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Complications of microwave and radiofrequency lung ablation: personal experience and review of the literature

Complicanze della termo-ablazione polmonare con microonde e radiofrequenza: esperienza personale e revisione della letteratura

  • Chest Radiology / Radiologia Toracica
  • Published:
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Abstract

Purpose

Complications correlated with percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) of lung tumours were retrospectively reviewed to compare them with data from the literature and to assess risk factors related with the procedures.

Materials and methods

From January 2003 to January 2009, 29 patients (36 lung lesions) were treated with RFA; from January 2007 to January 2009, 16 patients (17 lung lesions) were treated with MWA. Complications recorded at our institution are reported following the Society of Interventional Radiology guidelines. A systematic review of the literature was performed.

Results

Any major complication of RFA or MWA was recorded. In agreement with the literature, pneumothorax was the most frequent complication, even though the incidence in our series was lower than reported in the literature (3.5% vs. 4.3–18%). Other complications of RFA were pleural effusion and subcutaneous emphysema. No massive haemorrhages, haemoptysis, abscesses, pneumonia, infections or tumour seeding were recorded in our series. The most common complication of MWA was pneumothorax (25% vs. 39% reported in the literature). Pleural effusion was a common reaction, but therapeutic drainage was never required.

Conclusions

Pneumothorax is the most common complication of both techniques. RFA and MWA are both excellent choices in terms of safety and tolerance.

Riassunto

Obiettivo

Scopo del presente studio è stato analizzare retrospettivamente le complicanze registrate nel trattamento termo-ablativo con radiofrequenze (RFA) e con microonde (MWA) di tumori polmonari, confrontarli con i dati riportati in letteratura e valutare i fattori di rischio correlati alle due procedure.

Materiali e metodi

Da gennaio 2003 a gennaio 2009, 29 pazienti (36 lesioni polmonari) sono stati trattati con RFA; da gennaio 2007 a gennaio 2009, 16 pazienti (17 lesioni polmonari) sono stati trattati con MWA. Le complicanze da noi registrate sono state riportate seguendo le linee guida della Society of Interventional Radiology (SIR). È stata eseguita anche una revisione della letteratura.

Risultati

Nessuna complicanza maggiore è stata osservata. In accordo con i dati presenti in letteratura, lo pneumotorace è la complicanza più frequente anche se la sua incidenza nella nostra casistica è più bassa (5,8% versus 4,3%–18% in letteratura). Nella nostra casistica, le complicanze post-RFA includono la soffusione pleurica e l’enfisema sottocutaneo. Non è stato osservato nessun caso di emorragia massiva, emottisi, nessuna infezione polmonare, né ascesso né disseminazione tumorale. Anche, nei pazienti trattati con MWA, la complicanza più frequente è stata lo pneumotorace (25% versus 39% riportato in letteratura). La soffusione pleurica è un riscontro frequente, ma in nessun caso è stato necessario il posizionamento di un drenaggio.

Conclusioni

Lo pneumotorace è la complicanza più frequente in entrambe le procedure. La termo-ablazione percutanea, sia RFA che MWA, rappresenta un’ottima opzione terapeutica in termini di sicurezza e tolleranza.

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References/Bibliografia

  1. Shugarman LR, Mack K, Sorbero ME et al (2009). Race and sex differences in the receipt of timely and appropriate lung cancer treatment. Med Care 47:774–781

    Article  PubMed  Google Scholar 

  2. Simon CJ, Dupuy DE, Dipetrillo TA et al (2007) Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology 243:268–275

    Article  PubMed  Google Scholar 

  3. Grieco CA, Simon CJ, Mayo-Smith WW et al (2006) Percutaneous image guided thermal ablation and radiation therapy: outcomes of combined treatment for 41 patients with inoperable stage I/II non-small-cell lung cancer. J Vasc Interv Radiology 17:1117–1124

    Article  Google Scholar 

  4. Simon CJ, Dupuy DE, Mayo-Smith WW (2005) Microwave ablation: principles and applications. Radiographics 25:S69–S83

    Article  PubMed  Google Scholar 

  5. Carrafiello G, Laganà D, Mangini M et al (2008) Microwave tumors ablation: principles, clinical applications and review of preliminary experiences. Int J Surg 6(suppl 1):S65–S69

    Article  PubMed  Google Scholar 

  6. Sacks D, McClenny TE, Cardella JF, Lewis CA (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 14(suppl):S199–S202

