At Advanced Cancer Care in Atlanta, we are committed to providing patients with the latest, most effective treatment options. For years, stereotactic body radiation therapy (SBRT) has been a vital choice for patients with liver cancer who could not undergo surgery or ablation. Now, with the arrival of histotripsy, a new non-invasive approach is reshaping the landscape.

SBRT: Precision Radiation for Inoperable Tumors

Stereotactic Body Radiation Therapy (SBRT) uses high-dose, precisely targeted beams of radiation delivered over a few sessions. It can control liver tumors with minimal damage to nearby tissue when planned carefully.

Advantages of SBRT:

Non-invasive, no incisions or anesthesia Can target deep tumors not reachable by needles Effective option for patients who cannot undergo surgery or ablation Strong data supporting local tumor control (70–90% at 2 years)

Limitations of SBRT:

Risk of radiation-induced liver injury, especially in cirrhotic patients Requires multiple treatment sessions and careful motion management Collateral radiation exposure to healthy liver tissue Immune effects possible, but not fully predictable

Histotripsy: The Non-Thermal Alternative

Histotripsy is a non-invasive focused ultrasound therapy that uses acoustic cavitation (microbubbles) to mechanically break apart tumors. Unlike SBRT, it doesn’t rely on radiation or heat.

Advantages of histotripsy:

Non-invasive and incision-less, like SBRT Single treatment session in most cases No radiation exposure, preserving healthy liver function Effective even for tumors near blood vessels or bile ducts (avoids heat-sink and radiation dose limits) Early trials show ~90% local control at 12 months Potential for immune stimulation by exposing intact tumor antigens

Limitations of histotripsy:

Newer therapy, long-term survival data still developing Limited availability at select centers Not suitable for every tumor location due to acoustic barriers

Comparing Side by Side

Feature

SBRT

Histotripsy

Invasiveness

Non-invasive, outpatient

Non-invasive, outpatient

Treatment sessions

3–10 sessions over 1–2 weeks

Usually one session

Effect on healthy liver

Risk of radiation toxicity

Minimal, non-thermal tissue sparing

Local control

70–90% at 2 years

~90% at 12 months (early data)

Side effects

Fatigue, radiation-induced liver injury

Minimal pain, low complication rate

Immune effects

Variable immune modulation

Promising immune activation potential

Cost

Varies by course of treatment

Approx. $30,000 per treatment

Which Option Is Best?

SBRT remains an excellent choice for tumors not safely reached by ablation, especially when patients have limited treatment alternatives. It is guideline-supported and widely available. Histotripsy offers a groundbreaking alternative with fewer side effects, faster recovery, and no radiation exposure. It is especially compelling for patients with cirrhosis, vascular proximity, or prior liver radiation.

At Advanced Cancer Care Atlanta, every patient case is reviewed in our multidisciplinary tumor board. The decision between SBRT and histotripsy depends on tumor characteristics, liver function, prior treatments, and patient preference.

The Future of Non-Invasive Liver Cancer Therapy

Histotripsy is not here to replace SBRT but to expand options. Together, these two non-invasive therapies offer patients more tailored, less disruptive ways to fight liver cancer — with the shared goal of maximizing survival and quality of life.

Advanced Cancer Care is proud to lead in making both of these advanced treatments available to patients across Atlanta and the Southeast.

Innovation. Precision. Compassion. That is our promise.