Liver directed therapies are cancer treatments targeting the liver and sparing side effects in other parts of the body. These include thermal ablation in which high temperatures are generated within individual tumors causing tumor death. Microwave ablation is most commonly used for small tumors 4 or fewer in number. Catheter directed therapies involve placement of a long catheter introduced from the artery in the leg or arm and advanced into the liver. This catheter is then used to treat tumors in the liver. This can be accomplished using small plastic particles to block the blood supply to the tumor causing it to die. Alternatively these particles can be bound to chemotherapy providing for delivery of high dose chemotherapy directly to the liver reducing the side effects compared to standard chemotherapy. Particles can also be bound to radiation and delivered directly into the tumor achieving high dose radiation and reducing exposure of other organs. Catheter directed therapies are appropriate for larger tumors or patient with multiple liver tumors. These procedures are generally performed in the radiology department in sterile rooms by interventional radiologists with special expertise in oncology.