SBRT, Y-90 and TACE.

The right modality depends on tumour size and location, liver function, and whether the goal is cure, bridging to transplant or symptom control.

  • Radiofrequency ablation (RFA)

    The older thermal technology - smaller ablation zones, more affected by heat sink near vessels. Largely replaced by MWA for liver work in specialist UK units.

  • Cryoablation

    Freeze-thaw cycles. Better than MWA for tumours near major nerves or the diaphragm because the ice-ball is visible on imaging and cold is less painful.

  • Irreversible electroporation (IRE / NanoKnife)

    Non-thermal - the technique of choice for lesions within 5 mm of major bile ducts or vessels where MWA would risk a stricture.

  • Stereotactic body radiotherapy (SBRT)

    Non-invasive, delivered over 3 to 5 outpatient visits. Preferred for larger lesions (over 5 cm) or tumours that cannot be reached percutaneously.

  • Y-90 selective internal radiotherapy (SIRT)

    Radioactive microspheres delivered through the hepatic artery. Better for patients with multiple lesions across both lobes than single-target ablation.

  • TACE (transarterial chemoembolisation)

    A bridge to transplant for HCC on the waiting list, or a first-line treatment for intermediate-stage disease with multiple lesions.

Reading your ablation report

Your MWA report in four parts. Read the last one first.

Whichever technique was used, the report the interventional radiologist sends you keeps to the same shape.

A UK interventional radiologist reviewing a liver ablation report

A quiet reminder

Interventional radiology language is precise and can read coldly - ask your care team to explain anything that is unclear.

Ask your care team to explain anything that is unclear.

  1. 01 Header

    Diagnosis, lesion site and size

    The indication (HCC, colorectal metastasis, NET), the Couinaud segment, the largest diameter in millimetres and the pre-ablation vascular pattern.

  2. 02 Technique

    Antennae, power and cycle length

    Number and configuration of microwave antennae, generator power in watts, cycle duration in minutes, and any hydrodissection or track ablation used.

  3. 03 Findings

    Ablation zone and complications

    The size and shape of the immediate ablation zone on post-procedure imaging, whether the ablative margin looks adequate, and any bleeding or air near vulnerable structures.

  4. 04 Impression

    Follow-up imaging and MDT plan

    Read this first: when the first follow-up CT or MRI is booked, whether adjuvant therapy is planned, and the next MDT review date.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for liver ablation varies by insurer and by indication - usually funded when medically indicated with MDT support.

Frequently asked

Everything we get asked about liver MWA.

Quick answers on outpatient care, repeatability, insurance, size limits, liver function and recovery.

  • Is microwave liver ablation done as an outpatient?

    Most patients are treated as a day-case or with one overnight stay for observation. General anaesthesia and CT-guided punctures near the diaphragm often warrant one night on the ward, but many small lesions treated under ultrasound are true day-cases with home the same evening.

  • Can microwave ablation be repeated?

    Yes. Unlike surgery, MWA can be repeated for new or recurrent lesions in the same or a different part of the liver, provided the underlying liver function allows. This is one of its main advantages over resection, particularly for HCC in cirrhosis and for oligometastatic colorectal disease.

  • Will private insurance cover it?

    Bupa, AXA, Vitality, Aviva, Cigna, WPA and Healix generally cover liver ablation when medically indicated and supported by an MDT letter.

  • Is there a size limit for microwave ablation?

    Complete ablation rates are highest for lesions under 3 cm. Lesions between 3 and 5 cm are treatable with multi-antenna technique or combined MWA plus TACE. Lesions over 5 cm are usually better served by resection, SBRT or Y-90 radioembolisation.

  • Will my liver function be affected?

    A transient rise in liver enzymes and bilirubin for 3 to 5 days is expected as the treated volume undergoes necrosis. Baseline liver function usually returns within two weeks. Careful case selection in cirrhosis is essential to avoid tipping decompensated disease into liver failure.

  • How long is recovery?

    Most patients feel a mild right upper quadrant discomfort and flu-like symptoms for 3 to 7 days, well controlled with paracetamol. Office work is usually resumed within 3 to 5 days; heavy lifting and vigorous exercise are avoided for two weeks.

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