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DOI: 10.1148/radiol.2402050807
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Midterm Local Efficacy and Survival after Radiofrequency Ablation of Lung Tumors with Minimum Follow-up of 1 Year: Prospective Evaluation1

Thierry de Baère, MD, Jean Palussière, MD, Anne Aupérin, MD, Antoine Hakime, MD, Mohamed Abdel-Rehim, MD, Michèle Kind, MD, Clarisse Dromain, MD, Alain Ravaud, MD, Nathalie Tebboune, MD, Valérie Boige, MD, David Malka, MD, Clarisse Lafont, MD and Michel Ducreux, MD

1 From the Department of Interventional Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France (T.d.B., A.A., A.H., M.A., C.D., N.T., V.B., D.M., C.L., M.D.); and Department of Radiology, Centre Bergonié, Bordeaux, France (J.P., M.K., A.R.). Received May 11, 2005; revision requested July 11; revision received July 25; accepted September 1; final version accepted October 3. Address correspondence to T.d.B. (e-mail: debaere{at}igr.fr).


Figure 1
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  		Figure 1a: Images in 56-year-old patient with colon cancer and previous surgical resection of liver show 8-mm nodule of the right upper lung diagnosed at CT. (a) On transverse CT scan, RF electrode tines (arrowheads) have been deployed and encompass the nodule (white arrow); electrode shaft (black arrow) remains outside nodule. (b) View of LeVeen electrode tip shows needle shaft before (left) and after (right) deployment of tines. (c) Transverse CT scan immediately after RF ablation at one location shows a ground-glass opacity. (d) Transverse CT scan 36 hours after ablation shows more intense ground-glass opacity encompassing the metastasis (arrow). (e, f) Transverse CT scans obtained (e) 2 months and (f) 4 months after ablation show decrease in size of the ablated volume.

 

Figure 1
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  		Figure 1b: Images in 56-year-old patient with colon cancer and previous surgical resection of liver show 8-mm nodule of the right upper lung diagnosed at CT. (a) On transverse CT scan, RF electrode tines (arrowheads) have been deployed and encompass the nodule (white arrow); electrode shaft (black arrow) remains outside nodule. (b) View of LeVeen electrode tip shows needle shaft before (left) and after (right) deployment of tines. (c) Transverse CT scan immediately after RF ablation at one location shows a ground-glass opacity. (d) Transverse CT scan 36 hours after ablation shows more intense ground-glass opacity encompassing the metastasis (arrow). (e, f) Transverse CT scans obtained (e) 2 months and (f) 4 months after ablation show decrease in size of the ablated volume.

 

Figure 1
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  		Figure 1c: Images in 56-year-old patient with colon cancer and previous surgical resection of liver show 8-mm nodule of the right upper lung diagnosed at CT. (a) On transverse CT scan, RF electrode tines (arrowheads) have been deployed and encompass the nodule (white arrow); electrode shaft (black arrow) remains outside nodule. (b) View of LeVeen electrode tip shows needle shaft before (left) and after (right) deployment of tines. (c) Transverse CT scan immediately after RF ablation at one location shows a ground-glass opacity. (d) Transverse CT scan 36 hours after ablation shows more intense ground-glass opacity encompassing the metastasis (arrow). (e, f) Transverse CT scans obtained (e) 2 months and (f) 4 months after ablation show decrease in size of the ablated volume.

 

Figure 2
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  		Figure 2a: Transverse CT scans of 42-mm colon cancer metastasis of the left lower lobe obtained in the prone position. (a) Scan obtained during RF ablation shows deployed RF tines in the deepest part of the tumor. (b) Scan obtained 9 minutes after start of ablation shows a pneumothorax that caused anterior displacement of the tumor, but the electrode remained stable in the same location. The pneumothorax was aspirated with a 5-F needle catheter, and no chest tube was needed.

 

Figure 2
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  		Figure 2b: Transverse CT scans of 42-mm colon cancer metastasis of the left lower lobe obtained in the prone position. (a) Scan obtained during RF ablation shows deployed RF tines in the deepest part of the tumor. (b) Scan obtained 9 minutes after start of ablation shows a pneumothorax that caused anterior displacement of the tumor, but the electrode remained stable in the same location. The pneumothorax was aspirated with a 5-F needle catheter, and no chest tube was needed.

 

Figure 3
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  		Figure 3a: Box plots of (a) shortest and (b) longest tumor diameters and postablation opacity (in millimeters) seen at CT according to the time after RF ablation (in months). The size of the box is proportional to the number of observations, edges are the 25 and 75 percentiles, and the center line is the median (+ = mean). The ends of the vertical lines (ie, whiskers) indicate minimum and maximum values unless outliers ({square}) are present, in which case whiskers extended to a maximum of 1.5 times the interquartile range.

 

Figure 3
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  		Figure 3b: Box plots of (a) shortest and (b) longest tumor diameters and postablation opacity (in millimeters) seen at CT according to the time after RF ablation (in months). The size of the box is proportional to the number of observations, edges are the 25 and 75 percentiles, and the center line is the median (+ = mean). The ends of the vertical lines (ie, whiskers) indicate minimum and maximum values unless outliers ({square}) are present, in which case whiskers extended to a maximum of 1.5 times the interquartile range.

 

Figure 4
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  		Figure 4: Kaplan-Meier curves for incomplete local treatment according to the tumor size. Dotted line: tumor size < 20 mm. Solid line: tumor size ≥ 20 mm. Vertical bars denote 95% confidence interval of the actuarial rates. Log-rank test, P = .066.

 

Figure 5
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  		Figure 5: Kaplan-Meier curves for overall survival (solid line) and pulmonary evolution–free survival (dotted line). Vertical bars denote 95% confidence interval of actuarial rates. At 18 months, overall survival rate was 71% and pulmonary evolution–free survival rate was 34%.

 




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