Tomohisa Okuma MD, Presenter: Nothing to Disclose

Toshiyuki Matsuoka MD, Abstract Co-Author: Nothing to Disclose

Akira Yamamoto MD, Abstract Co-Author: Nothing to Disclose

Kenji Nakamura MD, Abstract Co-Author: Nothing to Disclose

Yuichi Inoue MD, Abstract Co-Author: Nothing to Disclose

To evaluate the technical success, complications, and effectiveness of re-RFA for recurrent lung tumor previously treated with RFA.

We retrospectively analyzed 112 nodules in 56 patients (mean age, 70 years; range, 40-94) treated with CT-guided RFA in our hospital from April 2000 to March 2007. Re-enlargement at the site of RFA seen on follow-up CT is defined as local recurrence. RFA was performed under conscious sedation with an expandable electrode (LeVeen electrode) and a 100-W generator (RF 2000). Ablation was continued until the impedance reached maximum (so-called roll-off). To complete ablation, several overlapping ablations were performed in different portions of the tumor.

In 11 treatment sessions for 10 patients, the tumors were considered to be recurrent on follow-up CT for a median of 9 months (range; 3-25 months) after the ‘first’ RFA. The treated lesions (mean size; 2.5 ± 0.6 cm) in these patients consisted of 5 recurrences of primary lung cancer, and 6 metastatic lung tumors from the esophagus (n=2), bladder (n=2), kidney (n=1), and colon (n=1). Re-RFA was completed successfully in all cases without major complications. The minor complications included pain during ablation (n=5), pneumothorax without requiring drainage (n=3), subcutaneous emphysema (n=1), hemoptysis (n=2), and fever up (n=4). 3/11 treatment sessions achieved roll-off and tumor diameters of less than 3 cm showed no re-relapse on follow-up for a median of 7 months. In 8/11, local tumor progression occurred on follow-up for a median of 5.5 months (range; 3-10 months). The causes of re-relapse were suspected to be that roll-off was not achieved, that the tumor was larger than 3 cm, that was near the bronchovascular bundle, and that there was insufficient ablation due to pain during the procedure.

To improve the therapeutic effect of re-RFA, it necessary to ablate with a sufficient safety margin and to achieve roll-off with proper pain control.

To improve the effect of percutaneous CT-guided radiofrequency ablation (RFA) for relapse of lung tumor previously treated with ablation, it is important to achieve ‘roll-off’ and a sufficient safety margin.

Okuma, T, Matsuoka, T, Yamamoto, A, Nakamura, K, Inoue, Y, Re-CT-guided Radiofrequency Ablation for Unresectable Lung Tumor of Local Recurrence Previously Treated with the Procedure.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5000893.html