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Izaaryene J, Grange R, Habouzit V, Grange S, Orsini B, Dassa M, Daidj N, Thierry L, Ferre M, Phelip JM, Lelong B, De Chaisemartin C, Mitry E, Piana G. Cryoablation for treatment of peripheral lung metastases from colorectal cancer: a bicenter retrospective study. Eur Radiol 2025; 35:3282-3293. [PMID: 39572449 DOI: 10.1007/s00330-024-11153-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 09/09/2024] [Accepted: 10/09/2024] [Indexed: 05/16/2025]
Abstract
OBJECTIVES To evaluate the oncological efficacy and complications of cryoablation (CA) in treating lung metastases from colorectal cancer (CRC) at the lung periphery. MATERIALS AND METHODS The inclusion criteria for this bicenter retrospective study included patients with histologically confirmed CRC, with radiologically confirmed lung metastases at the periphery of the lung (distance of less than or equal to 2 cm from the costal, diaphragmatic, or cervical pleura) treated with CA between January 2017 and June 2022. Patients with intra-parenchymal metastases or metastases close to the mediastinal pleura and patients without follow-up were excluded. RESULTS Seventy-three patients were included (median age: 69 years, range 47.0-83.0; 38 males, 52.0%) with 113 metastases and 89 procedures. Technical success was achieved in all procedures. During follow-up (median 22 months), on a per metastasis basis, local recurrence occurred for 8/113 (7%) of the metastases in 7 patients at a median time of 19 months; 7 had concomitant distant recurrence. Local progression-free survival rates were 95% at 1 year and 89% at 2, 3, and 4 years. Distant progression occurred in 41/73 (56.2%) patients, significantly associated with a history of liver metastasis and synchronous lung metastasis (p < 0.05). The median chemotherapy-free survival was 14 (IQR (5.0-21.5)) months. Complications were predominantly mild or moderate, with a low incidence of severe complications. CONCLUSION CA demonstrates high rate of local control and appears well-tolerated in the treatment of peripheral lung metastases from CRC. The procedure offers a viable therapeutic option, allowing patients a significant period without chemotherapy. KEY POINTS Question Despite its advantages over surgery, data on cryoablation of metastases from colorectal cancer at the periphery of the lung are lacking. Findings Cryoablation enabled very good local control, with local progression-free survival rates of 95% at 1 year and 89% at 2, 3, and 4 years. Clinical relevance Cryoablation is an effective treatment for local tumor control of lung metastases from colorectal cancer at the periphery of the lung. The treatment is well tolerated and can provide patients with substantial relief from chemotherapy.
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Affiliation(s)
- Jean Izaaryene
- Interventional Radiology Department, Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France.
| | - Rémi Grange
- Department of Interventional Radiology, University Hospital of Saint-Etienne, University Hospital of Saint-Etienne, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France
| | - Vincent Habouzit
- Department of Interventional Radiology, University Hospital of Saint-Etienne, University Hospital of Saint-Etienne, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France
| | - Sylvain Grange
- Department of Interventional Radiology, University Hospital of Saint-Etienne, University Hospital of Saint-Etienne, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France
| | - Bastien Orsini
- Department of Thoracic Surgery, Clairval Private Hospital, Ramsay Générale de Santé, Marseille, France
| | - Michael Dassa
- Interventional Radiology Department, Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Nassima Daidj
- Interventional Radiology Department, Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Louis Thierry
- Interventional Radiology Department, Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Marjorie Ferre
- Interventional Radiology Department, Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Jean Marc Phelip
- Department of Interventional Radiology, University Hospital of Saint-Etienne, University Hospital of Saint-Etienne, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France
| | - Bernard Lelong
- Surgery Department Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Cécile De Chaisemartin
- Surgery Department Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Emmanuel Mitry
- Oncology Department, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Gilles Piana
- Interventional Radiology Department, Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
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Álvarez Álvarez R, Manzano A, Agra Pujol C, Artigas Raventós V, Correa R, Cruz Jurado J, Fernandez JA, Garcia Del Muro X, Gonzalez JA, Hindi N, Lozano Lominchar P, Martínez-Trufero J, Méndez R, Muñoz M, Muñoz Casares C, Orbis Castellanos F, Orellana Fernandez R, Paniagua González M, Redondo A, Valverde Morales C, Asencio JM. Updated Review and Clinical Recommendations for the Diagnosis and Treatment of Patients with Retroperitoneal Sarcoma by the Spanish Sarcoma Research Group (GEIS). Cancers (Basel) 2023; 15:3194. [PMID: 37370803 DOI: 10.3390/cancers15123194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Soft tissue sarcomas (STS) are an uncommon and biologically heterogeneous group of tumors arising from mesenchymal cells. The incidence is estimated at five cases per 100,000 people per year. Retroperitoneal sarcomas (RPS) account for 10-15% of all STS, and their management depends on their anatomical characteristics and histotype. Due to their very low incidence, it is recommended that RPS be treated in reference centers and evaluated by an experienced multidisciplinary team (MDT). In Spain, the Spanish Group for Research in Sarcomas (GEIS) brings together experts from various specialties to promote research on sarcomas and improve treatment results. This paper summarizes the GEIS recommendations for the diagnosis, treatment, and follow-up of patients with RPS.
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Affiliation(s)
- Rosa Álvarez Álvarez
- Medical Oncology Department, Instituto de Investigacion Sanitaria Gregorio Marañon, Hospital Universitario Gregorio Marañon, 28007 Madrid, Spain
| | - Aránzazu Manzano
- Medical Oncology Department, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain
| | - Carolina Agra Pujol
- Pathology Department, Hospital Universitario Gregorio Marañon, Complutense University, 28007 Madrid, Spain
| | - Vicente Artigas Raventós
- Surgery Department, Hospital Universitario Sant Pau, Universidad Autonoma de Barcelona, 08035 Barcelona, Spain
| | - Raquel Correa
- Radiation Oncology Department, Hospital Virgen de la Victoria, 29010 Malaga, Spain
| | - Josefina Cruz Jurado
- Medical Oncology Department, Hospital Universitario Canarias, 38320 Santa Cruz de Tenerife, Spain
| | - Juan Angel Fernandez
- Sarcoma Multidisciplinary Unit, Surgery Department, Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
| | - Xavier Garcia Del Muro
- Sarcoma Multidisciplinary Unit, Medical Oncology Department, Idibell, Instituto Catalan Oncología Hospitalet, 08908 Barcelona, Spain
| | - Jose Antonio Gonzalez
- Surgery Department, Hospital Universitario Sant Pau, Universidad Autonoma de Barcelona, 08035 Barcelona, Spain
| | - Nadia Hindi
- Medical Oncology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
- Medical Oncology Department, Hospital General de Villalba, 28400 Madrid, Spain
- Health Research Institute-Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid (UAM), 28040 Madrid, Spain
| | - Pablo Lozano Lominchar
- Surgery Department, Hospital Universitario Gregorio Marañon, Complutense University, 28040 Madrid, Spain
| | | | - Ramiro Méndez
- Radiology Department, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain
| | - Mercedes Muñoz
- Radiation Oncology Department, Hospital Universitario Gregorio Marañon, Complutense University, 28007 Madrid, Spain
| | | | - Francisco Orbis Castellanos
- Sarcoma Multidisciplinary Unit, Surgery Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
| | | | - Miguel Paniagua González
- Radiology Department, Hospital Universitario Gregorio Marañon, Complutense University, 28007 Madrid, Spain
| | - Andres Redondo
- Medical Oncology Department, Hospital Universitario La Paz-IdiPAZ, 28046 Madrid, Spain
| | | | - Jose Manuel Asencio
- Surgery Department, Hospital Universitario Gregorio Marañon, Complutense University, 28040 Madrid, Spain
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Huang H, Zheng D, Chen H, Chen C, Wang Y, Xu L, Wang Y, He X, Yang Y, Li W. A CT-based radiomics approach to predict immediate response of radiofrequency ablation in colorectal cancer lung metastases. Front Oncol 2023; 13:1107026. [PMID: 36798816 PMCID: PMC9927400 DOI: 10.3389/fonc.2023.1107026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023] Open
Abstract
Objectives To objectively and accurately assess the immediate efficacy of radiofrequency ablation (RFA) on colorectal cancer (CRC) lung metastases, the novel multimodal data fusion model based on radiomics features and clinical variables was developed. Methods This case-control single-center retrospective study included 479 lung metastases treated with RFA in 198 CRC patients. Clinical and radiological data before and intraoperative computed tomography (CT) scans were retrieved. The relative radiomics features were extracted from pre- and immediate post-RFA CT scans by maximum relevance and minimum redundancy algorithm (MRMRA). The Gaussian mixture model (GMM) was used to divide the data of the training dataset and testing dataset. In the process of modeling in the training set, radiomics model, clinical model and fusion model were built based on a random forest classifier. Finally, verification was carried out on an independent test dataset. The receiver operating characteristic curves (ROC) were drawn based on the obtained predicted scores, and the corresponding area under ROC curve (AUC), accuracy, sensitivity, and specificity were calculated and compared. Results Among the 479 pulmonary metastases, 379 had complete response (CR) ablation and 100 had incomplete response ablation. Three hundred eighty-six lesions were selected to construct a training dataset and 93 lesions to construct a testing dataset. The multivariate logistic regression analysis revealed cancer antigen 19-9 (CA19-9, p<0.001) and the location of the metastases (p< 0.05) as independent risk factors. Significant correlations were observed between complete ablation and 9 radiomics features. The best prediction performance was achieved with the proposed multimodal data fusion model integrating radiomic features and clinical variables with the highest accuracy (82.6%), AUC value (0.921), sensitivity (80.3%), and specificity (81.4%). Conclusion This novel multimodal data fusion model was demonstrated efficient for immediate efficacy evaluation after RFA for CRC lung metastases, which could benefit necessary complementary treatment.
