Semin intervent Radiol 2013; 30(02): 169-175
DOI: 10.1055/s-0033-1342958
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lung Cancer Ablation: Complications

Takao Hiraki
1   Department of Radiology, Okayama University Medical School, Okayama, Japan
,
Hideo Gobara
1   Department of Radiology, Okayama University Medical School, Okayama, Japan
,
Hiroyasu Fujiwara
1   Department of Radiology, Okayama University Medical School, Okayama, Japan
,
Hiroaki Ishii
1   Department of Radiology, Okayama University Medical School, Okayama, Japan
,
Koji Tomita
1   Department of Radiology, Okayama University Medical School, Okayama, Japan
,
Mayu Uka
1   Department of Radiology, Okayama University Medical School, Okayama, Japan
,
Satoko Makimoto
1   Department of Radiology, Okayama University Medical School, Okayama, Japan
,
Susumu Kanazawa
1   Department of Radiology, Okayama University Medical School, Okayama, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
28 May 2013 (online)

Abstract

Although radiofrequency ablation for lung cancer is generally safe (with a mortality rate <1%), it may cause various complications. Common complications include pneumothorax, pleural effusion, and parenchymal hemorrhage. Although most complications can be treated conservatively or with minimal therapy, physicians should be aware of rare but serious complications. Potentially fatal complications include massive hemorrhage, intractable pneumothorax due to bronchopleural fistula, pulmonary artery pseudoaneurysm, systemic air embolism, and pneumonitis. Other serious complications include injury to the nearby tissues (e.g., brachial nerve plexus, phrenic nerve, diaphragm, and chest wall), needle tract seeding, lung abscess, empyema, and skin burn. Although cavitation of the ablation zone is usually insignificant clinically, such a cavity occasionally ruptures, leading to pneumothorax and bleeding. Cavities may also serve as a scaffold for fungal colonization. Precautions to minimize risk should be taken whenever possible. Nevertheless, serious complications may occur, and thus physicians should be aware of the appropriate treatments for these complications. This article reviews complications associated with lung cancer ablation.

