Semin intervent Radiol 2017; 34(02): 176-181
DOI: 10.1055/s-0037-1602592
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Decision Making in Interventional Oncology: Ablative Options in the Lung

Kyungmouk Steve Lee
1   Department of Radiology, Weill Cornell Medicine, New York
,
Joseph P. Erinjeri
2   Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
01 June 2017 (online)

Abstract

Image-guided ablation is safe and effective for the treatment of both primary and metastatic tumors in the lung. This article reviews the three most commonly used ablative options: radiofrequency ablation, microwave ablation, and cryoablation. We describe the advantages of each ablation modality in the lung and how to choose the most appropriate ablation device based on patient and tumor characteristics. The optimal technique for lung ablation is discussed and technical tips for improving clinical outcome are described.

 
  • References

  • 1 Brambilla E, Travis W. Lung cancer. In: Stewart BW, Wild CP. , eds. World Cancer Report. Lyon: World Health Organization; 2014
  • 2 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016; 66 (01) 7-30
  • 3 Kwan SW, Mortell KE, Talenfeld AD, Brunner MC. Thermal ablation matches sublobar resection outcomes in older patients with early-stage non-small cell lung cancer. J Vasc Interv Radiol 2014; 25 (01) 1-9.e1
  • 4 Kwan SW, Mortell KE, Hippe DS, Brunner MC. An economic analysis of sublobar resection versus thermal ablation for early-stage non-small-cell lung cancer. J Vasc Interv Radiol 2014; 25 (10) 1558-1564 , quiz 1565
  • 5 Binkley MS, Trakul N, Jacobs LR. , et al. Colorectal histology is associated with an increased risk of local failure in lung metastases treated with stereotactic ablative radiation therapy. Int J Radiat Oncol Biol Phys 2015; 92 (05) 1044-1052
  • 6 Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WW, Kavanagh PV, Safran H. Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 2000; 174 (01) 57-59
  • 7 Boston Scientific RF 3000 radiofrequency ablation system. Available at: http://www.bostonscientific.com/templatedata/imports/collateral/Radiology/broc_rf3000_03_us.pdf . Accessed April 27, 2017
  • 8 StarBurst (RITA) radiofrequency ablation system. Available at: http://www.angiodynamics.com/products/what-is-rfa . Accessed April 27, 2017
  • 9 Cool-Tip Covidien radiofrequency ablation system. Available at: http://surgical.covidien.com/products/ablation-systems/cool-tip-rf-ablation-system-e-series . Accessed April 27, 2017
  • 10 Simon CJ, Dupuy DE, DiPetrillo TA. , et al. Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology 2007; 243 (01) 268-275
  • 11 Ambrogi MC, Fanucchi O, Cioni R. , et al. Long-term results of radiofrequency ablation treatment of stage I non-small cell lung cancer: a prospective intention-to-treat study. J Thorac Oncol 2011; 6 (12) 2044-2051
  • 12 Chua TC, Sarkar A, Saxena A, Glenn D, Zhao J, Morris DL. Long-term outcome of image-guided percutaneous radiofrequency ablation of lung metastases: an open-labeled prospective trial of 148 patients. Ann Oncol 2010; 21 (10) 2017-2022
  • 13 Palussière J, Marcet B, Descat E. , et al. Lung tumors treated with percutaneous radiofrequency ablation: computed tomography imaging follow-up. Cardiovasc Intervent Radiol 2011; 34 (05) 989-997
  • 14 de Baère T, Aupérin A, Deschamps F. , et al. Radiofrequency ablation is a valid treatment option for lung metastases: experience in 566 patients with 1037 metastases. Ann Oncol 2015; 26 (05) 987-991
  • 15 Dupuy DE, Fernando HC, Hillman S. , et al. Radiofrequency ablation of stage IA non-small cell lung cancer in medically inoperable patients: results from the American College of Surgeons Oncology Group Z4033 (Alliance) trial. Cancer 2015; 121 (19) 3491-3498
  • 16 Lencioni R, Crocetti L, Cioni R. , et al. Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study). Lancet Oncol 2008; 9 (07) 621-628
  • 17 Simon CJ, Dupuy DE, Mayo-Smith WW. Microwave ablation: principles and applications. Radiographics 2005; 25 (Suppl. 01) S69-S83
  • 18 Evident (Covidien) microwave ablation system. Available at: http://surgical.covidien.com/products/ablation-systems . Accessed April 27, 2017
  • 19 Microtherm X. . BSD microwave ablation system. Available at: http://www.bsdmedical.com/usa/brochures/Microthermx_Brochure.pdf . Accessed April 27, 2017
  • 20 Avecure Medwaves microwave ablation system. Available at: http://www.medwaves.com/ . Accessed April 27, 2017
  • 21 Certus 140 Neuwave Medical microwave ablation system. Available at: http://www.neuwavemedical.com/NeuWaveMedicalFilePile/NeuWaveFDAClearancePress20101028Final9.pdf . Accessed April 27, 2017
  • 22 AMICA microwave ablation system. Available at: http://www.amarantoweb.com/hsmedical/drive/File/AMICA_eng.pdf . Accessed April 27, 2017
  • 23 Acculis MTA microwave ablation system. Available at: http://www.angiodynamics.com/products/Acculis . Accessed April 27, 2017