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Affiliation(s)
- Haozhe Huang
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Dezhong Zheng
- Laboratory for Medical Imaging Informatics, Shanghai Institute of Technical Physics, Shanghai, China,Department of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing, China
| | - Hong Chen
- Department of Medical Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Chen
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ying Wang
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lichao Xu
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yaohui Wang
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xinhong He
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yuanyuan Yang
- Laboratory for Medical Imaging Informatics, Shanghai Institute of Technical Physics, Shanghai, China,Department of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing, China,*Correspondence: Wentao Li, ; Yuanyuan Yang,
| | - Wentao Li
- Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China,*Correspondence: Wentao Li, ; Yuanyuan Yang,
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Golin M, Izaaryene J, Dassa M, Piana G, Ferre M. An ultra-low-dose protocol for computed tomography-guided lung radiofrequency ablations. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:041510. [PMID: 36575991 DOI: 10.1088/1361-6498/acabd2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
To evaluate the safety and efficacy of ultra-low-dose (ULD) protocol for computed tomography (CT)-guided lung radiofrequency ablation (RFA). Patients who had undergone lung RFA between November 2017 and January 2021 were consecutively and retrospectively included. Thirty patients were treated using a conventional standard protocol (SP), including helical acquisitions with mA automatic adjustment and sequential CT at 80 kVp; and 31, with a ULD protocol defined with helical acquisitions with fixed mA and sequential series at 100 kVp. These parameters were selected from those used for a diagnostic lung low-dose CT scanner. Patient characteristics, dose indicators, technical efficacy (minimal margin [MM], recurrence during follow-up), and complications (pneumothorax, alveolar haemorrhage, and haemoptysis) were recorded. We included 61 patients (median age, 65 [54-73] and 33 women), with no significant differences according to the type of protocol, except for the type of anaesthesia. Even if the number of helical acquisitions did not significantly change, all dose indicators significantly decreased by 1.5-fold-3-fold. The median dose-length-product and effective dose, with their ranges, respectively, were 465 mGy cm (315-554) and 6.5 mSv (4.4-7.8) in the SP group versus 178 mGy cm (154-267) and 2.5 mSv (2.2-3.7) in the ULD group, (p< 001). The ULD group exhibited lower intraoperator variability and better interoperator alignment than those of the SP group. The MM was not significantly different between the two groups (4.6 mm versus 5 mm,p= 16). One local recurrence was observed in each group at 8 months in the SP and at one year in the ULD group (p= 1). The complication rates did not differ significantly. Implementing an ULD protocol during lung RFA may provide similar efficacy, a reduction of dose indicators, and intra- and interoperator variability, without increasing complication rates, compared to those associated with an SP.
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Affiliation(s)
- Melissa Golin
- Interventional Radiology Department, Institute Paoli Calmettes, Aix Marseille University Institute Paoli Calmettes, 232 boulevard Sainte Marguerite, Marseille, 13009, France
| | - Jean Izaaryene
- Interventional Radiology Department, Institute Paoli Calmettes, Aix Marseille University Institute Paoli Calmettes, 232 boulevard Sainte Marguerite, Marseille, 13009, France
| | - Michael Dassa
- Interventional Radiology Department, Institute Paoli Calmettes, Aix Marseille University Institute Paoli Calmettes, 232 boulevard Sainte Marguerite, Marseille, 13009, France
| | - Gilles Piana
- Interventional Radiology Department, Institute Paoli Calmettes, Aix Marseille University Institute Paoli Calmettes, 232 boulevard Sainte Marguerite, Marseille, 13009, France
| | - Marjorie Ferre
- Interventional Radiology Department, Institute Paoli Calmettes, Aix Marseille University Institute Paoli Calmettes, 232 boulevard Sainte Marguerite, Marseille, 13009, France
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Ye X, Fan W, Wang Z, Wang J, Wang H, Niu L, Fang Y, Gu S, Liu L, Liu B, Zhuang Y, Wei Z, Li X, Li X, Li Y, Li C, Yang X, Yang W, Yang P, Lin Z, Meng Z, Hu K, Liu C, Huang Y, Huang G, Huang K, Peng Z, Han Y, Jin Y, Lei G, Zhai B, Li H, Pan J, Filippiadis D, Kelekis A, Pua U, Futacsi B, Yumchinserchin N, Iezzi R, Tang A, Roy SH. Clinical practice guidelines on image-guided thermal ablation of primary and metastatic lung tumors (2022 edition). J Cancer Res Ther 2022; 18:1213-1230. [PMID: 36204866 DOI: 10.4103/jcrt.jcrt_880_22] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The main contents of the Clinical Practice Guidelines on Image-Guided Thermal Ablation (IGTA) of Primary and Metastatic Lung Tumors (2022 Edition) include the following: epidemiology of primary and metastatic lung tumors; the concepts of the IGTA and common technical features; procedures, indications, contraindications, outcomes evaluation, and related complications of IGTA on primary and metastatic lung tumors; and limitations and future development.
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Affiliation(s)
- Xin Ye
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, China
| | - Weijun Fan
- Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China
| | - Zhongmin Wang
- Department of Interventional Radiology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Minhang, Shanghai, China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Haidian, Beijing, China
| | - Hui Wang
- Interventional Center, Jilin Provincial Cancer Hospital, Changchun, Jilin, China
| | - Lizhi Niu
- Department of Oncology, Affiliated Fuda Cancer Hospital, Jinan University, China
| | - Yong Fang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Shanzhi Gu
- Department of Interventional Radiology, Hunan Cancer Hospital, Hunan, China
| | - Lingxiao Liu
- Department of Interventional Radiology, Zhongshan Hospital, Shanghai Medical College of Fudan University, Xuhui, Shanghai, China
| | - Baodong Liu
- Department of Thoracic Surgery, Xuan Wu Hospital Affiliated to Capital Medical University, Xicheng, Beijing, China
| | - Yiping Zhuang
- Department of Interventional Therapy, Jiangsu Cancer Hospital, Jiangsu, China
| | - Zhigang Wei
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, China
| | - Xiao Li
- Department of Interventional Therapy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng, Beijing, China
| | - Xiaoguang Li
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, Dongcheng, Beijing, China
| | - Yuliang Li
- Department of Interventional Medicine, The Second Hospital of Shandong University, Jinan, Shandong, China
| | - Chunhai Li
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Xia Yang
- Department of Oncology, Shandong Provincial Hospital Afliated to Shandong First Medical University, Jinan, Shandong, China
| | - Wuwei Yang
- Department of Oncology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Po Yang
- Interventionael and Vascular Surgery, The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhengyu Lin
- Department of Intervention, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Zhiqiang Meng
- Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Dongan, Shanghai, China
| | - Kaiwen Hu
- Department of Oncology, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Chaoyang, China
| | - Chen Liu
- Department of Interventional Therapy, Beijing Cancer Hospital, Haidian, Beijing, China
| | - Yong Huang
- Department of Imaging, Affiliated Cancer Hospital of Shandong First Medical University, Jinan, Shandong, China
| | - Guanghui Huang
- Department of Oncology, Shandong Provincial Hospital Afliated to Shandong First Medical University, Jinan, Shandong, China
| | - Kaiwen Huang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Da'an District, Taipei, China
| | - Zhongmin Peng
- Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yue Han
- Department of Interventional Therapy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng, Beijing, China
| | - Yong Jin
- Interventionnal Therapy Department, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Guangyan Lei
- Department of Thoracic Surgery, Shanxi Provincial Cancer Hospital, Xinghualing, Taiyuan, China
| | - Bo Zhai
- Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Minhang, Shanghai, China
| | - Hailiang Li
- Department of Interventional Radiology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Jie Pan
- Department of Radiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng, Beijing, China
| | - Dimitris Filippiadis
- 2nd Department of Radiology, Division of Interventional Radiology, Medical School, Attikon University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexis Kelekis
- Radiology and Interventional Radiology at National and Kapodistrian University of Athens, Athens, Greece
| | - Uei Pua
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Balazs Futacsi
- Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - N Yumchinserchin
- The Intervention Radiology Department at Mongolia's National Cancer Center, Mongolia
| | - Roberto Iezzi
- Interventional Radiology Consultant at Fondazione Policlinico A. Gemelli IRCCS, Rome, Lazio, Italia
| | - Alex Tang
- Vascular and Interventional Radiology Centre, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
| | - Shuvro H Roy
- Choudhury Consultant in Diagnostic and Interventional Radiology, Naryana Health Group, India
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Zhang N, Coffman C, Wilson B, Gold J, Baum S, Tillmanns T, ElNaggar A. Radiofrequency and microwave ablation for treatment of recurrent gynecologic malignancies. Int J Gynecol Cancer 2022; 32:1045-1049. [PMID: 35680136 DOI: 10.1136/ijgc-2022-003444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Radiofrequency ablation and microwave ablation are used to vaporize tumors not amenable to surgical resection. We sought to evaluate the safety and efficacy of radiofrequency and microwave ablation for the treatment of isolated lesions in patients with recurrent gynecologic malignancy. METHODS Patients with gynecologic malignancies treated with radiofrequency or microwave ablation at a university-affiliated cancer center from April 2007 to January 2020 were evaluated. Clinical records were reviewed for number of prior chemotherapy regimens, response to ablation, time to progression, and location of progression. RESULTS Thirty-two patients received ablative therapy for treatment of isolated recurrences. Seventeen (53%) patients had ovarian cancer, seven (22%) had endometrial cancer, and eight (25%) had cervical cancer. Thirteen (41%) patients received radiofrequency ablation and 19 (59%) received microwave ablation. Patients had a median of 2 (range 1-12) prior lines of chemotherapy. Sixteen (50%) patients achieved a partial or complete response with two patients experiencing no progression at time of submission. Six (19%) patients had stable disease and 10 (31%) patients had progression at time of initial follow-up imaging. Median progression-free survival for the cohort was 7.3 months (range 1.4-64.7). No significant improvement in median progression-free survival was seen with the addition of adjuvant systemic therapy to radiofrequency or microwave ablation (6.9 vs 7.7 months; HR 0.7, 95% CI 0.3 to 1.7). Clinical benefit, defined as absence of definitive progression at the site of ablation or new target lesions at 4 months, was seen in 22 (68.8%) patients. No major complications occurred, with two patients reporting pain or weakness at the site of ablation. CONCLUSION Radiofrequency and microwave ablation demonstrated that 68.8% (n=22) of patients experienced clinical benefit at 4 months. Ablative therapy may be considered for the treatment of isolated lesions in patients with recurrent gynecologic malignancies.
