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 report major complications during RFA of unresectable lung tumors in our experience.

We retrospectively studied 112 nodules in 56 patients treated with CT-guided RFA in our hospital from April 2000 to March 2007. RFA was performed under local anesthesia and conscious sedation with an expandable electrode (LeVeen electrode) and a 100-W generator (RF 2000). The patients consisted of 43 with recurrent lung cancers and 69 with metastatic lung tumors from various organs. Tumor size ranged 0.8-6.5 cm; mean, 2.3 cm in diameter. RFA was performed in patients whose cancer was considered unresectable or who were unable to tolerate chemotherapy. The following patients were considered to be unsuitable candidates for RFA: patients with a lesion within 1 cm of the heart, mediastinum, or hilum, and patients with coagulation abnormalities. Major complications were defined as those that, if left untreated, might threaten the patient’s life, lead to substantial morbidity and disability, result in hospital admission, or substantially lengthen hospital stay.

Major complications were encountered in 9/112 (0.08%) treatment sessions. 3/9 cases of fever over 38.5°C were suspected of being acute pleuritis, and administration of antibiotic was required. 3/9 cases of abscess formationand were treated by antibiotic. 1/9 cases of massive pneumothorax required drainage and prolonged hospital stay. 1/9 patients had pneumothorax and refractory pleural effusion and required thoracocentesis. 1/9 patients experienced air embolism during electrode insertion, although the air embolism disappeared spontaneously and the patient was discharged without sustaining any neurological deficit.

RFA for lung tumors is generally a safe procedure with a low incidence of major complications. Knowledge of the major complications of RFA for lung tumors and their radiological and clinical appearance may facilitate early diagnosis and prompt treatment.

Major complications during CT-guided radiofrequency ablation (RFA) of lung tumor are rare. However, interventional radiologists performing the procedure should be aware of potential complications and be familiar with the appropriate management.

Okuma, T, Matsuoka, T, Yamamoto, A, Nakamura, K, Inoue, Y, Major Complications of Percutaneous CT-guided Radiofrequency Ablation of Lung Tumor in 112 Treatment Sessions.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5004144.html