Semin intervent Radiol 2022; 39(03): 285-291
DOI: 10.1055/s-0042-1753526
Review Article

The Latest on Lung Ablation

Peyton Cramer
1   Division of Interventional Radiology, Department of Radiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York
,
Bradley B. Pua
1   Division of Interventional Radiology, Department of Radiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Lung cancer is the second most common cancer in both men and women. Despite smoking cessation efforts and advances in lung cancer detection and treatment, long-term survival remains low. For early-stage primary lung carcinoma, surgical resection offers the best chance of long-term survival; however, only about one-third of patients are surgical candidates. For nonsurgical candidates, minimally invasive percutaneous thermal ablation therapies have become recognized as safe and effective treatment alternatives, including radiofrequency ablation, microwave ablation, and cryoablation. Lung ablation is also an acceptable treatment for limited oligometastatic and oligorecurrent diseases. This article discusses the technologies and techniques available for tumor ablation of thoracic malignancies, as well as new treatments on the horizon.

Keywords

lung cancer - radiofrequency ablation - microwave ablation - cryoablation - interventional radiology


Publication History

Article published online:
31 August 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Cancer.org. 2021. Lung Cancer Guide | What You Need to Know. [online] Accessed September 11, 2021 at: https://www.cancer.org/cancer/lung-cancer.html
    PubMed
  • 2 Robinson LA, Wagner Jr H, Ruckdeschel JC. American College of Chest Physicians. Treatment of stage IIIA non-small cell lung cancer. Chest 2003; 123 (1, Suppl): 202S-220S
    CrossrefPubMedGoogle Scholar
  • 3 Chheang S, Abtin F, Guteirrez A, Genshaft S, Suh R. Imaging features following thermal ablation of lung malignancies. Semin Intervent Radiol 2013; 30 (02) 157-168
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 de Baere T, Tselikas L, Catena V, Buy X, Deschamps F, Palussière J. Percutaneous thermal ablation of primary lung cancer. Diagn Interv Imaging 2016; 97 (10) 1019-1024
    CrossrefPubMedGoogle Scholar
  • 5 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
    CrossrefPubMedGoogle Scholar
  • 6 Jain SK, Dupuy DE, Cardarelli GA, Zheng Z, DiPetrillo TA. Percutaneous radiofrequency ablation of pulmonary malignancies: combined treatment with brachytherapy. AJR Am J Roentgenol 2003; 181 (03) 711-715
    CrossrefPubMedGoogle Scholar
  • 7 Tafti BA, Genshaft S, Suh R, Abtin F. Lung ablation: indications and techniques. Semin Intervent Radiol 2019; 36 (03) 163-175
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Palussière J, Catena V, Buy X. Percutaneous thermal ablation of lung tumors - radiofrequency, microwave and cryotherapy: Where are we going?. Diagn Interv Imaging 2017; 98 (09) 619-625
    CrossrefPubMedGoogle Scholar
  • 9 Pastorino U, Buyse M, Friedel G. et al; International Registry of Lung Metastases. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 1997; 113 (01) 37-49
    CrossrefPubMedGoogle Scholar
  • 10 Abtin F, De Baere T, Dupuy DE. et al. Updates on current role and practice of lung ablation. J Thorac Imaging 2019; 34 (04) 266-277
    CrossrefPubMedGoogle Scholar
  • 11 Mouli SK, Kurilova I, Sofocleous CT, Lewandowski RJ. The role of percutaneous image-guided thermal ablation for the treatment of pulmonary malignancies. AJR Am J Roentgenol 2017; 209 (04) 740-751
    CrossrefPubMedGoogle Scholar
  • 12 Lin M, Eiken P, Blackmon S. Image guided thermal ablation in lung cancer treatment. [published correction appears in J Thorac Dis. 2021 Jan;13(1):502] J Thorac Dis 2020; 12 (11) 7039-7047
    CrossrefPubMedGoogle Scholar
  • 13 Ma Y, Wallace AN, Waqar SN. et al. Percutaneous image-guided ablation in the treatment of osseous metastases from non-small cell lung cancer. Cardiovasc Intervent Radiol 2018; 41 (05) 726-733
    PubMedGoogle Scholar
  • 14 Alexander ES, Dupuy DE. Lung cancer ablation: technologies and techniques. Semin Intervent Radiol 2013; 30 (02) 141-150