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Affiliation(s)
- Naixin Zhang
- Obstetrics and Gynecology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Catherine Coffman
- Obstetrics and Gynecology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Ben Wilson
- Gynecologic Oncology, West Cancer Center, Memphis, Tennessee, USA
| | - Joann Gold
- Obstetrics and Gynecology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Scott Baum
- Interventional Radiology, West Cancer Center, Memphis, Tennessee, USA
| | - Todd Tillmanns
- Gynecologic Oncology, West Cancer Center, Memphis, Tennessee, USA
| | - Adam ElNaggar
- Gynecologic Oncology, West Cancer Center, Memphis, Tennessee, USA
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Imaging following thermal ablation of early lung cancers: expected post-treatment findings and tumour recurrence. Clin Radiol 2021; 76:864.e13-864.e23. [PMID: 34420686 DOI: 10.1016/j.crad.2021.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 07/13/2021] [Indexed: 12/22/2022]
Abstract
Thermal ablation is a minimally invasive technique that is growing in acceptance and popularity in the management of early lung cancers. Although curative resection remains the optimal treatment strategy for stage I pulmonary malignancies, percutaneous ablative treatments may also be considered for selected patients. These techniques can additionally be used in the treatment of oligometastatic disease. Thermal ablation of early lung tumours can be achieved using several different techniques. For example, microwave ablation (MWA) and radiofrequency ablation (RFA) utilise extreme heat, whereas cryoablation uses extremely cold temperatures to cause necrosis and ultimately cell death. Typically, post-ablation imaging studies are performed within the first 1-3 months with subsequent imaging performed at regular intervals to ensure treatment response and to evaluate for signs of recurrent disease. Surveillance imaging is usually undertaken with computed tomography (CT) and integrated positron-emission tomography (PET)/CT. Typical imaging findings are usually seen on CT and PET/CT following thermal ablation of lung tumours, and it is vital that radiologists are familiar with these appearances. In addition, radiologists should be aware of the imaging findings that indicate local recurrence following ablation. The objective of this review is to provide an overview of the expected post-treatment findings on CT and PET/CT following thermal ablation of early primary lung malignancies, as well as describing the imaging appearances of local recurrence.
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Multidisciplinary Management of Retroperitoneal Sarcoma: Diagnosis, Prognostic Factors and Treatment. Cancers (Basel) 2021; 13:cancers13164016. [PMID: 34439171 PMCID: PMC8392612 DOI: 10.3390/cancers13164016] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/06/2021] [Indexed: 01/07/2023] Open
Abstract
Simple Summary The management of retroperitoneal sarcomas can be challenging due to the variety of their presentation, histopathological types, and behaviours. This literature review provides a comprehensive and practical overview of the management of retroperitoneal sarcomas, focusing on diagnostic challenges, prognostic factors, multidisciplinary aspects of treatment and new research perspectives. Abstract Retroperitoneal sarcomas (RPS) are rare cancers whose management can be challenging due to various presentation patterns, multiple organ involvement, and a high local and distant recurrence rate. Histopathology and prognostic factors analysis are essential to predict the behaviour of the disease and plan the best therapeutic strategy. To date, surgery is still the main therapeutic option that guarantees a chance of cure from the primary disease. While chemotherapy and radiotherapy seem to be good options for controlling metastatic and recurrent irresectable disease, their role in the treatment of primary RPS remains unclear. This literature review aims to provide a comprehensive overview of the multidisciplinary aspects of RPS management in high-volume centres, summarising the diagnostic path, the prognostic factors, and the most suitable therapeutic options.
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Habert P, Di Bisceglie M, Bartoli A, Jacquier A, Brige P, Vidal V, Hak JF, Tradi F, Gaubert JY. Description of morphological evolution of lung tumors treated by percutaneous radiofrequency ablation: long term follow-up of 100 lesions with chest CT. Int J Hyperthermia 2021; 38:786-794. [PMID: 34032532 DOI: 10.1080/02656736.2021.1928773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Radiofrequency ablation (RFA) is a safe and effective minimally invasive treatment for pulmonary tumors. Patterns on chest computed tomography (CT) after RFA are classified into five types; however, the follow-up has not been fully described. The objectives of this study were to describe (1) the CT pattern 3 years after RFA and (2) its evolution over 7 years. MATERIALS AND METHODS Lesions treated with RFA between 2009 and 2017 and with ≥3 years of follow-up CT data were included. Lesions with local recurrences were excluded from the study. The morphology of the ablation zone was classified as nodular, fibrotic, atelectatic, cavitary, and disappeared. Other initial anatomical parameters were recorded. Kruskal-Wallis or Chi-square tests were used to compare the groups. RESULTS One hundred lung RFA scars were included, and a retrospective longitudinal study was performed. Three years after RFA, nodular, fibrotic, atelectatic, and cavitary scars, and disappearance were observed in 49%, 36%, 5%, 3%, and 6% of the scars, respectively. Evolution over 7 years showed that the fibrosis, atelectasis, and disappearance remained stable over time, whereas 28% of nodular scars evolved into fibrotic scars. Additionally, 45% of cavitary scars evolved into nodular scars. Pleural contact was associated with disappearance, and the use of a 20-mm needle was associated with atelectasis. CONCLUSION Follow-up after RFA showed that fibrosis, disappearance, and atelectasis remained stable over time. Nodular scars could evolve into fibrotic scars, and cavitary scars could evolve into nodular scars.
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Affiliation(s)
- Paul Habert
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Mathieu Di Bisceglie
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Axel Bartoli
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,Centre d'exploration métabolique par résonnance magnétique CEMEREM, Aix-Marseille Université, Marseille, France
| | - Alexis Jacquier
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,Centre d'exploration métabolique par résonnance magnétique CEMEREM, Aix-Marseille Université, Marseille, France
| | - Pauline Brige
- LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Vincent Vidal
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Jean-François Hak
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Farouk Tradi
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Jean-Yves Gaubert
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
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10
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Bonichon F, de Baere T, Berdelou A, Leboulleux S, Giraudet AL, Cuinet M, Drui D, Liberge R, Kelly A, Tenenbaum F, Legmann P, Do Cao C, Leenhardt L, Toubeau M, Godbert Y, Palussière J. Percutaneous thermal ablation of lung metastases from thyroid carcinomas. A retrospective multicenter study of 107 nodules. On behalf of the TUTHYREF network. Endocrine 2021; 72:798-808. [PMID: 33770383 DOI: 10.1007/s12020-020-02580-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/27/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine efficacy and safety of thermal ablation (TA) for the local treatment of lung metastases of thyroid cancer. METHODS We retrospectively studied 47 patients from 10 centers treated by TA (radiofrequency, microwaves, and cryoablation) over 10 years. The endpoints were overall survival (OS), local efficacy, complications (CTCAE classification), and factors associated with survival. OS curves after first TA were built using the Kaplan-Meier method and compared with the log-rank test. RESULTS A total of 107 lung metastases during 75 sessions were treated by radiofrequency (n = 56), microwaves (n = 9), and cryoablation (n = 10). Median follow-up time after TA was 5.2 years (0.2-13.3). OS was 93% at 2 years (95% confidence interval (CI): 86-94) and 79% at 3 years (95% CI: 66-91). On univariate and multivariate analysis with a Cox model, histology was the only significant factor for OS. OS at 3 years was 94% for follicular, oncocytic, or papillary follicular variant carcinomas, compared to 59% for papillary, medullary, insular or anaplastic carcinomas (P = 0.0001). The local control rate was 98.1% at 1 year and 94.8% at 2, 3, 4, and 5 years. Morbidity was low with no major complications (grade 4 and 5 CTCAE) and no complications in 29 of 75 sessions (38.7%). CONCLUSIONS TA is a useful, safe and effective option for local treatment of lung metastases from thyroid carcinoma. Prolonged OS was obtained, especially for lung metastases from follicular, oncocytic, or papillary follicular variant carcinomas. Achieving disease control with TA delays the need for systemic treatment.
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Affiliation(s)
- Françoise Bonichon
- Department of Nuclear Medicine and Thyroid Oncology, Institut Bergonié, Bordeaux, France.
| | - Thierry de Baere
- Department of Interventional Radiology, Gustave-Roussy, Villejuif, France
| | - Amandine Berdelou
- Department of Nuclear Medicine and Endocrine Cancer, Gustave-Roussy, Villejuif, France
| | - Sophie Leboulleux
- Department of Nuclear Medicine and Endocrine Cancer, Gustave-Roussy, Villejuif, France
| | | | - Marie Cuinet
- Department of Radiology, Léon Bérard Center, Lyon, France
| | - Delphine Drui
- Department of Endocrinology, Institut du Thorax, University Hospital, Nantes, France
| | - Renan Liberge
- Thoracic and General Radiology Department, University Hospital, Nantes, France
| | - Antony Kelly
- Department of Nuclear Medicine, Jean Perrin Center, Clermont Ferrand, France
| | - Florence Tenenbaum
- Nuclear Medicine Service, Hôpital Cochin, 27 rue du Faubourg St Jacques, 75014, Paris, France
| | - Paul Legmann
- Department of radiology, Hôpital Cochin, 27 rue du Faubourg St Jacques, 75014, Paris, France
| | | | - Laurence Leenhardt
- Unité Thyroïde Tumeurs Endocrines, Sorbonne Université, AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Michel Toubeau
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
| | - Yann Godbert
- Department of Nuclear Medicine and Thyroid Oncology, Institut Bergonié, Bordeaux, France
| | - Jean Palussière
- Department of Radiology, Institut Bergonié, Bordeaux, France
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11
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Páez-Carpio A, Gómez FM, Isus Olivé G, Paredes P, Baetens T, Carrero E, Sánchez M, Vollmer I. Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art. Insights Imaging 2021; 12:57. [PMID: 33914187 PMCID: PMC8085189 DOI: 10.1186/s13244-021-00997-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/09/2021] [Indexed: 12/25/2022] Open
Abstract
Image-guided percutaneous lung ablation has proven to be a valid treatment alternative in patients with early-stage non-small cell lung carcinoma or oligometastatic lung disease. Available ablative modalities include radiofrequency ablation, microwave ablation, and cryoablation. Currently, there are no sufficiently representative studies to determine significant differences between the results of these techniques. However, a common feature among them is their excellent tolerance with very few complications. For optimal treatment, radiologists must carefully select the patients to be treated, perform a refined ablative technique, and have a detailed knowledge of the radiological features following lung ablation. Although no randomized studies comparing image-guided percutaneous lung ablation with surgery or stereotactic radiation therapy are available, the current literature demonstrates equivalent survival rates. This review will discuss image-guided percutaneous lung ablation features, including available modalities, approved indications, possible complications, published results, and future applications.
