Giuseppe Belfiore MD, Presenter: Nothing to Disclose

Enrico Tedeschi MD, Abstract Co-Author: Nothing to Disclose

Giovanni Moggio MD, Abstract Co-Author: Nothing to Disclose

Riccardo Cioffi MD, Abstract Co-Author: Nothing to Disclose

Francesca C Cincotti MD, Abstract Co-Author: Nothing to Disclose

Renato Rossi MD, Abstract Co-Author: Nothing to Disclose

To evaluate safety, technical feasibility, complications, clinical results and imaging features of computed tomography (CT)-guided radiofrequency (RF) palliative ablation of unresectable primary lung cancer with 1-year follow-up.

44 CT-guided tumor ablation sessions were performed with a 17-G cooled-tip single or cluster electrode and a 200-W RF generator (Radionics ®, USA) in 40 patients (29M/11F; mean age 68 years; range: 44-75) with malignant unresectable primary lung tumors in mild sedation analgesia. We included non-surgical candidates with T1-T4 neoplasms, as long as confined to the thorax, with no involvement of the thoracic walls, massive invasion of the mediastinum or concurrent coagulation disorders.Follow-up contrast-enhanced (CE)-CT findings (size and enhancement) at 6 and 12 months after treatment (40 and 19 cases, respectively) were correlated with cyto-histopathologic assessment at CT-guided fine needle aspiration biopsy and/or core biopsy at 6 months (24 cases) and with subjective clinical scores assessing pain, cough and dyspnea at 6 and 12 months (38 and 19 cases, respectively).

RF ablation treatments were completed according to protocol (target temperature: 90-95° C for 9-12 minutes) in all cases, with only 13 minor complications (4 pneumothorax, 5 hemoptysis and 4 pleural effusions). 8 patients deceased within one year, due to non procedure-related causes.At 6 months, lesion size was reduced in 26 cases (>90% of original size in 7), unchanged in 12 and increased in 2, while CT enhancement was reduced in 21/30 measurable lesions. Biopsy showed total coagulation necrosis in 10 lesions and partial necrosis in 14, 4 of which in lesions with reduced enhancement. At 1-year, CE-CT (19 cases) showed unchanged size in 11, further size reduction in 8 and reduced enhancement in 10. Compared to pre-treatment clinical scores, improvement was observed in 25 and 11 cases at 6 and 12 months, respectively.

Palliation of unresectable lung cancer can be safely achieved with percutaneous RF ablation with minor patient discomfort. Follow-up should include histopathological data to assess the adequacy of treatment.

Belfiore, G, Tedeschi, E, Moggio, G, Cioffi, R, Cincotti, F, Rossi, R, CT-guided Radiofrequency Palliative Ablation of Unresectable Lung Cancer: Clinical and Imaging Findings at One-year Follow-up.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4415838.html