HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dupuy, D. E. Articles by Safran, H. Search for Related Content PubMed PubMed Citation Articles by Dupuy, D. E. Articles by Safran, H. Social Bookmarking                      What's this?

Percutaneous Radiofrequency Ablation of Malignancies in the Lung

¹ Department of Diagnostic Imaging, Rhode Island Hospital, Brown University School of Medicine, 593 Eddy St., Providence, RI 02903.
² Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157.
³ Department of Oncology, Rhode Island Hospital, Brown University School of Medicine, Providence, RI 02903.

Received April 13, 1999; accepted after revision June 15, 1999.

 
Address correspondence to D. E. Dupuy.

Introduction

Top Introduction Materials and Methods Results Discussion References

 
Radiofrequency (RF) ablation is a minimally invasive technique that is used for the treatment of primary and secondary liver tumors [1]. Early results indicate that tumor reduction and eradication can be achieved with this percutaneous imaging-guided procedure. For the most part, RF ablation can be performed under conscious sedation in the outpatient setting with a low incidence of side effects [1]. Malignant tumors in bone [2], head and neck [3], and bronchi [4] have also been treated with RF ablation with early results showing promise. A 30% 3-year survival has been shown in the RF ablation of colorectal hepatic metastases [5], but long-term results in extrahepatic malignancies are not available. The percutaneous technique has not been validated in the treatment of lung tumors. The technique has been applied to a lung tumor model in animals [6] but, to our knowledge, has not been reported in humans. This report describes the successful application of RF ablation in three patients with lung malignancies.

Materials and Methods

Top Introduction Materials and Methods Results Discussion References

 
The first patient is a 45-year-old man who in 1996 was diagnosed with stage IV bronchogenic adenocarcinoma, with a left infrahilar mass, mediastinal lymphadenopathy, and a solitary T4 bone lesion. Aggressive treatment with paclitaxel (Taxol; Bristol-Myers Squibb, Princeton, NJ) and external beam radiation effected a complete response of 2-years' duration. On follow-up chest CT, a new 2.5-cm mass was revealed within the radiation field in the left infrahilar region (Fig. 1A, Fig. 1B, Fig. 1C, Fig. 1D). Analysis of the biopsy sample confirmed recurrent adenocarcinoma. Bone scan and MR imaging of the spine were normal. The patient was not considered a candidate for surgery because of the extent of disease at the time of diagnosis. Additional radiation therapy was contraindicated to some extent because of the location of the nodule within the prior radiation field. Therefore, percutaneous RF ablation was considered the best option for attempting local tumor eradication.

View larger version (110K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1. —45-year-old man with inoperable lung cancer who presented with biopsy-proven local recurrence. A, CT scan of chest shows recurrent neoplasm (arrow) in radiation field after initial complete response with chemoradiation therapy.

View larger version (111K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1. —45-year-old man with inoperable lung cancer who presented with biopsy-proven local recurrence. B, CT scan obtained during radiofrequency (RF) ablation shows position of electrode in mass.

View larger version (117K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1. —45-year-old man with inoperable lung cancer who presented with biopsy-proven local recurrence. C, Supine CT scan obtained immediately after RF ablation and removal of electrode shows increased parenchymal density and peripheral ground-glass opacity around tumor corresponding to lesion induced by RF heat. Note absence of pneumothorax.

View larger version (127K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1. —45-year-old man with inoperable lung cancer who presented with biopsy-proven local recurrence. D, CT scan obtained at same level as C 6 weeks after C shows mass has become smaller and retracted toward hilum.

The second patient is a 66-year-old woman who was examined for pain in the right wall of the chest. Her medical history included stroke, emphysema, and myocardial infarction. An initial chest radiograph revealed a mass in the right lower lobe, which was biopsied and proven to be adenocarcinoma. Staging was based on CT of the chest and abdomen and total-body bone scan. No evidence of regional or distant disease was found, and disease was staged at 1B. The lung mass measured 5.0 cm on the CT image. The patient refused surgery because of her comorbid conditions and was scheduled for external beam radiotherapy. Because the mass was so large, RF ablation was selected for initial cytoreduction.

The third patient is a 58-year-old woman with a history of metastatic breast cancer that was treated with systemic chemotherapy and bone marrow transplantation. One lung metastasis had been treated with thoracotomy before the bone marrow transplantation. CT scans had recently shown a growing 2-cm pulmonary nodule adjacent to the left main pulmonary artery. Whole-body scanning with positron emission tomography showed radiopharmaceutic uptake in this nodule, but no evidence of other metastases. The nodule did not respond to external beam radiation and because of the high probability of additional metastases, surgery was not considered an option. Therefore, RF ablation was performed as a minimally invasive alternative.