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Affiliation(s)
- Alfredo Páez-Carpio
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain.
| | - Fernando M Gómez
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain.,Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Gemma Isus Olivé
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Pilar Paredes
- Department of Nuclear Medicine, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Tarik Baetens
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Enrique Carrero
- Department of Anesthesiology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Marcelo Sánchez
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ivan Vollmer
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
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12
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Tetta C, Carpenzano M, Algargoush ATJ, Algargoosh M, Londero F, Maessen JG, Gelsomino S. Non-surgical Treatments for Lung Metastases in Patients with Soft Tissue Sarcoma: Stereotactic Body Radiation Therapy (SBRT) and Radiofrequency Ablation (RFA). Curr Med Imaging 2021; 17:261-275. [PMID: 32819261 DOI: 10.2174/1573405616999200819165709] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/04/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Radio-frequency ablation (RFA) and Stereotactic Body Radiation Therapy (SBRT) are two emerging therapies for lung metastases. INTRODUCTION Aliterature review was performed to evaluate the outcomes and complications of these procedures in patients with lung metastases from soft tissue sarcoma (STS). METHODS After selection, seven studies were included for each treatment encompassing a total of 424 patients: 218 in the SBRT group and 206 in the RFA group. RESULTS The mean age ranged from 47.9 to 64 years in the SBRT group and from 48 to 62.7 years in the RFA group. The most common histologic subtype was, in both groups, leiomyosarcoma. In the SBRT group, median overall survival ranged from 25.2 to 69 months and median disease- free interval was from 8.4 to 45 months. Two out of seven studies reported G3 and one G3 toxicity, respectively. In RFA patients, overall survival ranged from 15 to 50 months. The most frequent complication was pneumothorax. Local control showed a high percentage for both procedures. CONCLUSION SBRT is recommended in patients unsuitable to surgery, in synchronous bilateral pulmonary metastases, in case of deep lesions and patients receiving high-risk systemic therapies. RFA is indicated in case of a long disease-free interval, in oligometastatic disease, when only the lung is involved, in small size lesions far from large vessels. Further large randomized studies are necessary to establish whether these treatments may also represent a reliable alternative to surgery.
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Affiliation(s)
- Cecilia Tetta
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Carpenzano
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, Maastricht, Netherlands
| | - Areej T J Algargoush
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, Maastricht, Netherlands
| | - Marwah Algargoosh
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, Maastricht, Netherlands
| | - Francesco Londero
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, Maastricht, Netherlands
| | - Jos G Maessen
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, Maastricht, Netherlands
| | - Sandro Gelsomino
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, Maastricht, Netherlands
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13
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Efficacy of Tract Embolization After Percutaneous Pulmonary Radiofrequency Ablation. Cardiovasc Intervent Radiol 2021; 44:903-910. [PMID: 33492452 DOI: 10.1007/s00270-020-02745-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/07/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE To evaluate the efficacy of tract embolization technique using gelatin sponge slurry with iodinated contrast medium (GSSI) to reduce the incidence of pneumothorax and chest tube placement after computed tomography-guided lung radiofrequency ablation (RFA). MATERIALS AND METHODS In this single-institute retrospective study, we examined all patients with metastatic cancer treated from January 2016 to December 2019 by interventional radiologists with computed tomography-guided lung RFA. Since 2017 in our institution, we have applied a tract embolization technique using GSSI for all RFA. Patients were included into those who underwent lung RFA performed either with GSSI (Group A) or without GSSI (Group B). Univariate and multivariate analyses were performed between the two groups to identify risk factors for pneumothorax and chest tube placement, including patient demographics and lesion characteristics. RESULTS This study included 116 patients (54 men, 62 women; mean age, 65 ± 11 years) who underwent RFA. Group A comprised 71 patients and Group B comprised 45 patients. Patients who underwent tract embolization had a significantly lower incidence of pneumothorax (Group A, 34% vs. Group B, 62%; p < 0.001) and chest tube insertion (Group A, 10% vs. Group B, 29%; p < 0.01). No embolic complications occurred. The hospitalization stay was significantly shorter in patients who underwent tract embolization (mean, 1.04 ± 0.2 days; p = 0.02). CONCLUSION Tract embolization after percutaneous lung RFA significantly reduced the rate of post-RFA pneumothorax and chest tube placement and was safer than the standard lung RFA technique.
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14
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Araujo-Filho JDAB, Menezes RSAA, Horvat N, Panizza PSB, Bernardes JPG, Damasceno RS, Oliveira BC, Menezes MR. Lung radiofrequency ablation: post-procedure imaging patterns and late follow-up. Eur J Radiol Open 2020; 7:100276. [PMID: 33225024 PMCID: PMC7666375 DOI: 10.1016/j.ejro.2020.100276] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 12/30/2022] Open
Abstract
RFA is an effective minimally invasive treatment for selected patients with primary and secondary lung tumors. We described the expected imaging features after RFA of lung tumors, and their frequency over time after the procedure. Radiologists should be familiar with these features in order to avoid misinterpretation and inadequate treatments. These normal post-procedure imaging features must be considered in future post-ablation follow-up protocols.
Purpose To describe expected imaging features on chest computed tomography (CT) after percutaneous radiofrequency ablation (RFA) of lung tumors, and their frequency over time after the procedure. Methods In this double-center retrospective study, we reviewed CT scans from patients who underwent RFA for primary or secondary lung tumors. Patients with partial ablation or tumor recurrence during the imaging follow-up were not included. The imaging features were assessed in pre-defined time points: immediate post-procedure, ≤4 weeks, 5−24 weeks, 25−52 weeks and ≥52 weeks. Late follow-up (3 and 5 years after procedure) was assessed clinically in 48 patients. Results The study population consisted of 69 patients and 144 pulmonary tumors. Six out of 69 (9%) patients had primary lung nodules (stage I) and 63/69 (91 %) had metastatic pulmonary nodules. In a patient-level analysis, immediately after lung RFA, the most common CT features were ground glass opacities (66/69, 96 %), consolidation (56/69, 81 %), and hyperdensity within the nodule (47/69, 68 %). Less than 4 weeks, ground glass opacities (including reversed halo sign) was demonstrated in 20/22 (91 %) patients, while consolidation and pleural thickening were detected in 17/22 patients (77 %). Cavitation, pneumatocele, pneumothorax and pleural effusions were less common features. From 5 weeks onwards, the most common imaging features were parenchymal bands. Conclusions Our study demonstrated the expected CT features after lung RFA, a safe and effective minimally invasive treatment for selected patients with primary and secondary lung tumors. Diagnostic and interventional radiologists should be familiar with the expected imaging features immediately after RFA and their change over time in order to avoid misinterpretation and inadequate treatments.
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Affiliation(s)
| | | | - Natally Horvat
- Radiology Department, Hospital Sírio-Libanês, Adma Jafet 91, São Paulo, SP, 01308-050, Brazil.,Radiology Department, Universidade de São Paulo, Travessa da Rua Dr. Ovídio Pires de Campos 75, São Paulo, SP, 05403-900, Brazil
| | | | - João Paulo Giacomini Bernardes
- Radiology Department, Hospital Sírio-Libanês Brasília - Centro De Oncologia Asa Sul, SGAS 613/614 Conjunto E Lote 95 - Asa Sul, Brasília, DF, 70200-730, Brazil
| | | | - Brunna Clemente Oliveira
- Radiology Department, Hospital Sírio-Libanês, Adma Jafet 91, São Paulo, SP, 01308-050, Brazil.,Radiology Department, Universidade de São Paulo, Travessa da Rua Dr. Ovídio Pires de Campos 75, São Paulo, SP, 05403-900, Brazil
| | - Marcos Roberto Menezes
- Radiology Department, Hospital Sírio-Libanês, Adma Jafet 91, São Paulo, SP, 01308-050, Brazil.,Radiology Department, Universidade de São Paulo, Travessa da Rua Dr. Ovídio Pires de Campos 75, São Paulo, SP, 05403-900, Brazil
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15
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Abstract
Lung ablation has been introduced into lung cancer treatment for about two decades. Currently, 3 main choices of thermal energy for lung ablation are radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation. As a mostly palliative, occasionally curative intent local treatment, the feasibility and safety of lung ablation have been validated in small size lung cancer treatment, especially in lung tumor ≤3 cm. Improved techniques and experience in recent years help render outcomes much better than before for lung cancer patients who are medically inoperable with early stage primary lung cancer, and patients with oligometastasis or local recurrence. For stage IA non-small cell lung cancer (NSCLC) patients underwent RFA, 1- and 2-year overall survival rate were reported as 86.3% and 69.8%. And 1- and 2-year local recurrence rate were reported as 68.9% and 59.8%. Limitations, including heat sink, skin burn, and inconsistent heat conduction, are observed in the first applied ablation technique, RFA. MWA and cryoablation are developed to overcome these limitations and achieve the goal of less morbidity. Generally, imaged guided thermal ablation has a good safety profile, with pneumothorax as the most common morbidity. This article will mainly discuss the current features and application of these ablation techniques in lung cancer treatment.
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Affiliation(s)
- Miao Lin
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Pat Eiken
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Shanda Blackmon
- Department of Surgery, Division of Thoracic Surgery, Mayo Clinic, Rochester, MN, USA
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Thakore S, Perez Lozada JC. Percutaneous Ablation of Intrathoracic Malignancy. CURRENT PULMONOLOGY REPORTS 2020. [DOI: 10.1007/s13665-020-00262-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Maas M, Beets-Tan R, Gaubert JY, Gomez Munoz F, Habert P, Klompenhouwer LG, Vilares Morgado P, Schaefer N, Cornelis FH, Solomon SB, van der Reijd D, Bilbao JI. Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice. Insights Imaging 2020; 11:83. [PMID: 32676924 PMCID: PMC7366866 DOI: 10.1186/s13244-020-00884-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/20/2020] [Indexed: 12/19/2022] Open
Abstract
Interventional radiology plays an important and increasing role in cancer treatment. Follow-up is important to be able to assess treatment success and detect locoregional and distant recurrence and recommendations for follow-up are needed. At ECIO 2018, a joint ECIO-ESOI session was organized to establish follow-up recommendations for oncologic intervention in liver, renal, and lung cancer. Treatments included thermal ablation, TACE, and TARE. In total five topics were evaluated: ablation in colorectal liver metastases (CRLM), TARE in CRLM, TACE and TARE in HCC, ablation in renal cancer, and ablation in lung cancer. Evaluated modalities were FDG-PET-CT, CT, MRI, and (contrast-enhanced) ultrasound. Prior to the session, five experts were selected and performed a systematic review and presented statements, which were voted on in a telephone conference prior to the meeting by all panelists. These statements were presented and discussed at the ECIO-ESOI session at ECIO 2018. This paper presents the recommendations that followed from these initiatives. Based on expert opinions and the available evidence, follow-up schedules were proposed for liver cancer, renal cancer, and lung cancer. FDG-PET-CT, CT, and MRI are the recommended modalities, but one should beware of false-positive signs of residual tumor or recurrence due to inflammation early after the intervention. There is a need for prospective preferably multicenter studies to validate new techniques and new response criteria. This paper presents recommendations that can be used in clinical practice to perform the follow-up of patients with liver, lung, and renal cancer who were treated with interventional locoregional therapies.
