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Review
. 2019 Jun;112(6):218-225.
doi: 10.1177/0141076818763335. Epub 2018 Mar 13.

Thoracic intervention and surgery to cure lung cancer: image-guided thermal ablation in primary lung cancer

Simon Smith  1 , Paul Jennings  1
Affiliations
Review

Thoracic intervention and surgery to cure lung cancer: image-guided thermal ablation in primary lung cancer

Simon Smith et al. J R Soc Med. 2019 Jun.
No abstract available

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Computed tomography showing radiofrequency ablation electrode with expandable tines deployed in right lung to treat 5 mm lung mass.
Figure 2.
Figure 2.
(a) Computed tomography showing radiofrequency electrode placed in small right lower lobe biopsy proven non-small cell lung cancer. (b) Computed tomography at one month after treatment showing cavity encasing tumour. Patient remained disease free and this area remained positron emission tomography negative until his death from unrelated causes seven years later.
Figure 3.
Figure 3.
(a) Computed tomography showing radiofrequency electrode deployed to treat small right lower lobe sarcoma metastasis. Treatment proceeded without incident. (b) Computed tomography performed 24 h after (a) when patient's condition deteriorated. Computed tomography shows large enhancing mass at site of ablation, consistent with a large false aneurysm.
Figure 4.
Figure 4.
Radiofrequency ablation electrode has been passed into a right para-mediastinal tumour (white arrow). A 21G needle (black arrow) has been inserted into the pleural space and 200 ml of air injected to produce a pneumothorax. Traction applied to the electrode to strip the tumour away from the mediastinum and superior vena cava (*) to prevent thermal injury.
Figure 5.
Figure 5.
(a) Image showing radiofrequency electrode in position close to a small metastasis which lies immediately adjacent to the lower lobe pulmonary artery. (b) at one month after treatment, shows the metastasis is smaller, indicating a satisfactory response. (c) Computerised tomography at four months in the same patient showing an increase in the size of the mass (arrow) indicating recurrence. This is due to ‘heat sink’ effect of the adjacent large vessel which cools the tumour margin and prevents adequate ablation.
See this image and copyright information in PMC

References

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    1. National Institute for Health and Care Excellence. Microwave ablation for treating primary lung cancer and metastases in the lung (IPG469), London: National Institute for Health and Care Excellence, 2013.

MeSH terms