All three patients were treated under CT guidance with a 17-gauge, 3-cm active-tip RF electrode (cooltip) and generator (Cosman Coagulator-1; Radionics, Burlington, MA) with maximum allowable output (120-140 W) for 12 min per lesion. Local anesthesia was achieved with intradermal and subcutaneous lidocaine (1%). Two 180-cm² grounding pads were placed on the patients' thighs. The first two patients had two areas treated with RF to cover the size of the tumor mass. These two patients were consciously sedated with IV midazolam and fentanyl. The last patient was anesthesized with general endotracheal anesthesia. A 2-hr postprocedural chest radiograph was obtained in all three patients to assess for pneumothorax. In addition, 1- and 2-week follow-up chest radiographs were obtained. Because of the temperature elevations seen in patients treated with RF ablation, patients were instructed to measure their temperatures.

Results

Top Introduction Materials and Methods Results Discussion References

 
No pneumothoraces were seen on the initial chest radiographs. The third patient had a chest CT 2 days after RF ablation for evaluation of chest pain, which showed a very small pneumothorax that did not warrant intervention. This patient also developed a moderate-sized pleural effusion. All three patients developed pleurisy with small- to moderate-sized pleural effusions, which in the first two patients resolved after approximately 1-2 weeks as determined by follow-up radiographs. Postprocedural fevers as high as 38.8°C developed in all three patients and lasted 2-3 days after the procedure. The first two patients were discharged after 2 hr of observation. The last patient developed a pneumonia, which required antibiotics.

Follow-up CT scan in the first patient 6 weeks after RF ablation revealed retraction of the treated region toward the hilum (Fig. 1A, Fig. 1B, Fig. 1C, Fig. 1D); a second follow-up CT scan at 3 months showed an area of masslike fibrosis. The patient remained asymptomatic on clinical examination; however, a repeated biopsy was performed. The histology revealed extensive necrosis and fibrosis with scattered atypical cells suggesting residual disease. A repeated RF ablation was performed in this same region. The second patient received a 2-week course of external beam radiation therapy, which started 3 weeks after the RF ablation, and remained asymptomatic on clinical examination. The second patient died of unknown causes in a nursing home 1 month after completion of external beam radiation. An autopsy request was refused by the family. The last patient had a follow-up positron emission tomography scan 3 months after the procedure that showed no evidence of metabolic activity in the area of RF ablation; she remains asymptomatic.

Discussion

Top Introduction Materials and Methods Results Discussion References

 
RF ablation is a promising new minimally invasive technique for the treatment of solid malignancies. Unlike other percutaneous techniques, RF ablation can provide controlled regions of coagulation necrosis with a single application to an area as large as 3-5 cm depending on the blood flow in the treated tissue [7]. Success in treating liver malignancies with a percutaneous approach has created interest in treating tumors in other organ systems [2, 3, 4]. Early evidence suggests that most patients can be treated under conscious sedation as an outpatient with no greater risk than that of conventional imaging-guided biopsy. Most patients with primary and secondary lung malignancies are not surgical candidates. Conventional treatment with systemic chemotherapy and external beam radiotherapy has not greatly affected the outcome in this group of patients [8]. Although speculative at this time, RF ablation may result in reduced tumor burden when combined with external beam radiation or systemic chemotherapy. Another unproven but potential application is in patients who have pulmonary metastatic disease that is poorly controlled with chemotherapy: RF ablation may be an option if there is only a small number of lesions. Despite the use of a larger RF electrode compared with standard 19- to 22-guage lung biopsy needles, the patients in our study did not develop significant pneumothoraces. This may be attributable to the fact that the pleura was traversed only once in two patients and that the mass in the other patient was in a peripheral location. In addition, a tissue sample was not obtained at the time of RF treatment so tissue laceration was probably less than that of a biopsy. Two of the three patients were treated as outpatients and, despite the contiguity of two of the tumors to a pulmonary artery, no significant bleeding was encountered. This can be explained by the blood flow in large vessels that acts as a heat sink and carries away the RF energy as fast as it is deposited in the tissue. Therefore, large-vessel damage is generally not encountered with RF ablation techniques. The cooling effect of large vessels may prevent adequate tumor ablation in areas of tumor that abut large vessels. This effect has been shown to be a factor in liver ablations [7].