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Affiliation(s)
- Monique Maas
- Dept of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Regina Beets-Tan
- Dept of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jean-Yves Gaubert
- Dept of Radiology, CHU Hospital Timone, Marseille, France.,Aix Marseille Univ, LIIE, Marseille, France
| | - Fernando Gomez Munoz
- Dept of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Dept of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Paul Habert
- Dept of Radiology, CHU Hospital Timone, Marseille, France.,Aix Marseille Univ, LIIE, Marseille, France
| | | | | | - Niklaus Schaefer
- Dept of Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Stephen B Solomon
- Dept of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - Jose Ignacio Bilbao
- Dept of Radiology, University Clinic of Navarra, Calle Benjamín de Tudela, 2, 31008, Pamplona, Navarra, Spain.
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18
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Venturini M, Cariati M, Marra P, Masala S, Pereira PL, Carrafiello G. CIRSE Standards of Practice on Thermal Ablation of Primary and Secondary Lung Tumours. Cardiovasc Intervent Radiol 2020; 43:667-683. [PMID: 32095842 DOI: 10.1007/s00270-020-02432-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 02/10/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Massimo Venturini
- Department of Diagnostic and Interventional Radiology, Circolo Hospital, Insubria University, Varese, Italy.
| | - Maurizio Cariati
- Department of Diagnostic and Interventional Radiology, ASST Santi Carlo e Paolo Hospital, Milan, Italy
| | - Paolo Marra
- Department of Radiology, Papa Giovanni XXIII Hospital Bergamo, Milano-Bicocca University, Milan, Italy
| | - Salvatore Masala
- Department of Radiology, San Giovanni Battista Hospital, Tor Vergata University, Rome, Italy
| | - Philippe L Pereira
- Clinic for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, SLK-Kliniken GmbH, Heilbronn, Germany
| | - Gianpaolo Carrafiello
- Department of Radiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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19
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Prud’homme C, Deschamps F, Moulin B, Hakime A, Al-Ahmar M, Moalla S, Roux C, Teriitehau C, de Baere T, Tselikas L. Image-guided lung metastasis ablation: a literature review. Int J Hyperthermia 2019; 36:37-45. [DOI: 10.1080/02656736.2019.1647358] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Clara Prud’homme
- Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Frederic Deschamps
- Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Benjamin Moulin
- Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Antoine Hakime
- Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Marc Al-Ahmar
- Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Salma Moalla
- Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Charles Roux
- Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Christophe Teriitehau
- Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Thierry de Baere
- Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Lambros Tselikas
- Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy Cancer Campus, Villejuif, France
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Temporal evaluation of the microwave ablation zone and comparison of CT and gross sizes during the first month post-ablation in swine lung. Diagn Interv Imaging 2019; 100:279-285. [DOI: 10.1016/j.diii.2018.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 12/22/2022]
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Rombouts SJE, Derksen TC, Nio CY, van Hillegersberg R, van Santvoort HC, Walma MS, Molenaar IQ, van Leeuwen MS. Computed tomography findings after radiofrequency ablation in locally advanced pancreatic cancer. Abdom Radiol (NY) 2018; 43:2702-2711. [PMID: 29492602 PMCID: PMC6132871 DOI: 10.1007/s00261-018-1519-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose The purpose of the study was to provide a systematic evaluation of the computed tomography(CT) findings after radiofrequency ablation (RFA) in locally advanced pancreatic cancer(LAPC). Methods Eighteen patients with intra-operative RFA-treated LAPC were included in a prospective case series. All CT-scans performed prior to RFA and 1 week and 3 months of post-RFA, according to standard regimen, were assessed by two radiologists in consensus, using standardized radiological scoring lists. Results 51 CT-scans were assessed. One week after RFA, the ablation zone was visible in all patients as a (partially) sharply defined (83%), heterogeneous area (94%). At 3 months of follow-up, the ablation zone was completely invaded by tumor in 67% of patients and still present, but decreased in 33%. In two patients (11%), local thrombosis and/or occlusion of the superior mesenteric vein occurred. The occlusions persisted without clinical consequences and the thrombosis disappeared. A peripancreatic fluid collection was visible 1 week after RFA in 3 patients, wherein the ablation zone extended ventrally outside of the pancreas. Conclusions Directly after RFA for LAPC, a well-defined ablation zone is visible on CT-imaging. This ablation zone is usually replaced by tumor ingrowth after 3 months. Moreover, the ablation zone regularly included vascular structures, with rare asymptomatic venous occlusion or thrombosis and without adverse effects on arteries. Electronic supplementary material The online version of this article (10.1007/s00261-018-1519-y) contains supplementary material, which is available to authorized users.
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Liu B, Ye X, Fan W, Li X, Feng W, Lu Q, Mao Y, Lin Z, Li L, Zhuang Y, Ni X, Shen J, Fu Y, Han J, Li C, Liu C, Yang W, Su Z, Wu Z, Liu L. Expert consensus on image-guided radiofrequency ablation of pulmonary tumors: 2018 edition. Thorac Cancer 2018; 9:1194-1208. [PMID: 30039918 PMCID: PMC6119618 DOI: 10.1111/1759-7714.12817] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 12/28/2022] Open
Abstract
Lung cancer ranks first in incidence and mortality in China. Surgery is the primary method to cure cancer, but only 20-30% of patients are eligible for curative resection. In recent years, in addition to surgery, other local therapies have been developed for patients with numerous localized primary and metastatic pulmonary tumors, including stereotactic body radiation therapy and thermal ablative therapies through percutaneously inserted applicators. Percutaneous thermal ablation of pulmonary tumors is minimally invasive, conformal, repeatable, feasible, cheap, has a shorter recovery time, and offers reduced morbidity and mortality. Radiofrequency ablation (RFA), the most commonly used thermal ablation technique, has a reported 80-90% rate of complete ablation, with the best results obtained in tumors < 3 cm in diameter. Because the clinical efficacy of RFA of pulmonary tumors has not yet been determined, this clinical guideline describes the techniques used in the treatment of localized primary and metastatic pulmonary tumors in nonsurgical candidates, including mechanism of action, devices, indications, techniques, potential complications, clinical outcomes, post-ablation surveillance, and use in combination with other therapies. In the future, the role of RFA in the treatment of localized pulmonary tumors should ultimately be determined by evidence from prospective randomized controlled trials comparing sublobar resection or stereotactic body radiation therapy.
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Affiliation(s)
- Bao‐Dong Liu
- Department of Thoracic Surgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Xin Ye
- Department of OncologyProvincial Hospital of Shandong UniversityJinanChina
| | - Wei‐Jun Fan
- Imaging and Interventional DepartmentSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Xiao‐Guang Li
- Minimally Invasive Department of CancerBeijing HospitalBeijingChina
| | - Wei‐Jian Feng
- Department of Oncology, Fuxing HospitalCapital Medical UniversityBeijingChina
| | - Qiang Lu
- Department of Thoracic Surgery, Tangdu HospitalAir Force Medical UniversityXi'anChina
| | - Yu Mao
- Department of Thoracic SurgeryHohhot No.1 Hospital of Inner Mongolia Autonomous RegionHohhotChina
| | - Zheng‐Yu Lin
- Intervention DepartmentThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Lu Li
- Department of Thoracic SurgeryThe 306th Hospital of PLABeijingChina
| | - Yi‐Ping Zhuang
- Minimally Invasive Intervention Department of Jiangsu Cancer HospitalNanjingChina
| | - Xu‐Dong Ni
- Department of Thoracic SurgeryShanghai Zhongshan HospitalShanghaiChina
| | - Jia‐Lin Shen
- Cancer Intervention DepartmentSouth Hospital of Shanghai Renji HospitalShanghaiChina
| | - Yi‐Li Fu
- Department of Thoracic SurgeryBeijing Chao Yang Hospital Affiliated to Capital Medical UniversityBeijingChina
| | - Jian‐Jun Han
- Minimally Invasive Department of Shandong Cancer HospitalJinanChina
| | - Chen‐Rui Li
- Intervention DepartmentCancer Hospital of Chinese Academy of Medical SciencesBeijingChina
| | - Chen Liu
- Intervention Department, Cancer HospitalPeking UniversityBeijingChina
| | - Wu‐Wei Yang
- Minimally Invasive Department of CancerThe 307th Hospital of PLABeijingChina
| | - Zhi‐Yong Su
- Department of Thoracic SurgeryAffiliated Hospital of Chifeng University of Inner Mongolia Autonomous RegionChifengChina
| | - Zhi‐Yuan Wu
- Radiation Intervention DepartmentShanghai Ruijin HospitalShanghaiChina
| | - Lei Liu
- Department of Thoracic Surgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
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Management of metastatic retroperitoneal sarcoma: a consensus approach from the Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG). Ann Oncol 2018; 29:857-871. [PMID: 29432564 PMCID: PMC6354678 DOI: 10.1093/annonc/mdy052] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Retroperitoneal sarcoma (RPS) is a rare disease accounting for 0.1%-0.2% of all malignancies. Management of RPS is complex and requires multidisciplinary, tailored treatment strategies at all stages, but especially in the context of metastatic or multifocal recurrent disease. Due to the rarity and heterogeneity of this family of diseases, the literature to guide management is limited. METHODS The Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG) is an international collaboration of sarcoma experts from all disciplines convened in an effort to overcome these limitations. The TARPSWG has compiled the available evidence surrounding metastatic and multifocally recurrent RPS along with expert opinion in an iterative process to generate a consensus document regarding the complex management of this disease. The objective of this document is to guide sarcoma specialists from all disciplines in the diagnosis and treatment of multifocal recurrent or metastatic RPS. RESULTS All aspects of patient assessment, diagnostic processes, local and systemic treatments, and palliation are reviewed in this document, and consensus recommendations provided accordingly. Recommendations were guided by available evidence, in conjunction with expert opinion where evidence was lacking. CONCLUSIONS This consensus document combines the available literature regarding the management of multifocally recurrent or metastastic RPS with the practical expertise of high-volume sarcoma centers from multiple countries. It is designed as a tool for decision making in the complex multidisciplinary management of this condition and is expected to standardize management across centers, thereby ensuring that patients receive the highest quality care.
