Microwave Ablation of Pulmonary Tumors Proves Effective

What are the data regarding microwave ablation of lung tumors? Does it work?

The objective of a 2008 article in Radiology was to determine the results, imaging, and safety of microwave ablation of pulmonary malignancies.

In all cases, the patients had a pulmonary malignancy that was either inoperable, or the patients refused surgical resection. Thirty patients had primary lung malignancy, and 20 had metastases of extrathoracic malignancy to the lungs.

Microwave ablation was performed under CT guidance. Tumors less than 2 cm were treated with a single applicator, and larger nodules were treated with several antennae or a multi-probe array.

Ablation times were 10 minutes for 3.7-cm active tips and five to 10 minutes for 1.6-cm active tips.

Postprocedural pneumotho races were treated with observation, catheter aspiration, and/or 8–10 French pigtail catheter insertion.

Follow-up CT imaging was performed at one, three and six-month intervals. At three- and six-month intervals, PET scanning was also performed. Select patients underwent re-ablation of their lung tumors.

Preliminary data indicate that, after microwave ablation, there is an increase in size of pulmonary nodules post-ablation due to thermal-induced lung necrosis, followed by a persistent decrease in pulmonary nodule diameter. Complications did include pneumothorax, hemoptysis, and skin burns.

The authors concluded that microwave ablation preliminarily leads to better survival and is relatively safe.

It would be of great interest to have a study comparing the different minimally invasive ablation methods — such as Radiofrequency (RF) ablation, cryoablation, and microwave ablation — with one another in the treatment of pulmonary tumors.

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Reference: Farrah J. Wolf, David J. Grand, Jason T. Machan, Thomas A. DiPetrillo, William W. Mayo-Smith, and Damian E. Dupuy.
Microwave Ablation of Lung Malignancies: Effectiveness, CT Findings, and Safety in 50 Patients. Radiology 2008 247: 871-879

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CME: Body Imaging: Abdominal, Thoracic and Vascular
University of California, San Francisco, Department of Radiology
This CME program carries 18.5 AMA PRA Category 1 Credits and is designed for the radiologist in clinical practice.
Hot topics include cardiac imaging, multidetector CT, CT/MR angiography, virtual colonoscopy, and tumor ablation.

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