References

Top Introduction Materials and Methods Results Discussion References

 

1. Solbiati L. New applications of ultrasonography: interventional ultrasound. Eur J Radiol 1998;27:200-206
2. Dupuy DE, Safran H, Mayo-Smith W, Goldberg SN. Percutaneous radiofrequency ablation of painful osseous metastatic disease (abstr). Radiology 1998;209(P):389
3. Solbiati L, Ierace T, Dellanoce M, Pravettoni G, Goldberg SN. Percutaneous US-guided radiofrequency ablation of metastatic lymph nodes from papillary cancer of the thyroid gland: initial experience in two patients. Radiology 1998;209(P):385
4. Marasso A, Bernardi V, Gai R, et al. Radiogrequency resection of bronchial tumors in combination with cryotherapy: evaluation of a new technique. Thorax 1998;53:106-109[Abstract]
5. Solbiati L, Goldberg SN, Ierace T, Dellanoce M, Livraghi T, Gazelle GS. Long-term follow-up of liver metastases treated with percutaneous US-guided radiofrequency (RF) ablation using internally-cooled electrodes. Radiology 1998:209(P):449
6. Goldberg SN, Gazelle GS, Compton SS, Mcloud TC. Radiofrequency tissue ablation in the rabbit lung: efficacy and complications. Acad Radiol 1995;2:776-784[Medline]
7. Goldberg SN, Hahn PF, Tanabe KK, et al. Percutaneous radiofrequency tissue ablation: does perfusion-mediated tissue cooling limit coagulation necrosis? J Vasc Intervent Radiol 1998;9:101-105[Medline]
8. Schottenfeld D. Epidemiology of lung cancer. In: Pass HI, Mitchell JB, Johnson DH, Turrisi AT, eds. Lung cancer principles and practice. Philadelphia: Lippincott-Raven, 1996:305-321

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati

This article has been cited by other articles:

				J. C. Zhu, T. D. Yan, and D. L. Morris A Systematic Review of Radiofrequency Ablation for Lung Tumors Ann. Surg. Oncol., June 1, 2008; 15(6): 1765 - 1774. [Abstract] [Full Text] [PDF]

				M NOMURA, K YAMAKADO, Y NOMOTO, A NAKATSUKA, N II, H TAKAKI, Y YAMASHITA, and K TAKEDA Complications after lung radiofrequency ablation: risk factors for lung inflammation Br. J. Radiol., March 1, 2008; 81(963): 244 - 249. [Abstract] [Full Text] [PDF]

				P. A. Linden, J. O. Wee, M. T. Jaklitsch, and Y. L. Colson Extending Indications for Radiofrequency Ablation of Lung Tumors Through an Intraoperative Approach Ann. Thorac. Surg., February 1, 2008; 85(2): 420 - 423. [Abstract] [Full Text] [PDF]

				H. C. Fernando Radiofrequency Ablation to Treat Non-Small Cell Lung Cancer and Pulmonary Metastases Ann. Thorac. Surg., February 1, 2008; 85(2): S780 - S784. [Abstract] [Full Text] [PDF]

				A. Pennathur, J. D. Luketich, G. Abbas, M. Chen, H. C. Fernando, W. E. Gooding, M. J. Schuchert, S. Gilbert, N. A. Christie, and R. J. Landreneau Radiofrequency ablation for the treatment of stage I non-small cell lung cancer in high-risk patients. J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 857 - 864. [Abstract] [Full Text] [PDF]

				S. Rossi, M. Gallati, L. Rosa, A. Marini, F. T. Viera, M. Maestri, and P. Dionigi Effect of Hyperbarism on Radiofrequency Ablation Outcome Am. J. Roentgenol., October 1, 2007; 189(4): 876 - 882. [Abstract] [Full Text] [PDF]

				J. H. Donohoo, M. T. Anderson, and W. W. Mayo-Smith Pacemaker Reprogramming After Radiofrequency Ablation of a Lung Neoplasm Am. J. Roentgenol., October 1, 2007; 189(4): 890 - 892. [Full Text] [PDF]

				K. Tsushima, T. Koizumi, T. Tanabe, R. Nakagawa, S. Yoshikawa, M. Yasuo, and K. Kubo Bronchoscopy-guided radiofrequency ablation as a potential novel therapeutic tool Eur. Respir. J., June 1, 2007; 29(6): 1193 - 1200. [Abstract] [Full Text] [PDF]