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刘 宝, 叶 欣, 范 卫, 李 晓, 冯 威, 卢 强, 毛 宇, 林 征, 李 鲁, 庄 一, 倪 旭, 沈 加, 傅 毅, 韩 建, 李 忱, 柳 晨, 杨 武, 苏 志, 吴 志, 刘 磊. [Expert Consensus for Image-guided Radiofrequency Ablation of Pulmonary Tumors (2018 Version)]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2018; 21:76-88. [PMID: 29526174 PMCID: PMC5973020 DOI: 10.3779/j.issn.1009-3419.2018.02.09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- 宝东 刘
- 100053 北京, 首都医科大学宣武医院胸外科Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - 欣 叶
- 250100 济南, 山东大学附属省立医院肿瘤科Department of Oncolog y, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250100, China
| | - 卫君 范
- 510060 广州, 中山大学肿瘤医院影像与微创介入中心Imaging and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - 晓光 李
- 100005 北京, 北京医院肿瘤微创中心Department of Tumor Minimally Invasive Therapy, Beijing Hospital, Beijing 100005, China
| | - 威建 冯
- 100038 北京, 首都医科大学附属复兴医院肿瘤科Department of Oncolog y, Fuxing Hospital, Capital Medical University, Beijing 100038, China
| | - 强 卢
- 710038 西安, 空军军医大学唐都医院胸外科Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - 宇 毛
- 010020 呼和浩特, 内蒙古自治区呼和浩特市第一医院胸外科Department of Thoracic Surgery, Hohhot First Hospital, Inner Mongolia, Hohhot 010020, China
| | - 征宇 林
- 350005 福州, 福建医科大学附属第一医院介入科Department of Interventional Therapy, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - 鲁 李
- 100101 北京, 解放军306医院胸外科Department of Thoracic Surgery, 306th Hospital of PLA, Beijing 100101, China
| | - 一平 庄
- 210009 南京, 江苏省肿瘤医院介入科Department of Interventional Therapy, Jiangsu Cancer Hospital, Nanjing 210009, China
| | - 旭东 倪
- 200001 上海, 复旦大学附属中山医院胸外科Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200001, China
| | - 加林 沈
- 200001 上海, 上海交通大学医学院附属仁济医院南院肿瘤介入科Department of Tumor Interventional Therapy, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China
| | - 毅立 傅
- 100020 北京, 首都医科大学附属北京朝阳医院胸外科Department of Thoracic Surgery, Chaoyang Hospital, Capital medical University, Beijing 100020, China
| | - 建军 韩
- 250117 济南, 山东省肿瘤医院微创介入科Department of Minimally Invasive Interventional Therapy, Shandong Provincial Tumor Hospital, Jinan 250117, China
| | - 忱瑞 李
- 100020 北京, 中国医学科学院肿瘤医院介入治疗科Department of Interventional Therapy, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - 晨 柳
- 100142 北京, 北京大学肿瘤医院介入治疗科Department of Interventional Therapy, Beijing Cancer Hospital, Beijing 100142, China
| | - 武威 杨
- 100071 北京, 解放军307医院肿瘤微创治疗科Department of Tumor Minimally Invasive Therapy, 307th Hospital of PLA, Beijing 100071, China
| | - 志勇 苏
- 024005 赤峰, 赤峰学院附属医院胸外科Affiliated Hospital of Chifeng University, Chifeng 024005, China
| | - 志远 吴
- 200025 上海, 上海交通大学医学院附属瑞金医院放射介入科Department of Interventional Radiolog y, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - 磊 刘
- 100053 北京, 首都医科大学宣武医院胸外科Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Chen T, Jin J, Chen S. Clinical assessment of computed tomography guided radiofrequency ablation in the treatment of inoperable patients with pulmonary tumors. J Thorac Dis 2017; 9:5131-5142. [PMID: 29312719 DOI: 10.21037/jtd.2017.11.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background To enhance our understanding of the feasibility, effectiveness, safety and quality of life (QoL) of radiofrequency ablation (RFA) for inoperable patients with pulmonary tumors. Methods The data of 88 patients with pulmonary tumors undergoing RFA were collected. Proof of malignancy was obtained by biopsy in all patients. Diagnoses included non-small cell lung cancer (NSCLC) in 74 patients and pulmonary metastases in 14 patients. Patients underwent computed tomography (CT)-guided RFA according to standard protocol and had a 2-year follow-up. Results assessment included feasibility (correct placement of the ablation probe into all targeted tumors), effectiveness (overall survival rate and local control rate), safety (treatment-related complication and changes in pulmonary function) and QoL. Results One hundred and thirty-four RFAs were successfully conducted in 88 patients with 96 nodules. Correct placement of ablation probe into targeted tumors with completion of the planned treatment protocol was feasible in all 88 (100%) patients and no procedure-related deaths occurred. Major complication rate was 4.5% (4/88), which consisted of symptomatic pneumothorax (2/88) and high fever (2/88). No significant worsening of pulmonary function was observed. Tumors shrank obviously at 6 months after RFA with a statistically significance (P<0.001).The overall survival rate in 6 months, 1 year and 2 years were 100%, 95.5% and 70.5%, respectively while the local control rate in 6 months, 1 year and 2 years were 92.1%, 87.5% and 51.1% respectively. There was no significant difference of overall survival rate and local control rate between NSCLC and metastatic carcinoma. No significant worsening of QoL was observed. Conclusions CT-guided RFA is a feasible, effective and safe therapy for inoperable patients with pulmonary tumors. However, RFA could not obviously improve the QoL in the patients with pulmonary tumors. More prospective studies comparing RFA with standard non-surgical treatment options were needed.
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Affiliation(s)
- Tianming Chen
- Department of Thoracic Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medicinal University, Nanjing 210009, China.,Department of Cancer Surgery, Yifu Hospital Affiliated to Nanjing Medicinal University, Nanjing 210009, China
| | - Jiewen Jin
- Department of Thoracic Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medicinal University, Nanjing 210009, China
| | - Shilin Chen
- Department of Thoracic Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medicinal University, Nanjing 210009, China
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The Role of Percutaneous Image-Guided Thermal Ablation for the Treatment of Pulmonary Malignancies. AJR Am J Roentgenol 2017; 209:740-751. [DOI: 10.2214/ajr.17.18368] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Palussière J, Catena V, Buy X. Percutaneous thermal ablation of lung tumors – Radiofrequency, microwave and cryotherapy: Where are we going? Diagn Interv Imaging 2017; 98:619-625. [DOI: 10.1016/j.diii.2017.07.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 07/11/2017] [Indexed: 12/23/2022]
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Lung ablation: Best practice/results/response assessment/role alongside other ablative therapies. Clin Radiol 2017; 72:657-664. [DOI: 10.1016/j.crad.2017.01.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/26/2016] [Accepted: 01/12/2017] [Indexed: 02/06/2023]
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30
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叶 欣, 范 卫, 王 徽, 王 俊, 古 善, 冯 威, 庄 一, 刘 宝, 李 晓, 李 玉, 杨 坡, 杨 霞, 杨 武, 陈 俊, 张 嵘, 林 征, 孟 志, 胡 凯, 柳 晨, 彭 忠, 韩 玥, 靳 勇, 雷 光, 翟 博, 黄 广, 中国抗癌协会肿瘤微创治疗专业委员会肺癌微创治疗分会. [Expert Consensus for Thermal Ablation of Primary and Metastatic Lung Tumors
(2017 Edition)]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2017; 20:433-445. [PMID: 28738958 PMCID: PMC5972946 DOI: 10.3779/j.issn.1009-3419.2017.07.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- 欣 叶
- 250014 济南, 山东大学附属省立医院肿瘤科Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan 250014, China
| | - 卫君 范
- 510060 广州, 中山大学肿瘤医院影像与微创介入中心Imaging and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - 徽 王
- 130012 长春, 吉林省肿瘤医院介入治疗中心Interventional Treatment Center, Jilin Provincial Tumor Hospital, Changchun 130012, China
| | - 俊杰 王
- 100191 北京, 北京大学第三医院放射治疗科Department of Radiation Oncology, Peking University 3rd Hospital, Beijing 100191, China
| | - 善智 古
- 410013 长沙, 湖南省肿瘤医院放射介入科Department of Interventional Therapy, Hunan Provincial Tumor Hospital, Changsha 410013, China
| | - 威健 冯
- 100045 北京, 首都医科大学附属复兴医院肿瘤科Department of Oncology, Fuxing Hospital Affiliated to the Capital University of Medical Sciences, Beijing 100045, China
| | - 一平 庄
- 210009 南京, 江苏省肿瘤医院介入科Department of Interventional Therapy, Jiangsu Cancer Hospital, Nanjing 210009, China
| | - 宝东 刘
- 100053 北京, 首都医科大学宣武医院胸外科Department of Thoracic Surgery, Xuanwu Hospital Affiliated to the Capital University of Medical Sciences, Beijing 100053, China
| | - 晓光 李
- 100005 北京, 北京医院肿瘤微创中心Department of Tumor Minimally Invasive Therapy, Beijing Hospital, Beijing 100005, China
| | - 玉亮 李
- 250033 济南, 山东大学第二医院介入治疗中心Interventional Treatment Center, Shandong University Second Hospital, Ji'nan 250033, China
| | - 坡 杨
- 150001 哈尔滨, 哈尔滨医科大学第四人民医院介入放射科Department of Interventional Radiology, The Fourth Hospital of Harbin Medical University, Harbin 150001, China
| | - 霞 杨
- 250014 济南, 山东大学附属省立医院肿瘤科Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan 250014, China
| | - 武威 杨
- 100071 北京, 解放军307医院肿瘤微创治疗科Department of Tumor Minimally Invasive Therapy, 307 Hospital, Beijing 100071, China
| | - 俊辉 陈
- 510060 广州, 中山大学肿瘤医院影像与微创介入中心Imaging and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - 嵘 张
- 518036 深圳, 北京大学深圳医院微创介入科Department of Minimally Invasive Interventional Therapy, Shenzhen Hospital of Beijing University, Shenzhen 518036, China
| | - 征宇 林
- 350005 福州, 福建医科大学附属第一医院介入科Department of Interventional Therapy, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - 志强 孟
- 200032 上海, 复旦大学肿瘤医院微创治疗科Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - 凯文 胡
- 100078 北京, 北京中医药大学东方医院肿瘤科Department of Oncology, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100078, China
| | - 晨 柳
- 100083 北京, 北京肿瘤医院介入治疗科Department of Interventional Therapy, Beijing Cancer Hospital, Beijing 100083, China
| | - 忠民 彭
- 250014 济南, 山东省立医院胸外科Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan 250014, China
| | - 玥 韩
- 100021 北京, 中国医学科学院肿瘤医院介入治疗科Department of Interventional Therapy, Tumor Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China
| | - 勇 靳
- 215004 苏州, 苏州大学第二附属医院介入治疗科Department of Interventional Therapy, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - 光焰 雷
- 710061 西安, 陕西省肿瘤医院胸外科Department of Thoracic Surgery, Shanxi Provincial Tumor Hospital, Xi'an 710061, China
| | - 博 翟
- 200127 上海, 上海交通大学仁济医院肿瘤介入治疗科Tumor Interventional Therapy Center, Shanghai Renji Hospital, Shanghai 200127, China
| | - 广慧 黄
- 250014 济南, 山东大学附属省立医院肿瘤科Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan 250014, China
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Lee KS, Erinjeri JP. Decision Making in Interventional Oncology: Ablative Options in the Lung. Semin Intervent Radiol 2017; 34:176-181. [PMID: 28579685 DOI: 10.1055/s-0037-1602592] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Image-guided ablation is safe and effective for the treatment of both primary and metastatic tumors in the lung. This article reviews the three most commonly used ablative options: radiofrequency ablation, microwave ablation, and cryoablation. We describe the advantages of each ablation modality in the lung and how to choose the most appropriate ablation device based on patient and tumor characteristics. The optimal technique for lung ablation is discussed and technical tips for improving clinical outcome are described.