 
  • References

  • 1 Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WW, Kavanagh PV, Safran H. Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 2000; 174 (1) 57-59
  • 2 Steinke K, Sewell PE, Dupuy D , et al. Pulmonary radiofrequency ablation—an international study survey. Anticancer Res 2004; 24 (1) 339-343
  • 3 Hiraki T, Tajiri N, Mimura H , et al. Pneumothorax, pleural effusion, and chest tube placement after radiofrequency ablation of lung tumors: incidence and risk factors. Radiology 2006; 241 (1) 275-283
  • 4 Yamagami T, Kato T, Hirota T, Yoshimatsu R, Matsumoto T, Nishimura T. Pneumothorax as a complication of percutaneous radiofrequency ablation for lung neoplasms. J Vasc Interv Radiol 2006; 17 (10) 1625-1629
  • 5 Okuma T, Matsuoka T, Yamamoto A , et al. Frequency and risk factors of various complications after computed tomography-guided radiofrequency ablation of lung tumors. Cardiovasc Intervent Radiol 2008; 31 (1) 122-130
  • 6 Nour-Eldin NE, Naguib NN, Saeed AS , et al. Risk factors involved in the development of pneumothorax during radiofrequency ablation of lung neoplasms. AJR Am J Roentgenol 2009; 193 (1) W43-8
  • 7 Yoshimatsu R, Yamagami T, Terayama K, Matsumoto T, Miura H, Nishimura T. Delayed and recurrent pneumothorax after radiofrequency ablation of lung tumors. Chest 2009; 135 (4) 1002-1009
  • 8 Clasen S, Kettenbach J, Kosan B , et al. Delayed development of pneumothorax after pulmonary radiofrequency ablation. Cardiovasc Intervent Radiol 2009; 32 (3) 484-490
  • 9 Sakurai J, Hiraki T, Mukai T , et al. Intractable pneumothorax due to bronchopleural fistula after radiofrequency ablation of lung tumors. J Vasc Interv Radiol 2007; 18 (1 Pt 1) 141-145
  • 10 Kodama H, Yamakado K, Murashima S , et al. Intractable bronchopleural fistula caused by radiofrequency ablation: endoscopic bronchial occlusion with silicone embolic material. Br J Radiol 2009; 82 (983) e225-e227
  • 11 Cannella M, Cornelis F, Descat E , et al. Bronchopleural fistula after radiofrequency ablation of lung tumours. Cardiovasc Intervent Radiol 2011; 34 (Suppl. 02) S171-S174
  • 12 Nomura M, Yamakado K, Nomoto Y , et al. Complications after lung radiofrequency ablation: risk factors for lung inflammation. Br J Radiol 2008; 81 (963) 244-249
  • 13 Tajiri N, Hiraki T, Mimura H , et al. Measurement of pleural temperature during radiofrequency ablation of lung tumors to investigate its relationship to occurrence of pneumothorax or pleural effusion. Cardiovasc Intervent Radiol 2008; 31 (3) 581-586
  • 14 Lee JM, Jin GY, Goldberg SN , et al. Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report. Radiology 2004; 230 (1) 125-134
  • 15 Sano Y, Kanazawa S, Gobara H , et al. Feasibility of percutaneous radiofrequency ablation for intrathoracic malignancies: a large single-center experience. Cancer 2007; 109 (7) 1397-1405
  • 16 Steinke K, King J, Glenn D, Morris DL. Pulmonary hemorrhage during percutaneous radiofrequency ablation: a more frequent complication than assumed?. Interact Cardiovasc Thorac Surg 2003; 2 (4) 462-465
  • 17 Nour-Eldin NE, Naguib NN, Mack M, Abskharon JE, Vogl TJ. Pulmonary hemorrhage complicating radiofrequency ablation, from mild hemoptysis to life-threatening pattern. Eur Radiol 2011; 21 (1) 197-204
  • 18 Vaughn C, Mychaskiw II G, Sewell P. Massive hemorrhage during radiofrequency ablation of a pulmonary neoplasm. Anesth Analg 2002; 94 (5) 1149-1151
  • 19 Dupuy DE, Mayo-Smith WW, Abbott GF, DiPetrillo T. Clinical applications of radio-frequency tumor ablation in the thorax. Radiographics 2002; 22 (Spec No) S259-S269
  • 20 Herrera LJ, Fernando HC, Perry Y , et al. Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates. J Thorac Cardiovasc Surg 2003; 125 (4) 929-937
  • 21 Sakurai J, Mimura H, Gobara H, Hiraki T, Kanazawa S. Pulmonary artery pseudoaneurysm related to radiofrequency ablation of lung tumor. Cardiovasc Intervent Radiol 2010; 33 (2) 413-416
  • 22 Yamakado K, Takaki H, Takao M , et al. Massive hemoptysis from pulmonary artery pseudoaneurysm caused by lung radiofrequency ablation: successful treatment by coil embolization. Cardiovasc Intervent Radiol 2010; 33 (2) 410-412
  • 23 Soh J, Toyooka S, Gobara H , et al. A case of delayed massive hemothorax caused by the rupture of a pulmonary artery pseudoaneurysm after radiofrequency ablation of lung tumors. Jpn J Clin Oncol 2012; 42 (7) 646-649
  • 24 Hiraki T, Mimura H, Gobara H , et al. Two cases of needle-tract seeding after percutaneous radiofrequency ablation for lung cancer. J Vasc Interv Radiol 2009; 20 (3) 415-418
  • 25 Yamakado K, Akeboshi M, Nakatsuka A , et al. Tumor seeding following lung radiofrequency ablation: a case report. Cardiovasc Intervent Radiol 2005; 28 (4) 530-532
  • 26 Hiraki T, Gobara H, Mimura H , et al. Brachial nerve injury caused by percutaneous radiofrequency ablation of apical lung cancer: a report of four cases. J Vasc Interv Radiol 2010; 21 (7) 1129-1133
  • 27 Matsui Y, Hiraki T, Gobara H , et al. Phrenic nerve injury after radiofrequency ablation of lung tumors: retrospective evaluation of the incidence and risk factors. J Vasc Interv Radiol 2012; 23 (6) 780-785
  • 28 Le TX, Andrews RT. Thermal osteonecrosis of the rib after radiofrequency ablation in the thorax. J Vasc Interv Radiol 2008; 19 (6) 940-944
  • 29 Hiraki T, Gobara H, Shibamoto K , et al. Technique for creation of artificial pneumothorax for pain relief during radiofrequency ablation of peripheral lung tumors: report of seven cases. J Vasc Interv Radiol 2011; 22 (4) 503-506
  • 30 Hiraki T, Gobara H, Masaoka Y, Toyooka S, Kanazawa S. Diaphragmatic hernia after percutaneous radiofrequency ablation of lung tumor. J Vasc Interv Radiol 2011; 22 (12) 1777-1778
  • 31 Hiraki T, Gobara H, Kato K, Toyooka S, Mimura H, Kanazawa S. Bronchiolitis obliterans organizing pneumonia after radiofrequency ablation of lung cancer: report of three cases. J Vasc Interv Radiol 2012; 23 (1) 126-130
  • 32 Okuma T, Matsuoka T, Hamamoto S, Nakamura K, Inoue Y. Percutaneous computed tomography-guided radiofrequency ablation of lung tumors complicated with idiopathic interstitial pneumonia. Ann Thorac Surg 2009; 87 (3) 948-950
  • 33 Okuma T, Matsuoka T, Tutumi S, Nakmura K, Inoue Y. Air embolism during needle placement for CT-guided radiofrequency ablation of an unresectable metastatic lung lesion. J Vasc Interv Radiol 2007; 18 (12) 1592-1594
  • 34 Ghaye B, Bruyère PJ, Dondelinger RF. Nonfatal systemic air embolism during percutaneous radiofrequency ablation of a pulmonary metastasis. AJR Am J Roentgenol 2006; 187 (3) 327-328
  • 35 Jin GY, Lee JM, Lee YC, Han YM. Acute cerebral infarction after radiofrequency ablation of an atypical carcinoid pulmonary tumor. AJR Am J Roentgenol 2004; 182 (4) 990-992
  • 36 Yamamoto A, Matsuoka T, Toyoshima M , et al. Assessment of cerebral microembolism during percutaneous radiofrequency ablation of lung tumors using diffusion-weighted imaging. AJR Am J Roentgenol 2004; 183 (6) 1785-1789
  • 37 Okuma T, Matsuoka T, Yamamoto A , et al. Factors contributing to cavitation after CT-guided percutaneous radiofrequency ablation for lung tumors. J Vasc Interv Radiol 2007; 18 (3) 399-404
  • 38 Hiraki T, Gobara H, Mimura H , et al. Aspergilloma in a cavity formed after percutaneous radiofrequency ablation for lung cancer. J Vasc Interv Radiol 2009; 20 (11) 1499-1500
  • 39 Chua TC, Sarkar A, Saxena A, Glenn D, Zhao J, Morris DL. Long-term outcome of image-guided percutaneous radiofrequency ablation of lung metastases: an open-labeled prospective trial of 148 patients. Ann Oncol 2010; 21 (10) 2017-2022