				S.-Y. Chiou, J.-B. Liu, and L. Needleman Current Status of Sonographically Guided Radiofrequency Ablation Techniques J. Ultrasound Med., April 1, 2007; 26(4): 487 - 499. [Abstract] [Full Text] [PDF]

				C. J. Simon, D. E. Dupuy, T. A. DiPetrillo, H. P. Safran, C. A. Grieco, T. Ng, and W. W. Mayo-Smith Pulmonary Radiofrequency Ablation: Long-term Safety and Efficacy in 153 Patients Radiology, April 1, 2007; 243(1): 268 - 275. [Abstract] [Full Text] [PDF]

				E. Liapi and J.-F. H. Geschwind Transcatheter and Ablative Therapeutic Approaches for Solid Malignancies J. Clin. Oncol., March 10, 2007; 25(8): 978 - 986. [Abstract] [Full Text] [PDF]

				R. J. Zagoria "Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer"-- a commentary. Am. J. Roentgenol., November 1, 2006; 187(5): 1149 - 1150. [Full Text] [PDF]

				T. Okuma, T. Matsuoka, T. Okamura, Y. Wada, A. Yamamoto, Y. Oyama, K. Koyama, K. Nakamura, Y. Watanabe, and Y. Inoue 18F-FDG Small-Animal PET for Monitoring the Therapeutic Effect of CT-Guided Radiofrequency Ablation on Implanted VX2 Lung Tumors in Rabbits J. Nucl. Med., August 1, 2006; 47(8): 1351 - 1358. [Abstract] [Full Text] [PDF]

				V. Teichgraber, C. Aube, D. Schmidt, E. Jehle, C. Konig, C. D. Claussen, and P. L. Pereira Percutaneous MR-guided radiofrequency ablation of recurrent sacrococcygeal chordomas. Am. J. Roentgenol., August 1, 2006; 187(2): 571 - 574. [Abstract] [Full Text] [PDF]

				B. A. Elliott, T. B. Curry, T. D. Atwell, M. J. Brown, and S. H. Rose Lung isolation, one-lung ventilation, and continuous positive airway pressure with air for radiofrequency ablation of neoplastic pulmonary lesions. Anesth. Analg., August 1, 2006; 103(2): 463 - 4, table of contents. [Abstract] [Full Text] [PDF]

				C. L. Nguyen, W. J. Scott, and M. Goldberg Radiofrequency ablation of lung malignancies. Ann. Thorac. Surg., July 1, 2006; 82(1): 365 - 371. [Abstract] [Full Text] [PDF]

				M. C. Ambrogi, M. Lucchi, P. Dini, F. Melfi, G. Fontanini, P. Faviana, O. Fanucchi, and A. Mussi Percutaneous radiofrequency ablation of lung tumours: results in the mid-term. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 177 - 183. [Abstract] [Full Text] [PDF]

				J M Lee, J K Han, J M Chang, S Y Chung, S H Kim, J Y Lee, and B I Choi Radiofrequency ablation in pig lungs: in vivo comparison of internally cooled, perfusion and multitined expandable electrodes. Br. J. Radiol., July 1, 2006; 79(943): 562 - 571. [Abstract] [Full Text] [PDF]

				M. C. Ambrogi, G. Fontanini, R. Cioni, P. Faviana, O. Fanucchi, and A. Mussi Biologic effects of radiofrequency thermal ablation on non-small cell lung cancer: Results of a pilot study J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1002 - 1006. [Abstract] [Full Text] [PDF]

				M. Kawamura, Y. Izumi, N. Tsukada, K. Asakura, H. Sugiura, H. Yashiro, K. Nakano, S. Nakatsuka, S. Kuribayashi, and K. Kobayashi Percutaneous cryoablation of small pulmonary malignant tumors under computed tomographic guidance with local anesthesia for nonsurgical candidates J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1007 - 1013. [Abstract] [Full Text] [PDF]

				K. Singh, D. Samartzis, A. R. Vaccaro, G. B. J. Andersson, H. S. An, and J. G. Heller Current concepts in the management of metastatic spinal disease: THE ROLE OF MINIMALLY-INVASIVE APPROACHES J Bone Joint Surg Br, April 1, 2006; 88-B(4): 434 - 442. [Full Text] [PDF]