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Affiliation(s)
| | - Joseph P Erinjeri
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York
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32
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Yang Q, Qi H, Zhang R, Wan C, Song Z, Zhang L, Fan W. Risk Factors for Local Progression after Percutaneous Radiofrequency Ablation of Lung Tumors: Evaluation Based on a Review of 147 Tumors. J Vasc Interv Radiol 2017; 28:481-489. [DOI: 10.1016/j.jvir.2016.11.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 10/25/2016] [Accepted: 11/21/2016] [Indexed: 02/07/2023] Open
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Abstract
OBJECTIVES To study the various local treatments available for thyroid cancer metastases, investigate techniques and assess their advantages and limitations and roles in the overall treatment strategy for metastatic disease. RESULTS We investigated metastases surgery, external radiation therapy, embolization, chemoembolization, cementoplasty, radiofrequency ablation and cryotherapy, describing techniques, advantages and drawbacks and possible complications. Indications were reviewed according to metastases location, and the roles of the various techniques are discussed in the overall treatment strategy for thyroid cancer metastases. Despite the advent of new targeted therapies, local treatment still has an important role to play: either palliative or, in oligometastatic involvement, curative. Even in extensive disease, it may allow postponement of tyrosine kinase inhibitor therapy, which, once initiated, has to be continued life-long, is expensive and is not free of side-effects.
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Maxwell AWP, Healey TT, Dupuy DE. Percutaneous Thermal Ablation for Small-Cell Lung Cancer: Initial Experience with Ten Tumors in Nine Patients. J Vasc Interv Radiol 2016; 27:1815-1821. [PMID: 27776982 DOI: 10.1016/j.jvir.2016.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/06/2016] [Accepted: 09/06/2016] [Indexed: 01/24/2023] Open
Abstract
PURPOSE To evaluate outcomes in a small cohort of patients with local or disseminated small-cell lung cancer (SCLC) who received percutaneous thermal ablation therapy. MATERIALS AND METHODS Ten biopsy-proven SCLC tumors in 9 consecutive patients (5 men, 4 women; average age, 73.8 y ± 12.4) were retrospectively evaluated. Average tumor sizes were 1.8 cm ± 0.5 and 2.6 cm ± 1.2 among patients with local and disseminated disease, respectively. Microwave and radiofrequency ablation were each used for 5 tumors. None of the patients with local SCLC received adjuvant therapy following thermal ablation. Median follow-up duration was 16 months (range, 2-48 mo). Median and 1-year overall survival (OS) were compared for patients in the local and disseminated disease groups. RESULTS Median and 1-year OS were better among patients treated for local SCLC compared with disseminated disease (47.0 vs 5.5 mo and 3 [100%] vs 2 [40%], respectively). Pneumothorax occurred in 5 patients (55.6%), and 3 patients received successful outpatient thoracostomy tube placement. No patients were hospitalized, and there were no major complications. CONCLUSIONS This preliminary analysis suggests favorable outcomes in selected patients with local SCLC who undergo percutaneous thermal ablation without adjuvant therapy.
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Affiliation(s)
- Aaron W P Maxwell
- Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI 02903.
| | - Terrance T Healey
- Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI 02903
| | - Damian E Dupuy
- Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI 02903
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Alberti N, Buy X, Frulio N, Montaudon M, Canella M, Gangi A, Crombe A, Palussière J. Rare complications after lung percutaneous radiofrequency ablation: Incidence, risk factors, prevention and management. Eur J Radiol 2016; 85:1181-91. [DOI: 10.1016/j.ejrad.2016.03.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/30/2016] [Accepted: 03/31/2016] [Indexed: 01/05/2023]
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Abstract
Lung metastasectomy can prolong survival in patients with metastatic colorectal carcinoma. Thermal ablation offers a potential solution with similar reported survival outcomes. It has minimal effect on pulmonary function, or quality of life, can be repeated, and may be considered more acceptable to patients because of the associated shorter hospital stay and recovery. This review describes the indications, technique, reported outcomes, complications and radiologic appearances after thermal ablation of colorectal lung metastases.
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Affiliation(s)
- Carole A Ridge
- 1 Department of Radiology, Mater Misericordiae University Hospital, Dublin 7, Ireland ; 2 Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Stephen B Solomon
- 1 Department of Radiology, Mater Misericordiae University Hospital, Dublin 7, Ireland ; 2 Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
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Liu B, Zhi X. [Expert Consensus for Image-guided Radiofrequency Ablation of Pulmonary Tumors]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2015; 18:251-9. [PMID: 25975294 PMCID: PMC6015213 DOI: 10.3779/j.issn.1009-3419.2015.05.01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Baodong Liu
- Department of Thoracic Surgery, Xuanwu Hospital, Capital medical University, Beijing 100053, China
| | - Xiuyi Zhi
- Department of Thoracic Surgery, Xuanwu Hospital, Capital medical University, Beijing 100053, China
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PET/Computed Tomography and Thermoablation (Radiofrequency, Microwave, Cryotherapy, Laser Interstitial Thermal Therapy). PET Clin 2015; 10:519-40. [DOI: 10.1016/j.cpet.2015.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Liu BD, Zhi XY. Expert consensus on image-guided radiofrequency ablation of pulmonary tumors-2015 edition. Transl Lung Cancer Res 2015; 4:310-21. [PMID: 26207221 PMCID: PMC4483478 DOI: 10.3978/j.issn.2218-6751.2015.06.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 04/05/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Bao-Dong Liu
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xiu-Yi Zhi
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Liu BD, Zhi XY. Expert consensus on image-guided radiofrequency ablation of pulmonary tumors-2015 edition. ANNALS OF TRANSLATIONAL MEDICINE 2015; 3:128. [PMID: 26207256 PMCID: PMC4481367 DOI: 10.3978/j.issn.2305-5839.2015.06.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 04/05/2015] [Indexed: 01/26/2023]
Affiliation(s)
- Bao-Dong Liu
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xiu-Yi Zhi
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Liu BD, Zhi XY. Expert consensus on image-guided radiofrequency ablation of pulmonary tumors-2015 edition. J Thorac Dis 2015; 7:E148-59. [PMID: 26101663 PMCID: PMC4454848 DOI: 10.3978/j.issn.2072-1439.2015.05.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 04/05/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Bao-Dong Liu
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xiu-Yi Zhi
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Cazzato RL, Battistuzzi JB, Catena V, Grasso RF, Zobel BB, Schena E, Buy X, Palussiere J. Cone-Beam Computed Tomography (CBCT) Versus CT in Lung Ablation Procedure: Which is Faster? Cardiovasc Intervent Radiol 2015; 38:1231-6. [PMID: 25787903 DOI: 10.1007/s00270-015-1078-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 02/13/2015] [Indexed: 12/16/2022]
Abstract
AIM To compare cone-beam CT (CBCT) versus computed tomography (CT) guidance in terms of time needed to target and place the radiofrequency ablation (RFA) electrode on lung tumours. MATERIALS AND METHODS Patients at our institution who received CBCT- or CT-guided RFA for primary or metastatic lung tumours were retrospectively included. Time required to target and place the RFA electrode within the lesion was registered and compared across the two groups. Lesions were stratified into three groups according to their size (<10, 10-20, >20 mm). Occurrences of electrode repositioning, repositioning time, RFA complications, and local recurrence after RFA were also reported. RESULTS Forty tumours (22 under CT, 18 under CBCT guidance) were treated in 27 patients (19 male, 8 female, median age 67.25 ± 9.13 years). Thirty RFA sessions (16 under CBCT and 14 under CT guidance) were performed. Multivariable linear regression analysis showed that CBCT was faster than CT to target and place the electrode within the tumour independently from its size (β = -9.45, t = -3.09, p = 0.004). Electrode repositioning was required in 10/22 (45.4 %) tumours under CT guidance and 5/18 (27.8 %) tumours under CBCT guidance. Pneumothoraces occurred in 6/14 (42.8 %) sessions under CT guidance and in 6/16 (37.5 %) sessions under CBCT guidance. Two recurrences were noted for tumours receiving CBCT-guided RFA (2/17, 11.7 %) and three after CT-guided RFA (3/19, 15.8 %). CONCLUSION CBCT with live 3D needle guidance is a useful technique for percutaneous lung ablation. Despite lesion size, CBCT allows faster lung RFA than CT.
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Affiliation(s)
- Roberto Luigi Cazzato
- Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. .,Department of Radiology and Diagnostic Imaging, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy.
| | - Jean-Benoit Battistuzzi
- Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France.
| | - Vittorio Catena
- Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France.
| | - Rosario Francesco Grasso
- Department of Radiology and Diagnostic Imaging, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy.
| | - Bruno Beomonte Zobel
- Department of Radiology and Diagnostic Imaging, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy.
| | - Emiliano Schena
- Unit of Measurements and Biomedical Instrumentations, Biomedical Engineering Laboratory, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 198, 00128, Rome, Italy.
| | - Xavier Buy
- Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France.
| | - Jean Palussiere
- Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France.