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Botsa EI, Thanou IL, Papatheodoropoulou AT, Thanos LI. Thermal ablation in the management of adrenal metastasis originating from non-small cell lung cancer: a 5-year single-center experience. Chin Med J (Engl) 2017; 130 (17) 2027-2032
    CrossrefPubMedGoogle Scholar
  • 16 Frenk NE, Daye D, Tuncali K. et al. Local control and survival after image-guided percutaneous ablation of adrenal metastases. J Vasc Interv Radiol 2018; 29 (02) 276-284
    CrossrefPubMedGoogle Scholar
  • 17 Sofocleous CT, Sideras P, Petre EN, Solomon SB. Ablation for the management of pulmonary malignancies. AJR Am J Roentgenol 2011; 197 (04) W581-W589
    CrossrefPubMedGoogle Scholar
  • 18 Mehta HJ, Ross C, Silvestri GA, Decker RH. Evaluation and treatment of high-risk patients with early-stage lung cancer. Clin Chest Med 2011; 32 (04) 783-797
    CrossrefPubMedGoogle Scholar
  • 19 Yang X, Ye X, Zhang L. et al. Microwave ablation for lung cancer patients with a single lung: clinical evaluation of 11 cases. Thorac Cancer 2018; 9 (05) 548-554
    CrossrefPubMedGoogle Scholar
  • 20 Ruscio L, Planche O, Zetlaoui P, Benhamou D. Percutaneous radiofrequency ablation of pulmonary metastasis and thoracic paravertebral block under computed tomographic scan guidance: a case report. A A Pract 2018; 11 (08) 213-215
    CrossrefPubMedGoogle Scholar
  • 21 Rose SC. Radiofrequency ablation of pulmonary malignancies. Semin Respir Crit Care Med 2008; 29 (04) 361-383
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Cheung Ning M, Karmakar MK. Right thoracic paravertebral anaesthesia for percutaneous radiofrequency ablation of liver tumours. Br J Radiol 2011; 84 (1005): 785-789
    CrossrefPubMedGoogle Scholar
  • 23 García FJS, Aragón EM, Alvarez SA. et al. Ultrasound-guided thoracic paravertebral block for pulmonary radiofrequency ablation. J Cardiothorac Vasc Anesth 2022; 36 (02) 553-556
    CrossrefPubMedGoogle Scholar
  • 24 Steinke K, Haghighi KS, Wulf S, Morris DL. Effect of vessel diameter on the creation of ovine lung radiofrequency lesions in vivo: preliminary results. J Surg Res 2005; 124 (01) 85-91
    CrossrefPubMedGoogle Scholar
  • 25 Lubner MG, Brace CL, Hinshaw JL, Lee Jr FT. Microwave tumor ablation: mechanism of action, clinical results, and devices. J Vasc Interv Radiol 2010; 21 (08) , Suppl): S192-S203
    CrossrefPubMedGoogle Scholar
  • 26 Gage AA, Baust J. Mechanisms of tissue injury in cryosurgery. Cryobiology 1998; 37 (03) 171-186
    CrossrefPubMedGoogle Scholar
  • 27 Lyons GR, Askin G, Pua BB. Clinical outcomes after pulmonary cryoablation with the use of a triple freeze protocol. J Vasc Interv Radiol 2018; 29 (05) 714-721
    CrossrefPubMedGoogle Scholar
  • 28 Hiraki T, Tajiri N, Mimura H. et al. Pneumothorax, pleural effusion, and chest tube placement after radiofrequency ablation of lung tumors: incidence and risk factors. Radiology 2006; 241 (01) 275-283
    CrossrefPubMedGoogle Scholar
  • 29 Lu Q, Cao W, Huang L. et al. CT-guided percutaneous microwave ablation of pulmonary malignancies: results in 69 cases. World J Surg Oncol 2012; 10: 80
    CrossrefPubMedGoogle Scholar
  • 30 Okuma T, Matsuoka T, Yamamoto A. et al. Frequency and risk factors of various complications after computed tomography-guided radiofrequency ablation of lung tumors. Cardiovasc Intervent Radiol 2008; 31 (01) 122-130
    CrossrefPubMedGoogle Scholar
  • 31 Yamagami T, Kato T, Hirota T, Yoshimatsu R, Matsumoto T, Nishimura T. Usefulness and limitation of manual aspiration immediately after pneumothorax complicating interventional radiological procedures with the transthoracic approach. Cardiovasc Intervent Radiol 2006; 29 (06) 1027-1033
    CrossrefPubMedGoogle Scholar
  • 32 Yoshimatsu R, Yamagami T, Terayama K, Matsumoto T, Miura H, Nishimura T. Delayed and recurrent pneumothorax after radiofrequency ablation of lung tumors. Chest 2009; 135 (04) 1002-1009
    CrossrefPubMedGoogle Scholar
  • 33 Cannella M, Cornelis F, Descat E. et al. Bronchopleural fistula after radiofrequency ablation of lung tumours. Cardiovasc Intervent Radiol 2011; 34 (Suppl. 02) S171-S174
    CrossrefPubMedGoogle Scholar