				S. Rossi, R. Dore, A. Cascina, V. Vespro, F. Garbagnati, L. Rosa, V. Ravetta, A. Azzaretti, P. Di Tolla, G. Orlandoni, et al. Percutaneous computed tomography-guided radiofrequency thermal ablation of small unresectable lung tumours. Eur. Respir. J., March 1, 2006; 27(3): 556 - 563. [Abstract] [Full Text] [PDF]

				D. E. Dupuy, T. DiPetrillo, S. Gandhi, N. Ready, T. Ng, W. Donat, and W. W. Mayo-Smith Radiofrequency Ablation Followed by Conventional Radiotherapy for Medically Inoperable Stage I Non-small Cell Lung Cancer Chest, March 1, 2006; 129(3): 738 - 745. [Abstract] [Full Text] [PDF]

				C. L. Nguyen, W. J. Scott, N. A. Young, T. Rader, L. R. Giles, and M. Goldberg Radiofrequency Ablation of Primary Lung Cancer: Results From an Ablate and Resect Pilot Study Chest, November 1, 2005; 128(5): 3507 - 3511. [Abstract] [Full Text] [PDF]

				A. Yamamoto, K. Nakamura, T. Matsuoka, M. Toyoshima, T. Okuma, Y. Oyama, Y. Ikura, M. Ueda, and Y. Inoue Radiofrequency Ablation in a Porcine Lung Model: Correlation Between CT and Histopathologic Findings Am. J. Roentgenol., November 1, 2005; 185(5): 1299 - 1306. [Abstract] [Full Text] [PDF]

				M. G. Radvany, P. F. Allan, W. C. Frey, K. P. Banks, and D. Malave Pulmonary Radiofrequency Ablation Complicated by Subcutaneous Emphysema and Pneumomediastinum Treated with Fibrin Sealant Injection Am. J. Roentgenol., October 1, 2005; 185(4): 894 - 898. [Full Text] [PDF]

				J. D. Bojarski, D. E. Dupuy, and W. W. Mayo-Smith CT Imaging Findings of Pulmonary Neoplasms After Treatment with Radiofrequency Ablation: Results in 32 Tumors Am. J. Roentgenol., August 1, 2005; 185(2): 466 - 471. [Abstract] [Full Text] [PDF]

				S. A. Shock, P. F. Laeseke, L. A. Sampson, W. D. Lewis, T. C. Winter III, J. P. Fine, and F. T. Lee Jr Hepatic Hemorrhage Caused by Percutaneous Tumor Ablation: Radiofrequency Ablation versus Cryoablation in a Porcine Model Radiology, July 1, 2005; 236(1): 125 - 131. [Abstract] [Full Text] [PDF]

				S. N. Goldberg, C. J. Grassi, J. F. Cardella, J. W. Charboneau, G. D. Dodd II, D. E. Dupuy, D. Gervais, A. R. Gillams, R. A. Kane, F. T. Lee Jr, et al. Image-guided Tumor Ablation: Standardization of Terminology and Reporting Criteria Radiology, June 1, 2005; 235(3): 728 - 739. [Abstract] [Full Text] [PDF]

				H. Wang, P. J. Littrup, Y. Duan, Y. Zhang, H. Feng, and Z. Nie Thoracic Masses Treated with Percutaneous Cryotherapy: Initial Experience with More than 200 Procedures Radiology, April 1, 2005; 235(1): 289 - 298. [Abstract] [Full Text] [PDF]

				H. C. Fernando, A. D. Hoyos, R. J. Landreneau, S. Gilbert, W. E. Gooding, P. O. Buenaventura, N. A. Christie, C. Belani, and J. D. Luketich Radiofrequency ablation for the treatment of non-small cell lung cancer in marginal surgical candidates J. Thorac. Cardiovasc. Surg., March 1, 2005; 129(3): 639 - 644. [Abstract] [Full Text] [PDF]

				H. Nomori, Y. Imazu, K. Watanabe, T. Ohtsuka, T. Naruke, T. Kobayashi, and K. Suemasu Radiofrequency Ablation of Pulmonary Tumors and Normal Lung Tissue in Swine and Rabbits Chest, March 1, 2005; 127(3): 973 - 977. [Abstract] [Full Text] [PDF]

				T. J. Vogl, A. Wetter, S. Lindemayr, and S. Zangos Treatment of Unresectable Lung Metastases with Transpulmonary Chemoembolization: Preliminary Experience Radiology, March 1, 2005; 234(3): 917 - 922. [Abstract] [Full Text] [PDF]