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Saumet L, Deschamps F, Marec-Berard P, Gaspar N, Corradini N, Petit P, Sirvent N, Brugières L. Radiofrequency ablation of metastases from osteosarcoma in patients under 25 years: the SCFE experience. Pediatr Hematol Oncol 2015; 32:41-9. [PMID: 25007012 DOI: 10.3109/08880018.2014.926469] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Radiofrequency ablation (RFA) has demonstrated its effectiveness in controlling metastases measuring less than 3 cm in several adult malignancies but not yet in osteosarcoma. We report our experience of RFA in the treatment of metastases in adolescents and young adults (AYA) with osteosarcoma. PROCEDURE Sixteen patients treated for osteosarcoma in French Society of Childhood Cancer centers had undergone an RFA procedure between 2006 and 2012. RESULTS Thirteen sessions were performed in 10 patients to treat 22 lung metastases. Seven patients were in complete remission at last follow up (range 19-51 months; median, 24 months after RFA). None had a recurrence at RFA sites. We report three cases each of hemoptysis and pneumothorax. Eight sessions were performed in seven patients to treat bone lesions. PROCEDURE was intended as: curative for a small metastatic lesion (n = 3, all in remission more than 3 years after); local control of small bone lesions in multi-metastatic diseases (n = 3); analgesia (n = 1). Complications included one first-degree burn, one fracture, and one soft tissue infection. CONCLUSIONS RFA is feasible in AYA with osteosarcoma. It efficiently achieved local control of small peripheral lung metastases. Its role in the curative care of small secondary bone lesions remains to be confirmed.
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Affiliation(s)
- L Saumet
- 1Department of Paediatric Oncology, Hôpital Arnaud de Villeneuve, Montpellier, France
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Ye X, Fan W, Chen JH, Feng WJ, Gu SZ, Han Y, Huang GH, Lei GY, Li XG, Li YL, Li ZJ, Lin ZY, Liu BD, Liu Y, Peng ZM, Wang H, Yang WW, Yang X, Zhai B, Zhang J. Chinese expert consensus workshop report: Guidelines for thermal ablation of primary and metastatic lung tumors. Thorac Cancer 2015; 6:112-121. [PMID: 26273346 PMCID: PMC4448461 DOI: 10.1111/1759-7714.12152] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 07/16/2014] [Indexed: 12/31/2022] Open
Abstract
Although surgical resection is the primary means of curing both primary and metastatic lung cancers, about 80% of lung cancers cannot be removed by surgery. As most patients with unresectable lung cancer receive only limited benefits from traditional radiotherapy and chemotherapy, many new local treatment methods have emerged, including local ablation therapy. The Minimally Invasive and Comprehensive Treatment of Lung Cancer Branch, Professional Committee of Minimally Invasive Treatment of Cancer of the Chinese Anti-Cancer Association has organized multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim at standardizing thermal ablation procedures and criteria for selecting treatment candidates and assessing outcomes; and for preventing and managing post-ablation complications.
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Affiliation(s)
- Xin Ye
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, China
| | - Weijun Fan
- Imaging and Interventional Center, Sun Yat-sen University Cancer CenterGuangzhou, China
| | - Jun-hui Chen
- Department of Minimally Invasive Interventional Therapy, Shenzhen Hospital of Beijing UniversityShenzhen, China
| | - Wei-jian Feng
- Department of Oncology, Fuxing Hospital Affiliated to the Capital University of Medical SciencesBeijing, China
| | - Shan-zhi Gu
- Department of Interventional Therapy, Hunan Provincial Tumor HospitalChangsha, China
| | - Yue Han
- Department of Imaging, Tumor Institute and Hospital, Chinese Academy of Medical SciencesBeijing, China
| | - Guang-hui Huang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, China
| | - Guang-yan Lei
- Department of Thoracic Surgery, Shanxi Provincial Tumor HospitalXi'an, China
| | - Xiao-guang Li
- Department of Radiology, Peking Union Medical College HospitalBeijing, China
| | - Yu-liang Li
- Interventional Treatment Center, Shandong University Second HospitalJinan, China
| | - Zhen-jia Li
- Research Office of CT Diagnosis and Treatment, Shandong Provincial Institute of Medical ImagingJinan, China
| | - Zheng-yu Lin
- Department of Interventional Therapy, the First Affiliated Hospital of Fujian Medical UniversityFuzhou, China
| | - Bao-dong Liu
- Department of Thoracic Surgery, Xuanwu Hospital Affiliated to the Capital University of Medical SciencesBeijing, China
| | - Ying Liu
- Department of Oncology, Armed Police Hospital of Guangdong ProvinceGuangzhou, China
| | - Zhong-min Peng
- Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, China
| | - Hui Wang
- Interventional Treatment Center, Jilin Provincial Tumor HospitalChangchun, China
| | - Wu-wei Yang
- Department of Tumor Minimally Invasive Therapy, 307 HospitalBeijing, China
| | - Xia Yang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, China
| | - Bo Zhai
- Tumor Interventional Therapy Center, Shanghai Renji HospitalShanghai, China
| | - Jun Zhang
- Center of Lung Cancer, the First Affiliated Hospital of China Medical UniversityShenyang, China
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Ridge CA, Solomon SB, Thornton RH. Thermal ablation of stage I non-small cell lung carcinoma. Semin Intervent Radiol 2014; 31:118-24. [PMID: 25053863 DOI: 10.1055/s-0034-1373786] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ablation options for the treatment of localized non-small cell lung carcinoma (NSCLC) include radiofrequency ablation, microwave ablation, and cryotherapy. Irreversible electroporation is a novel ablation method with the potential of application to lung tumors in risky locations. This review article describes the established and novel ablation techniques used in the treatment of localized NSCLC, including mechanism of action, indications, potential complications, clinical outcomes, postablation surveillance, and use in combination with other therapies.
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Affiliation(s)
- Carol A Ridge
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Stephen B Solomon
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Raymond H Thornton
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
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叶 欣, 中国抗癌协会肿瘤微创治疗专业委员会肺癌微创综合治疗分会. [Expert consensus for thermal ablation of primary and metastatic lung tumors]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2014; 17:294-301. [PMID: 24758903 PMCID: PMC6000017 DOI: 10.3779/j.issn.1009-3419.2014.04.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 03/24/2014] [Indexed: 02/07/2023]
Affiliation(s)
- 欣 叶
- 510060 广州,中山大学肿瘤防治中心影像介入中心Department of Oncology, Shandong Provincial Hospital Affliated to Shandong University, Ji'nan 250014, China
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Daste A, Gross-Goupil M, Ravaud A. Pulmonary aspergilloma: an unexpected complication of radiofrequency ablation in the management of targeted therapy for a patient with metastatic renal cell carcinoma. Clin Genitourin Cancer 2014; 12:e115-6. [PMID: 24524970 DOI: 10.1016/j.clgc.2014.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 01/04/2014] [Accepted: 01/06/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Amaury Daste
- Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, Bordeaux, France.
| | - Marine Gross-Goupil
- Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, Bordeaux, France
| | - Alain Ravaud
- Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, Bordeaux, France; University of Bordeaux 2 (Victor Segalen), Bordeaux, France
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Garetto I, Busso M, Sardo D, Filippini C, Solitro F, Grognardi ML, Veltri A. Radiofrequency ablation of thoracic tumours: lessons learned with ablation of 100 lesions. Radiol Med 2013; 119:33-40. [PMID: 24234185 DOI: 10.1007/s11547-013-0308-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 10/02/2012] [Indexed: 02/06/2023]
Abstract
PURPOSE Our aim was to analyse the results of our first 100 radiofrequency ablation (RFA) procedures, of primary (nonsmall-cell lung cancers, NSCLC) and secondary (MTS) lung cancers to assess what lessons could be learned from our experience. MATERIALS AND METHODS We analysed 100 lesions (mean size 23 mm) in 81 patients (25 NSCLC/56 MTS). On the basis of the clinical-radiological evolution, we analysed complete ablation (CA) versus partial ablation (PA) at the first computed tomography (CT) scan and during the follow-up (mean 23 months), time to progression (TTP) and survival. Possible predictive factors for local effectiveness and survival were sought. RESULTS At the first CT scan CA was obtained in 88 %; the difference between the mean diameter of lesions achieving CA and PA was significant (20 versus 38 mm; p = 0.0001). A threshold of 30 mm (p = 0.0030) and the histological type (NSCLC 75 %/MTS 94 %; p = 0.0305) were also predictive of CA. A total of 18.4 % of the CA recurred (average TTP 19 months). Survival at 1, 2 and 3 years was 84.5, 65.4 and 51.5 %, respectively. The predictors of survival at 3 years were the coexistence of other MTS (p = 0.0422) and a diameter <20 mm (p = 0.0323), but not the local effectiveness of RFA. CONCLUSION RFA for thoracic malignancies is accurate for lesions up to 30 mm, especially if metastatic; survival is more closely related to staging factors than to the local effectiveness of RFA.
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Affiliation(s)
- Irene Garetto
- Dipartimento di Oncologia, Istituto di Radiologia, Università di Torino, Regione Gonzole 10, 10043, Orbassano, TO, Italy
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Bonichon F, Palussière J, Godbert Y, Pulido M, Descat E, Devillers A, Meunier C, Leboulleux S, de Baère T, Galy-Lacour C, Lagoarde-Segot L, Cazeau AL. Diagnostic accuracy of 18F-FDG PET/CT for assessing response to radiofrequency ablation treatment in lung metastases: a multicentre prospective study. Eur J Nucl Med Mol Imaging 2013; 40:1817-27. [DOI: 10.1007/s00259-013-2521-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 07/11/2013] [Indexed: 01/21/2023]
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50
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Alberti N, Frulio N, Trillaud H, Jougon J, Jullie ML, Palussiere J. Pulmonary aspergilloma in a cavity formed after percutaneous radiofrequency ablation. Cardiovasc Intervent Radiol 2013; 37:537-40. [PMID: 23636252 DOI: 10.1007/s00270-013-0631-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 03/29/2013] [Indexed: 01/15/2023]
Abstract
We report two cases of pulmonary aspergilloma (PA) in a cavity formed after percutaneous radiofrequency ablation (PRFA), a rare complication that has only been described once in the literature. The first patient was a 59-year-old white woman treated for a secondary lung nodule of an advanced hepatocellular carcinoma. One month after PRFA, a consolidation of a cavity was noticed with an "air crescent sign," and aspergilloma serology was highly positive. A bisegmentectomy was performed due to the proximity of the lesion to mediastinal vessels and the absence of significant regression after antifungal treatment. Histological examination confirmed the diagnosis of PA. The second patient was a 61-year-old white man followed-up for a non-small-cell lung cancer. A cavitation with thick margins in the ablation zone was noticed 6 months after PRFA. A biopsy was performed, and aspergilloma was diagnosed. Medical treatment with itraconazole was administered for 13 months, and there was significant regression.
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Affiliation(s)
- N Alberti
- Department of Radiology, CHU de Bordeaux, Hôpital Saint-André, 33076, Bordeaux, France,
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