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CT-Guided Radiofrequency Ablation: A Potential Complementary Therapy for Patients with Unresectable Primary Lung Cancer—A Preliminary Report of 33 Patients

Giuseppe Belfiore1, Giovanni Moggio1, Enrico Tedeschi1, Michele Greco1, Riccardo Cioffi2, Francesca Cincotti3 and Renato Rossi4

1 Department of Radiology, "San Sebastiano" Caserta's Hospital, Via F. Palasciano, Caserta 81100, Italy.
2 Department of Pneumology, "San Sebastiano" Caserta's Hospital, Caserta 81100, Italy.
3 Department of Anesthesiology, "San Sebastiano" Caserta's Hospital, Caserta 81100, Italy.
4 Department of Pathology, "San Sebastiano" Caserta's Hospital, Caserta 81100, Italy.



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  		Fig. 1A. —61-year-old woman with adenocarcinoma. Right lung CT scan was obtained with patient in right-side decubitus position. Needle is positioned in lesion (size, < 3 cm) in right retrobronchial space.

 


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  		Fig. 1B. —61-year-old woman with adenocarcinoma. Posttreatment CT scan shows minimal parenchymal–pleural effusion caused by cauterization. Perilesional ground-glass opacity can also be seen.

 


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  		Fig. 1C. —61-year-old woman with adenocarcinoma. On 6-month follow-up contrast-enhanced CT scan, size of ablation zone is stabilized and shows low CT density.

 


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  		Fig. 1D. —61-year-old woman with adenocarcinoma. Photomicrograph of cytohistologic specimen obtained at 6-month follow-up shows total coagulation necrosis. (H and E, x2.5)

 


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  		Fig. 2A. —67-year-old man with recurrent adenocarcinoma. Left lung CT scan obtained with patient in supine position shows positioning of needle with lateral approach in lesion (< 3 cm) of basal lobe.

 


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  		Fig. 2B. —67-year-old man with recurrent adenocarcinoma. Posttreatment CT scan shows lesion with reduced CT density and some bubbles of necrosis.

 


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  		Fig. 2C. —67-year-old man with recurrent adenocarcinoma. On 6-month follow-up contrast-enhanced CT scan, lesion is actually not visible.

 


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  		Fig. 3A. —47-year-old man with adenocarcinoma. Right lung CT scan obtained with patient in right-side decubitus position shows needle in 4-cm lesion in inferior lobe.

 


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  		Fig. 3B. —47-year-old man with adenocarcinoma. On 6-month follow-up contrast-enhanced CT scan obtained with patient in supine position shows partial reduction in lesion size with linear fibrosis.

 


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  		Fig. 4A. —73-year-old woman with adenocarcinoma. Left lung CT scan obtained with patient in prone position shows needle in lesion (diameter, < 3 cm) located close to aortic wall.

 


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  		Fig. 4B. —73-year-old woman with adenocarcinoma. On 1-year follow-up CT scan, reduction in size of ablation zone is evident.

 


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  		Fig. 5A. —67-year-old man with squamous carcinoma. Left lung CT scan shows needle positioned in solid tissue of large mass with central cavitation in apical dorsal segment (prone decubitus position).

 


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  		Fig. 5B. —67-year-old man with squamous carcinoma. On 6-month follow-up CT scan obtained after second session of radiofrequency ablation performed 3 months after initial session, increase in ablation zone and decrease in CT density of central component are observed.

 


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  		Fig. 5C. —67-year-old man with squamous carcinoma. Photomicrographs of cytohistologic specimens obtained in different areas of mass shows residual neoplastic areas and large area of coagulation necrosis mixed with some neoplastic cells. (H and E, x2.5)

 


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  		Fig. 5D. —67-year-old man with squamous carcinoma. After third radiofrequency ablation session, 12-month follow-up CT scan shows increase of central cavitation area and reduced wall thickness in lesion.

 

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