Roberto Iezzi1,2, Roberto Cioni3, Domenico Basile4, Nevio Tosoratti5, Alessandro Posa6, Marco Busso4, Carla Cappelli3, Stefano Margaritora7,8, Marcello Carlo Ambrogi9, Alessandra Cassano7,10, Rossella Scandiffio3, Marco Calandri4, Laura Crocetti3, Vincenzo Valentini7,11, Riccardo Manfredi6,7, Andrea Veltri4. 1. Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia - Istituto di Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A Gemelli 8, 00168, Rome, Italy. roberto.iezzi.md@gmail.com. 2. Università Cattolica del Sacro Cuore, Rome, Italy. roberto.iezzi.md@gmail.com. 3. Division of Interventional Radiology, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Cisanello University Hospital, Pisa, Italy. 4. Radiology Unit, San Luigi Gonzaga University Hospital - Department of Oncology, University of Turin, Turin, Italy. 5. R&D Unit, HS Hospital Service SpA, Aprilia, LT, Italy. 6. Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia - Istituto di Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A Gemelli 8, 00168, Rome, Italy. 7. Università Cattolica del Sacro Cuore, Rome, Italy. 8. UOC di Chirurgia Toracica, Dipartimento di Scienze Cardiovascolari e Toraciche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy. 9. Division of Thoracic Surgery, Cardio Vascular and Thoracic Department, University Hospital of Pisa, Pisa, Italy. 10. UOC di Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-metaboliche e Nefro-urologiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy. 11. UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
Abstract
OBJECTIVES: To prospectively assess reproducibility, safety, and efficacy of microwave ablation (MWA) in the treatment of unresectable primary and secondary pulmonary tumors. METHODS: Patients with unresectable primary and metastatic lung tumors up to 4 cm were enrolled in a multicenter prospective clinical trial and underwent CT-guided MWA. Treatments were delivered using pre-defined MW power and duration settings, based on target tumor size and histology classifications. Patients were followed for up to 24 months. Treatment safety, efficacy, and reproducibility were assessed. Ablation volumes were measured at CT scan and compared with ablation volumes obtained on ex vivo bovine liver using equal treatment settings. RESULTS: From September 2015 to September 2017, 69 MWAs were performed in 54 patients, achieving technical success in all cases and treatment completion without deviations from the standardized protocol in 61 procedures (88.4%). Immediate post-MWA CT scans showed ablation dimensions smaller by about 25% than in the ex vivo model; however, a remarkable volumetric increase (40%) of the treated area was observed at 1 month post-ablation. No treatment-related deaths nor complications were recorded. Treatments of equal power and duration yielded fairly reproducible ablation dimensions at 48-h post-MWA scans. In comparison with the ex vivo liver model, in vivo ablation sizes were systematically smaller, by about 25%. Overall LPR was 24.7%, with an average TLP of 8.1 months. OS rates at 12 and 24 months were 98.0% and 71.3%, respectively. CONCLUSIONS: Percutaneous CT-guided MWA is a reproducible, safe, and effective treatment for malignant lung tumors up to 4 cm in size. KEY POINTS: • Percutaneous MWA treatment of primary and secondary lung tumors is a repeatable, safe, and effective therapeutic option. • It provides a fairly reproducible performance on both the long and short axis of the ablation zone. • When using pre-defined treatment duration and power settings according to tumor histology and size, LPR does not increase with increasing tumor size (up to 4 cm) for both primary and metastatic tumors.
OBJECTIVES: To prospectively assess reproducibility, safety, and efficacy of microwave ablation (MWA) in the treatment of unresectable primary and secondary pulmonary tumors. METHODS:Patients with unresectable primary and metastatic lung tumors up to 4 cm were enrolled in a multicenter prospective clinical trial and underwent CT-guided MWA. Treatments were delivered using pre-defined MW power and duration settings, based on target tumor size and histology classifications. Patients were followed for up to 24 months. Treatment safety, efficacy, and reproducibility were assessed. Ablation volumes were measured at CT scan and compared with ablation volumes obtained on ex vivo bovine liver using equal treatment settings. RESULTS: From September 2015 to September 2017, 69 MWAs were performed in 54 patients, achieving technical success in all cases and treatment completion without deviations from the standardized protocol in 61 procedures (88.4%). Immediate post-MWA CT scans showed ablation dimensions smaller by about 25% than in the ex vivo model; however, a remarkable volumetric increase (40%) of the treated area was observed at 1 month post-ablation. No treatment-related deaths nor complications were recorded. Treatments of equal power and duration yielded fairly reproducible ablation dimensions at 48-h post-MWA scans. In comparison with the ex vivo liver model, in vivo ablation sizes were systematically smaller, by about 25%. Overall LPR was 24.7%, with an average TLP of 8.1 months. OS rates at 12 and 24 months were 98.0% and 71.3%, respectively. CONCLUSIONS: Percutaneous CT-guided MWA is a reproducible, safe, and effective treatment for malignant lung tumors up to 4 cm in size. KEY POINTS: • Percutaneous MWA treatment of primary and secondary lung tumors is a repeatable, safe, and effective therapeutic option. • It provides a fairly reproducible performance on both the long and short axis of the ablation zone. • When using pre-defined treatment duration and power settings according to tumor histology and size, LPR does not increase with increasing tumor size (up to 4 cm) for both primary and metastatic tumors.
Authors: Mario Ghosn; Ahmed S Elsakka; Fourat Ridouani; Raphael Doustaly; Louie Mingione; Kevin Royalty; Etay Ziv; Erica Alexander; Aaron Maxwell; Sebastien Monette; Hyun S Kim; Robert F Short; Alda Lui Tam; Robert D Suh; Stephen B Solomon Journal: Transl Lung Cancer Res Date: 2022-02
Authors: Janani S Reisenauer; Patrick W Eiken; Matthew R Callstrom; Geoffrey B Johnson; Karlyn Pierson; Bettie Lechtenberg; Shanda H Blackmon Journal: J Thorac Dis Date: 2022-04 Impact factor: 2.895