  • 24 Wolf FJ, Grand DJ, Machan JT, Dipetrillo TA, Mayo-Smith WW, Dupuy DE. Microwave ablation of lung malignancies: effectiveness, CT findings, and safety in 50 patients. Radiology 2008; 247 (03) 871-879
  • 25 Vogl TJ, Worst TS, Naguib NNN, Ackermann H, Gruber-Rouh T, Nour-Eldin N-EA. Factors influencing local tumor control in patients with neoplastic pulmonary nodules treated with microwave ablation: a risk-factor analysis. AJR Am J Roentgenol 2013; 200 (03) 665-672
  • 26 Belfiore G, Ronza F, Belfiore MP. , et al. Patients' survival in lung malignancies treated by microwave ablation: our experience on 56 patients. Eur J Radiol 2013; 82 (01) 177-181
  • 27 Gage AA, Baust J. Mechanisms of tissue injury in cryosurgery. Cryobiology 1998; 37 (03) 171-186
  • 28 Izumi Y, Oyama T, Ikeda E, Kawamura M, Kobayashi K. The acute effects of transthoracic cryoablation on normal lung evaluated in a porcine model. Ann Thorac Surg 2005; 79 (01) 318-322 , discussion 322
  • 29 Hinshaw JL, Littrup PJ, Durick N. , et al. Optimizing the protocol for pulmonary cryoablation: a comparison of a dual- and triple-freeze protocol. Cardiovasc Intervent Radiol 2010; 33 (06) 1180-1185
  • 30 Yamauchi Y, Izumi Y, Hashimoto K. , et al. Percutaneous cryoablation for the treatment of medically inoperable stage I non-small cell lung cancer. PLoS One 2012; 7 (03) e33223
  • 31 Maiwand MO. The role of cryosurgery in palliation of tracheo-bronchial carcinoma. Eur J Cardiothorac Surg 1999; 15 (06) 764-768
  • 32 Endocare cryotherapy system. Available at: https://www.healthtronics.com/physicians/cryotherapy/cryotherapy-services-and-solutions . Accessed April 27, 2017
  • 33 Cryohit cryotherapy system. Available at: http://www.galilmedical.com/ . Accessed April 27, 2017
  • 34 de Baere T, Tselikas L, Woodrum D. , et al. Evaluating cryoablation of metastatic lung tumors in patients--safety and efficacy: the ECLIPSE trial--interim analysis at 1 year. J Thorac Oncol 2015; 10 (10) 1468-1474
  • 35 Yashiro H, Nakatsuka S, Inoue M. , et al. Factors affecting local progression after percutaneous cryoablation of lung tumors. J Vasc Interv Radiol 2013; 24 (06) 813-821
  • 36 Moore W, Talati R, Bhattacharji P, Bilfinger T. Five-year survival after cryoablation of stage I non-small cell lung cancer in medically inoperable patients. J Vasc Interv Radiol 2015; 26 (03) 312-319
  • 37 Welch BT, Brinjikji W, Schmit GD. , et al. A national analysis of the complications, cost, and mortality of percutaneous lung ablation. J Vasc Interv Radiol 2015; 26 (06) 787-791
  • 38 Hiraki T, Gobara H, Mimura H. , et al. Brachial nerve injury caused by percutaneous radiofrequency ablation of apical lung cancer: a report of four cases. J Vasc Interv Radiol 2010; 21 (07) 1129-1133
  • 39 Matsui Y, Hiraki T, Gobara H. , et al. Phrenic nerve injury after radiofrequency ablation of lung tumors: retrospective evaluation of the incidence and risk factors. J Vasc Interv Radiol 2012; 23 (06) 780-785
  • 40 Kashima M, Yamakado K, Takaki H. , et al. Complications after 1000 lung radiofrequency ablation sessions in 420 patients: a single center's experiences. AJR Am J Roentgenol 2011; 197 (04) W576-80
  • 41 Borghol S, Alberti N, Frulio N. , et al. Pulmonary artery pseudoaneurysm after radiofrequency ablation: report of two cases. Int J Hyperthermia 2015; 31 (01) 1-4
  • 42 Vaughn C, Mychaskiw II G, Sewell P. Massive hemorrhage during radiofrequency ablation of a pulmonary neoplasm. Anesth Analg 2002; 94 (05) 1149-1151
  • 43 Nomura M, Yamakado K, Nomoto Y. , et al. Complications after lung radiofrequency ablation: risk factors for lung inflammation. Br J Radiol 2008; 81 (963) 244-249
  • 44 Beland MD, Wasser EJ, Mayo-Smith WW, Dupuy DE. Primary non-small cell lung cancer: review of frequency, location, and time of recurrence after radiofrequency ablation. Radiology 2010; 254 (01) 301-307
  • 45 Durick NA, Laeseke PF, Broderick LS. , et al. Microwave ablation with triaxial antennas tuned for lung: results in an in vivo porcine model. Radiology 2008; 247 (01) 80-87
  • 46 Lee KS, Takaki H, Yarmohammadi H. , et al. Pleural puncture that excludes the ablation zone decreases the risk of pneumothorax after percutaneous microwave ablation in porcine lung. J Vasc Interv Radiol 2015; 26 (07) 1052-1058
  • 47 Sakurai J, Hiraki T, Mukai T. , et al. Intractable pneumothorax due to bronchopleural fistula after radiofrequency ablation of lung tumors. J Vasc Interv Radiol 2007; 18 (1, Pt 1): 141-145
  • 48 Anai H, Uchida BT, Pavcnik D. , et al. Effects of blood flow and/or ventilation restriction on radiofrequency coagulation size in the lung: an experimental study in swine. Cardiovasc Intervent Radiol 2006; 29 (05) 838-845
  • 49 Hinshaw JL, Sampson L, Lee Jr FTJ, Laeseke PF, Brace CL. Does selective intubation increase ablation zone size during pulmonary cryoablation?. J Vasc Interv Radiol 2008; 19 (10) 1497-1501