  • 34 Alberti N, Buy X, Frulio N. et al. Rare complications after lung percutaneous radiofrequency ablation: incidence, risk factors, prevention and management. Eur J Radiol 2016; 85 (06) 1181-1191
    CrossrefPubMedGoogle Scholar
  • 35 Nour-Eldin NE, Naguib NN, Mack M, Abskharon JE, Vogl TJ. Pulmonary hemorrhage complicating radiofrequency ablation, from mild hemoptysis to life-threatening pattern. Eur Radiol 2011; 21 (01) 197-204
    CrossrefPubMedGoogle Scholar
  • 36 Inoue M, Nakatsuka S, Yashiro H. et al. Percutaneous cryoablation of lung tumors: feasibility and safety. J Vasc Interv Radiol 2012; 23 (03) 295-302 , quiz 305
    CrossrefPubMedGoogle Scholar
  • 37 Sakurai J, Mimura H, Gobara H, Hiraki T, Kanazawa S. Pulmonary artery pseudoaneurysm related to radiofrequency ablation of lung tumor. Cardiovasc Intervent Radiol 2010; 33 (02) 413-416
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 40 Palussière J, Canella M, Cornelis F. et al. Retrospective review of thoracic neural damage during lung ablation - what the interventional radiologist needs to know about neural thoracic anatomy. Cardiovasc Intervent Radiol 2013; 36 (06) 1602-1613
    CrossrefPubMedGoogle Scholar
  • 41 Yamakado K, Akeboshi M, Nakatsuka A. et al. Tumor seeding following lung radiofrequency ablation: a case report. Cardiovasc Intervent Radiol 2005; 28 (04) 530-532
    CrossrefPubMedGoogle Scholar
  • 42 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
    CrossrefPubMedGoogle Scholar
  • 43 Livraghi T, Lazzaroni S, Meloni F, Solbiati L. Risk of tumour seeding after percutaneous radiofrequency ablation for hepatocellular carcinoma. Br J Surg 2005; 92 (07) 856-858
    CrossrefPubMedGoogle Scholar
  • 44 Okuma T, Matsuoka T, Tutumi S, Nakmura K, Inoue Y. Air embolism during needle placement for CT-guided radiofrequency ablation of an unresectable metastatic lung lesion. J Vasc Interv Radiol 2007; 18 (12) 1592-1594
    CrossrefPubMedGoogle Scholar
  • 45 Maas M, Beets-Tan R, Gaubert JY. et al. Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice. Insights Imaging 2020; 11 (01) 83
    CrossrefPubMedGoogle Scholar
  • 46 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
    CrossrefPubMedGoogle Scholar
  • 47 Kodama H, Yamakado K, Takaki H. et al. Lung radiofrequency ablation for the treatment of unresectable recurrent non-small-cell lung cancer after surgical intervention. Cardiovasc Intervent Radiol 2012; 35 (03) 563-569
    CrossrefPubMedGoogle Scholar
  • 48 McDevitt JL, Mouli SK, Nemcek AA, Lewandowski RJ, Salem R, Sato KT. Percutaneous cryoablation for the treatment of primary and metastatic lung tumors: identification of risk factors for recurrence and major complications. J Vasc Interv Radiol 2016; 27 (09) 1371-1379
    CrossrefPubMedGoogle Scholar
  • 49 Yamakado K, Inoue Y, Takao M. et al. Long-term results of radiofrequency ablation in colorectal lung metastases: single center experience. Oncol Rep 2009; 22 (04) 885-891
    CrossrefPubMedGoogle Scholar
  • 50 Yan TD, King J, Sjarif A, Glenn D, Steinke K, Morris DL. Percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma: prognostic determinants for survival. Ann Surg Oncol 2006; 13 (11) 1529-1537
    CrossrefPubMedGoogle Scholar
  • 51 de Baere T, Robinson JM, Rao P, Teriitehau C, Deschamps F. Radiofrequency ablation of lung metastases close to large vessels during vascular occlusion: preliminary experience. J Vasc Interv Radiol 2011; 22 (06) 749-754
    CrossrefPubMedGoogle Scholar
  • 52 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
    CrossrefPubMedGoogle Scholar
  • 53 Yang X, Ye X, Zheng A. et al. Percutaneous microwave ablation of stage I medically inoperable non-small cell lung cancer: clinical evaluation of 47 cases. J Surg Oncol 2014; 110 (06) 758-763
    CrossrefPubMedGoogle Scholar
  • 54 Healey TT, March BT, Baird G, Dupuy DE. Microwave ablation for lung neoplasms: a retrospective analysis of long-term results. J Vasc Interv Radiol 2017; 28 (02) 206-211
    CrossrefPubMedGoogle Scholar
  • 55 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
    CrossrefPubMedGoogle Scholar
  • 56 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
    CrossrefPubMedGoogle Scholar