    Article  PubMed  Google Scholar 

  7. Cardella JF, Kundu S, Miller DL et al (2009) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 20:S189–S191

    Article  PubMed  Google Scholar 

  8. Zhu JC, Yan TD, Glen D et al (2009) Radiofrequency ablation of lung tumors: feasibility and safety. Ann Thorac Surg 87:1023–1029

    Article  PubMed  Google Scholar 

  9. Hiraki T, Tajiri N, Mimura H et al (2006) Pneumothorax, pleural effusion, and chest tube placement after radiofrequency ablation of lung tumors: incidence and risk factors. Radiology 241:275–283

    Article  PubMed  Google Scholar 

  10. Laganà D, Carrafiello G, Mangini M et al (2006) Radiofrequency ablation of primary and metastatic lung tumors: preliminary experience with a single center device. Surg Endos 20:1262–1267

    Article  Google Scholar 

  11. Okuma T, Matsuoka T, Yamamoto A et al (2008) Frequency and risk factors of various complications after computed tomography-guided radiofrequency ablation of lung tumors. Cardiovasc Intervent Radiol 31:122–123

    Article  PubMed  Google Scholar 

  12. Wolf FJ, Grand DJ, Machan JT et al (2008) Microwave ablation of lung malignancies: effectiveness, CT findings, and safety in 50 patients. Radiology 247:871–879

    Article  PubMed  Google Scholar 

  13. Nishino M, Jackman DM, Hatabu H et al (2010) New Response Evaluation Criteria in Solid Tumors (RECIST) guidelines for advanced non-small-cell lung cancer: comparison with original RECIST and impact on assessment of tumor response to targeted therapy. AJR Am J Roentgenol 195:W221–W228

    Article  PubMed  Google Scholar 

  14. Wright SA, Sampson LA, Warner TF et al (2005) Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology 236:132–139

    Article  PubMed  Google Scholar 

  15. Goldberg SN, Grassi CJ, Cardella JF et al (2005). Image-guided tumor ablation: standardization of terminology and reporting criteria. Radiology 235:728–739

    Article  PubMed  Google Scholar 

  16. Carrafiello G, Laganà D, Ianniello A et al (2007) Post-radiofrequency ablation syndrome after percutaneous radiofrequency of abdominal tumours: one centre experience and review of published works. Australas Radiology 51:550–554

    Article  CAS  Google Scholar 

  17. Hollen PJ, Gralla RJ, Kris MG et al (2005) A comparison of visual analogue and numerical rating scale formats for the Lung Cancer Symptom Scale (LCSS): does format affect patient ratings of symptoms and quality of life quality of life? Qual Life Res 14:837–847

    Article  PubMed  CAS  Google Scholar 

  18. de Baere T, Palussiere J, Auperin A et al (2006) Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum followup of 1 year: prospective evaluation. Radiology 240:587–596

    Article  PubMed  Google Scholar 

  19. National Cancer Institute, version 2.0 (1999) Cancer therapy evaluation program: common toxicity evaluation manual. Available at: ctep.cancer.gov/reporting/ctc.html. Last access May 2011

  20. Suzuki T, Yamagami T, Tanaka O et al (2010). Percutaneous radiofrequency ablation for lung tumors beneath the rib under CT fluoroscopic guidance with gantry tilt. Acta Radiol 51:389–395

    Article  PubMed  Google Scholar 

  21. Pennathur A, Abbas G, Gooding WE et al (2009) Image-guided radiofrequency ablation of lung neoplasm in 100 consecutive patients by a thoracic surgical service. Ann Thorac Surg 88:1601–1606

    Article  PubMed  Google Scholar 

  22. Thanos L, Mylona S, Ptohis N et al (2009) Percutaneous radiofrequency thermal ablation in the management of lung tumors: presentation of clinical experience on a series of 35 patients. Diagn Interv Radiol 15:290–296

    PubMed  Google Scholar 

  23. Shu Yan Huo A, Lawson Morris D et al (2009) Use of percutaneous radiofrequency ablation in pulmonary metastases from renal cell carcinoma. Ann Surg Oncol 16:3169–3175

    Article  PubMed  Google Scholar 

  24. Dequanter D, Lothaire P (2009) Tumour characteristics and therapeutic results after percutaneous radiofrequency ablation of secondary lung neoplasms. Clin Transl Oncol 11:393–395

    Article  PubMed  Google Scholar 

  25. Soga N, Yamakado K, Gohara H et al (2009) Percutaneous radiofrequency ablation for unresectable pulmonary metastases from renal cell carcinoma. BJU Int 104:790–794

