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. 2022 Sep 30;8(5):2475-2485.
doi: 10.3390/tomography8050206.

Prediction of Ablation Volume in Percutaneous Lung Microwave Ablation: A Single Centre Retrospective Study

Anna Maria Ierardi  1 , Pasquale Grillo  2 , Maria Chiara Bonanno  2 , Andrea Coppola  3 , Valentina Vespro  1 , Maria Carmela Andrisani  1 , Davide Tosi  4 , Paolo Mendogni  4 , Sara Franzi  4 , Massimo Venturini  3   5 , Gianpaolo Carrafiello  1   6
Affiliations

Prediction of Ablation Volume in Percutaneous Lung Microwave Ablation: A Single Centre Retrospective Study

Anna Maria Ierardi et al. Tomography. .

Abstract

Background: Percutaneous Microwave Ablation (MWA) of lung malignancies is a procedure with many technical challenges, among them the risk of residual disease. Recently, dedicated software able to predict the volume of the ablated area was introduced. Cone-beam computed tomography (CBCT) is the imaging guidance of choice for pulmonary ablation in our institution. The volumetric prediction software (VPS) has been installed and used in combination with CBCT to check the correct position of the device. Our study aimed to compare the results of MWA of pulmonary tumours performed using CBCT with and without VPS.

Methods: We retrospectively reviewed 1-month follow-up enhanced contrast-enhanced computed tomography (CECT) scans of 10 patients who underwent ablation with the assistance of VPS (group 1) and of 10 patients who were treated without the assistance of VPS (group 2). All patients were treated for curative purposes, the maximum axial diameter of lesions ranged between 5 and 22 mm in group 1 and between 5 and 25 mm in group 2. We compared the presence of residual disease between the two groups.

Results: In group 1 residual disease was seen in only 1 patient (10%) in which VPS had ensured complete coverage of the tumour. In group 2 residual disease was found in 3 patients (30%).

Conclusions: Using this software during MWA of lung malignancies could improve the efficacy of the treatment compared to the conventional only CBCT guidance.

Keywords: lung ablation; lung cancer treatment; microwave ablation; prediction software.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
VPS was applied to CBCT images. (a) On axial and (d) sagittal CBCT scans the tumour has been segmented. (b) On axial and (e) sagittal CBCT scan, MWA is placed over the virtual one, the predicted ablation volume is seen as a purple ellipsoid and the green line (black arrow) shows that the predicted volume entirely encompasses the segmented lesion. (c) Axial and (f) sagittal 3D reconstruction of the lesion and predicted ablation volume.
Figure 2
Figure 2
VPS was applied to CBCT images. (a) on sagittal CBCT scan, MWA is placed over the virtual one and (b) the predicted ablation volume is seen as a purple ellipsoid and the red line (white arrow) shows that the nodule is not completely encompassed in the predicted volume.
Figure 3
Figure 3
Workflow from pre-procedural CBCT planning to 1-month follow-up CECT [16]. Reproduced with the permission from Anna Maria Ierardi, Acta Radiologica, published by SAGE, 2016.
Figure 4
Figure 4
80-years-old man with lung metastasis from larynx carcinoma in the right upper lobe. (a) Axial pre-treatment CT. Axial 1-month follow-up CECT after MWA with VPS shows (b) a large consolidation with well-defined margins and cavitation and (c) with contrast enhancement.
Figure 5
Figure 5
83-years-old man with NSCLC in the right upper lobe. (a) Axial pre-treatment CT. Axial 1-month follow-up CECT after MWA with VPS shows (b) a nodular-shaped margin of the consolidation of the ablation zone and (c) with the uptake of contrast, suggestive of residual disease.
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References

    1. Ferlay J., Soerjomataram I., Dikshit R., Eser S., Mathers C., Rebelo M., Parkin D.M., Forman D., Bray F. Cancer Incidence and Mortality Worldwide: Sources, Methods and Major Patterns in GLOBOCAN 2012. Int. J. Cancer. 2015;136:E359–E386. doi: 10.1002/ijc.29210. - DOI - PubMed
    1. Hoy H., Lynch T., Beck M. Surgical Treatment of Lung Cancer. Crit. Care Nurs. Clin. N. Am. 2019;31:303–313. doi: 10.1016/j.cnc.2019.05.002. - DOI - PubMed
    1. Kondo H., Okumura T., Ohde Y., Nakagawa K. Surgical Treatment for Metastatic Malignancies. Pulmonary Metastasis: Indications and Outcomes. Int. J. Clin. Oncol. 2005;10:81–85. doi: 10.1007/s10147-004-0472-7. - DOI - PubMed
    1. Piltz S., Meimarakis G., Wichmann M.W., Hatz R., Schildberg F.W., Fuerst H. Long-Term Results after Pulmonary Resection of Renal Cell Carcinoma Metastases. Ann. Thorac. Surg. 2002;73:1082–1087. doi: 10.1016/S0003-4975(01)03602-5. - DOI - PubMed
    1. Pfannschmidt J., Dienemann H., Hoffmann H. Surgical Resection of Pulmonary Metastases From Colorectal Cancer: A Systematic Review of Published Series. Ann. Thorac. Surg. 2007;84:324–338. doi: 10.1016/j.athoracsur.2007.02.093. - DOI - PubMed

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