  • 57 Palussière J, Chomy F, Savina M. et al. Radiofrequency ablation of stage IA non-small cell lung cancer in patients ineligible for surgery: results of a prospective multicenter phase II trial. J Cardiothorac Surg 2018; 13 (01) 91
    CrossrefPubMedGoogle Scholar
  • 58 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
    CrossrefPubMedGoogle Scholar
  • 59 Vogl TJ, Naguib NN, Gruber-Rouh T, Koitka K, Lehnert T, Nour-Eldin NE. Microwave ablation therapy: clinical utility in treatment of pulmonary metastases. [published correction appears in Radiology. 2013 Mar;266(3):1000] Radiology 2011; 261 (02) 643-651
    CrossrefPubMedGoogle Scholar
  • 60 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
    CrossrefPubMedGoogle Scholar
  • 61 Callstrom MR, Woodrum DA, Nichols FC. et al. Multicenter study of metastatic lung tumors targeted by interventional cryoablation evaluation (SOLSTICE). J Thorac Oncol 2020; 15 (07) 1200-1209
    CrossrefPubMedGoogle Scholar
  • 62 Hiraki T, Gobara H, Iishi T. et al. Percutaneous radiofrequency ablation for pulmonary metastases from colorectal cancer: midterm results in 27 patients. J Vasc Interv Radiol 2007; 18 (10) 1264-1269
    CrossrefPubMedGoogle Scholar
  • 63 Yamauchi Y, Izumi Y, Kawamura M. et al. Percutaneous cryoablation of pulmonary metastases from colorectal cancer. PLoS One 2011; 6 (11) e27086
    CrossrefPubMedGoogle Scholar
  • 64 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
    CrossrefPubMedGoogle Scholar
  • 65 Wu J, Bai HX, Chan L. et al. Sublobar resection compared with stereotactic body radiation therapy and ablation for early stage non-small cell lung cancer: a national cancer database study. J Thorac Cardiovasc Surg 2020; 160 (05) 1350-1357.e11
    CrossrefPubMedGoogle Scholar
  • 66 Zemlyak A, Moore WH, Bilfinger TV. Comparison of survival after sublobar resections and ablative therapies for stage I non-small cell lung cancer. J Am Coll Surg 2010; 211 (01) 68-72
    CrossrefPubMedGoogle Scholar
  • 67 Kim SR, Han HJ, Park SJ. et al. Comparison between surgery and radiofrequency ablation for stage I non-small cell lung cancer. Eur J Radiol 2012; 81 (02) 395-399
    CrossrefPubMedGoogle Scholar
  • 68 Crabtree T, Puri V, Timmerman R. et al. Treatment of stage I lung cancer in high-risk and inoperable patients: comparison of prospective clinical trials using stereotactic body radiotherapy (RTOG 0236), sublobar resection (ACOSOG Z4032), and radiofrequency ablation (ACOSOG Z4033). J Thorac Cardiovasc Surg 2013; 145 (03) 692-699
    CrossrefPubMedGoogle Scholar
  • 69 Song P, Sun W, Pang M, He W, Zhang W, Sheng L. Efficacy comparison between microwave ablation combined with radiation therapy and radiation therapy alone for locally advanced nonsmall-cell lung cancer. J Cancer Res Ther 2021; 17 (03) 715-719
    CrossrefPubMedGoogle Scholar
  • 70 Sebek J, Kramer S, Rocha R. et al. Bronchoscopically delivered microwave ablation in an in vivo porcine lung model. ERJ Open Res 2020; 6 (04) 00146-02020
    CrossrefPubMedGoogle Scholar
  • 71 Yoneda KY, Herth F, Spangler T, Raina S, Panescu D. Long-term survival results following endobronchial RF ablation in a healthy-porcine model. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020: 5252-5258
    PubMedGoogle Scholar
  • 72 Chan JWY, Lau RWH, Ngai JCL. et al. Transbronchial microwave ablation of lung nodules with electromagnetic navigation bronchoscopy guidance-a novel technique and initial experience with 30 cases. Transl Lung Cancer Res 2021; 10 (04) 1608-1622
    CrossrefPubMedGoogle Scholar
  • 73 Koizumi T, Tsushima K, Tanabe T. et al. Bronchoscopy-guided cooled radiofrequency ablation as a novel intervention therapy for peripheral lung cancer. Respiration 2015; 90 (01) 47-55
    CrossrefPubMedGoogle Scholar
  • 74 Zerbini A, Pilli M, Penna A. et al. Radiofrequency thermal ablation of hepatocellular carcinoma liver nodules can activate and enhance tumor-specific T-cell responses. Cancer Res 2006; 66 (02) 1139-1146
    CrossrefPubMedGoogle Scholar
  • 75 Shao C, Yang M, Pan Y. et al. Case report: abscopal effect of microwave ablation in a patient with advanced squamous NSCLC and resistance to immunotherapy. Front Immunol 2021; 12: 696749
    CrossrefPubMedGoogle Scholar