				P. R. Morrison, E. vanSonnenberg, S. Shankar, J. Godleski, S. G. Silverman, K. Tuncali, M. T. Jaklitsch, and F. A. Jolesz Radiofrequency Ablation of Thoracic Lesions: Part 1, Experiments in the Normal Porcine Thorax Am. J. Roentgenol., February 1, 2005; 184(2): 375 - 380. [Abstract] [Full Text] [PDF]

				E. vanSonnenberg, S. Shankar, P. R. Morrison, R. T. Nair, S. G. Silverman, M. T. Jaklitsch, F. Liu, L. Cheung, K. Tuncali, A. T. Skarin, et al. Radiofrequency Ablation of Thoracic Lesions: Part 2, Initial Clinical Experience--Technical and Multidisciplinary Considerations in 30 Patients Am. J. Roentgenol., February 1, 2005; 184(2): 381 - 390. [Abstract] [Full Text] [PDF]

				D. Haemmerich, F. T. Lee Jr, D. J. Schutt, L. A. Sampson, J. G. Webster, J. P. Fine, and D. M. Mahvi Large-Volume Radiofrequency Ablation of ex Vivo Bovine Liver with Multiple Cooled Cluster Electrodes Radiology, February 1, 2005; 234(2): 563 - 568. [Abstract] [Full Text] [PDF]

				A. Yamamoto, T. Matsuoka, M. Toyoshima, T. Okuma, Y. Oyama, M. Hamuro, K. Nakayama, K. Inoue, K. Nakamura, and Y. Inoue Assessment of Cerebral Microembolism During Percutaneous Radiofrequency Ablation of Lung Tumors Using Diffusion-Weighted Imaging Am. J. Roentgenol., December 1, 2004; 183(6): 1785 - 1789. [Abstract] [Full Text] [PDF]

				G. Belfiore, G. Moggio, E. Tedeschi, M. Greco, R. Cioffi, F. Cincotti, and R. Rossi CT-Guided Radiofrequency Ablation: A Potential Complementary Therapy for Patients with Unresectable Primary Lung Cancer--A Preliminary Report of 33 Patients Am. J. Roentgenol., October 1, 2004; 183(4): 1003 - 1011. [Abstract] [Full Text] [PDF]

				G. Y. Jin, J. M. Lee, Y. C. Lee, Y. M. Han, and Y. S. Lim Primary and Secondary Lung Malignancies Treated with Percutaneous Radiofrequency Ablation: Evaluation with Follow-Up Helical CT Am. J. Roentgenol., October 1, 2004; 183(4): 1013 - 1020. [Abstract] [Full Text] [PDF]

				J. Louie, J. P. McGahan, E. H. Moore, J. Goodnight, and J. Brock Radio Frequency Ablation of Lung Metastasis Using Sonographic Guidance J. Ultrasound Med., September 1, 2004; 23(9): 1241 - 1244. [Full Text] [PDF]

				K. Steinke, J. King, D. W. Glenn, and D. L. Morris Percutaneous Radiofrequency Ablation of Lung Tumors with Expandable Needle Electrodes: Tips from Preliminary Experience Am. J. Roentgenol., September 1, 2004; 183(3): 605 - 611. [Full Text] [PDF]

				C. Gadaleta, V. Mattioli, G. Colucci, A. Cramarossa, V. Lorusso, E. Canniello, A. Timurian, G. Ranieri, G. Fiorentini, M. De Lena, et al. Radiofrequency Ablation of 40 Lung Neoplasms: Preliminary Results Am. J. Roentgenol., August 1, 2004; 183(2): 361 - 368. [Abstract] [Full Text] [PDF]

				P. L. Pereira, J. Trubenbach, M. Schenk, J. Subke, S. Kroeber, I. Schaefer, C. T. Remy, D. Schmidt, J. Brieger, and C. D. Claussen Radiofrequency Ablation: In Vivo Comparison of Four Commercially Available Devices in Pig Livers Radiology, August 1, 2004; 232(2): 482 - 490. [Abstract] [Full Text] [PDF]

K. Yasui, S. Kanazawa, Y. Sano, T. Fujiwara, S. Kagawa, H. Mimura, S. Dendo, T. Mukai, H. Fujiwara, T. Iguchi, et al. Thoracic Tumors Treated with CT-guided Radiofrequency Ablation: Initial Experience Radiology, June 1, 2004; 231(3): 850 - 857. [Abstract] [Full Text]