Farrah Joyce Wolf BS, Presenter: Nothing to Disclose

David J. Grand MD, Abstract Co-Author: Nothing to Disclose

Thomas A. DiPetrillo MD, Abstract Co-Author: Nothing to Disclose

Jason Machan, Abstract Co-Author: Nothing to Disclose

William W. Mayo-Smith MD, Abstract Co-Author: Research support, General Electric Company Research support, Bracco Group

Damian E. Dupuy MD, Abstract Co-Author: Consultant, Abla-Tx Inc Consultant, Veran Medical Technologies, Inc Grant, Endocare, Inc Grant, Veran Medical Technologies, Inc Speakers Bureau, Tyco Healthcare (Valley Lab)

A new thermal ablation technique, Microwave Ablation (MWA), offers significant advantages such as a more efficient convection profile, making it necessary to examine the safety and efficacy of MWA in the percutaneous treatment of lung malignancies.

From 11/10/2003 to 8/28/2006, 50 patients (28 males, 22 females, mean age 70 ± 15) underwent 66 percutaneous MWA treatments for 82 intraparenchymal pulmonary masses (no chest wall involvement) (mean 1.42 ± 1.01 tumors/patient) (mean max tumor diameter 3.5cm ± 1.6cm). Each tumor was ablated under CT-guidance for 7-10 minutes at 45-60 Watts with a 3.7 or 1.6 cm antenna. 1-, 3- and 6-month follow-up contrast-enhanced CT and PET scan images were reviewed.

Of the 50 patients, 27 had biopsy proven NSCLC, 3 SCLC, and the remainder metastatic disease from colorectal (8), breast (3) and other primary malignancies. All 50 patients had technical completion of their ablation. Immediate complications included PTX (CTCAE Grade 1, 18/66, Grade 2, 8/66), and hemoptysis (4/66). During the follow-up period (mean 10 ± 6.8 months), 26% of patients (13/50) were found to have residual disease at the ablation site, as was predicted by index size >3cm (P = 0.01). An additional 22% of patients (11/50) had recurrent disease resulting in a 1-year local control rate of 67 ± 10% with a mean 16.2 ± 1.3 months to first recurrence. Kaplan-Meier analysis yielded an actuarial survival of 65 ± 7% at 1 year, 55 ± 9% at 2 years, and 45 ± 11% at 3 years from the date of ablation. Yet, an analysis of cancer-specific mortality yielded a 1-year survival of 83 ± 6%, 2-year survival of 73 ± 9%, and a 3-year survival of 61 ± 13% not significantly affected by index size > or ≤ 3cm, or the presence of residual disease.

This preliminary work shows that MWA can be safely applied to lung tumors. Continued study is warranted and ongoing.

Surgically unresectable lung malignancies, as determined by tumor characteristics and patient morbidity, have been treated with minimally invasive, image-guided microwave ablation.

Wolf, F, Grand, D, DiPetrillo, T, Machan, J, Mayo-Smith, W, Dupuy, D, Microwave Ablation of Lung Malignancies: CT Findings, Safety, and Efficacy in 50 Patients.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011442.html