    Article  PubMed  Google Scholar 

  26. Pennathur A, Abbas G, Qureshi I et al (2009) Radiofrequency ablation for the treatment of pulmonary metastases. Ann Thorac Surg 87:1030–1036

    Article  PubMed  Google Scholar 

  27. Lanuti M, Sharma A, Digumarthy SR et al (2009) Radiofrequency ablation for treatment of medically inoperable stage I non-small cell lung cancer. J Thorac Cardiovasc Surg 13:160–166

    Article  Google Scholar 

  28. Nomura M, Yamakado K, Nomoto Y et al (2008) Complications after lung radiofrequency ablation: risk factors for lung inflammation. Br J Radiol 81:244–249

    Article  PubMed  CAS  Google Scholar 

  29. Hiraki T, Gobara H, Iishi T et al (2007) Percutaneous radiofrequency ablation for clinical stage I non-small cell lung cancer: results in 20 nonsurgical candidates. J Thorac Cardiovasc Surg 134:1306–1312

    Article  PubMed  Google Scholar 

  30. Cariati M, Giordano G, Midulla M et al (2007) Radiofrequency ablation of pulmonary lesions. Radiol Med 112:149–156

    Article  PubMed  CAS  Google Scholar 

  31. Sano Y, Kanazawa S, Gobara H et al (2007). Feasibility of percutaneous radiofrequency ablation for intrathoracic malignancies: a large single-center experience. Cancer 109:1397–1405

    Article  PubMed  Google Scholar 

  32. Durick NA, Laeseke PF, Broderick LS et al (2008) Microwave ablation with triaxial antennas tuned for lung: results in an in vivo porcine model. Radiology 247:80–87

    Article  PubMed  Google Scholar 

  33. Brace CL, Hinshaw JL, Laeseke PF et al (2009) Pulmonary thermal ablation: comparison of radiofrequency and microwave devices by using gross pathologic and CT findings in a swine model. Radiology 251:705–711

    Article  PubMed  Google Scholar 

  34. Carrafiello G, Mangini M, De Bernardi I et al (2010) Microwave ablation therapy for treating primary and secondary lung tumours: technical note. Radiol Med 115:962–974

    Article  PubMed  CAS  Google Scholar 

  35. Gillams AR (2005) Complications of percutaneous therapy. Cancer Imaging 5:110–113

    Article  PubMed  CAS  Google Scholar 

  36. Carrafiello G, Laganà D, Pellegrino C et al (2008) Ablation of painful metastatic bone tumors: a systematic review. Int J Surg 6:47–52

    Article  Google Scholar 

  37. Baère T, Palussière J, Aupérin A et al (2006) Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum followup of one year: prospective evaluation. Radiology 203:587–596

    Article  Google Scholar 

  38. Friedman M, Mikityansky I, Kam A et al (2004) Radiofrequency ablation of cancer. Cardiovasc Intervent Radiol 27:427–434

    Article  PubMed  Google Scholar 

  39. Hiraki T, Mimura H, Gobara H et al (2009) Two cases of needletract seeding after percutaneous radiofrequency ablation for lung cancer. J Vasc Interv Radiol 20:415–418

    Article  PubMed  Google Scholar 

  40. Gazelle GS, Goldberg SN, Solbiati L et al (2000) Tumor ablation with radiofrequency energy. Radiology 217:633–646

    PubMed  CAS  Google Scholar 

  41. Belfiore G, Moggio G, Tedeschi E et al (2004) CT-guided radiofrequency ablation: a potential complementary therapy for patients with unresectable primary lung cancer-a preliminary report of 33 patients. AJR Am J Roentgenol 183:1003–1011

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Research Centre in Interventional Radiology, University of Insubria, Viale Borri 57, 21100, Varese, Italy

    G. Carrafiello, M. Mangini, F. Fontana, A. Di Massa, A. M. Ierardi, E. Cotta, F. Piacentino, L. Nocchi Cardim, C. Pellegrino & C. Fugazzola

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  1. G. Carrafiello
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  2. M. Mangini
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  3. F. Fontana
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  4. A. Di Massa
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  5. A. M. Ierardi
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  6. E. Cotta
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  7. F. Piacentino
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  8. L. Nocchi Cardim
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  9. C. Pellegrino
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  10. C. Fugazzola
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Correspondence to G. Carrafiello.

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Carrafiello, G., Mangini, M., Fontana, F. et al. Complications of microwave and radiofrequency lung ablation: personal experience and review of the literature. Radiol med 117, 201–213 (2012). https://doi.org/10.1007/s11547-011-0741-2

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  • DOI: https://doi.org/10.1007/s11547-011-0741-2

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