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15.06.2022 | Chest

Comparison of expected imaging findings following percutaneous microwave and cryoablation of pulmonary tumors: ablation zones and thoracic lymph nodes

verfasst von: Maria M. Wrobel, Alexis M. Cahalane, Dessislava Pachamanova, Konstantin S. Leppelmann, Stuart G. Silverman, Amita Sharma, Paul B. Shyn, Nathaniel D. Mercaldo, Florian J. Fintelmann

Erschienen in: European Radiology | Ausgabe 12/2022

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Abstract

Objective

To compare temporal changes of ablation zones and lymph nodes following lung microwave ablation (MWA) and cryoablation.

Methods

This retrospective cohort study compared lung ablation zones and thoracic lymph nodes following MWA and cryoablation performed 2006–2020. In the ablation zone cohort, ablation zone volumes were measured on serial CT for 12 months. In the lymph node cohort, the sum of bidimensional products of lymph node diameters was measured before (baseline) and up to 6 months following ablation. Cumulative incidence curves estimated the time to 75% ablation zone reduction and linear mixed-effects regression models compared the temporal distribution of ablation zones and lymph node sizes between modalities.

Results

Ablation zones of 59 tumors treated in 45 sessions (16 MWA, 29 cryoablation) in 36 patients were evaluated. Differences in the time to 75% volume reduction between modalities were not detected. Following MWA, half of the ablation zones required an estimated time of 340 days to achieve a 75% volume reduction compared to 214 days following cryoablation (p = .30). Thoracic lymph node sizes after 33 sessions (13 MWA, 20 cryoablation) differed between modalities (baseline–32 days, p = .01; 32–123 days, p = .001). Following MWA, lymph nodes increased on average by 38 mm² (95%CI, 5.0–70.7; p = .02) from baseline to 32 days, followed by an estimated decrease of 50 mm² (32–123 days; p = .001). Following cryoablation, changes in lymph nodes were not detected (baseline–32 days, p = .33).

Conclusion

The rate of ablation zone volume reduction did not differ between MWA and cryoablation. Thoracic lymph nodes enlarged transiently after MWA but not after cryoablation.

Key Points

• Contrary to current belief, the rate of lung ablation zone volume reduction did not differ between microwave and cryoablation.

• Transient enlargement of thoracic lymph nodes after microwave ablation was not associated with regional tumor spread and decreased within six months following ablation.

• No significant thoracic lymph node enlargement was observed following cryoablation.

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de Baere T, Tselikas L, Woodrum D et al (2015) Evaluating cryoablation of metastatic lung tumors in patients--safety and efficacy: the ECLIPSE trial--interim analysis at 1 year. J Thorac Oncol 10:1468–1474CrossRefPubMed

Moore W, Talati R, Bhattacharji P, Bilfinger T (2015) Five-year survival after cryoablation of stage I non-small cell lung cancer in medically inoperable patients. J Vasc Interv Radiol 26:312–319CrossRefPubMed

Iezzi R, Cioni R, Basile D et al (2020) Standardizing percutaneous microwave ablation in the treatment of lung tumors: a prospective multicenter trial (MALT study). Eur Radiol. https://doi.org/10.1007/s00330-020-07299-2

Palussiere J, Catena V, Buy X (2017) Percutaneous thermal ablation of lung tumors - Radiofrequency, microwave and cryotherapy: where are we going? Diagn Interv Imaging 98:619–625CrossRefPubMed

Leppelmann KS, Levesque VM, Bunck AC et al (2021) Outcomes following percutaneous microwave and cryoablation of lung metastases from adenoid cystic carcinoma of the head and neck: a bi-institutional retrospective cohort study. Ann Surg Oncol 28:5829–5839CrossRefPubMed

Fintelmann FJ, Braun P, Mirzan SH et al (2020) Percutaneous cryoablation: safety and efficacy for pain palliation of metastases to pleura and chest wall. J Vasc Interv Radiol 31:294–300CrossRefPubMed

Dupuy DE (2011) Image-guided thermal ablation of lung malignancies. Radiology 260:633–655CrossRefPubMed

Ito N, Nakatsuka S, Inoue M et al (2012) Computed tomographic appearance of lung tumors treated with percutaneous cryoablation. J Vasc Interv Radiol 23:1043–1052CrossRefPubMed

Chheang S, Abtin F, Guteirrez A, Genshaft S, Suh R (2013) Imaging features following thermal ablation of lung malignancies. Semin Intervent Radiol 30:157–168CrossRefPubMedPubMedCentral

10.

Abtin F, De Baere T, Dupuy DE et al (2019) Updates on current role and practice of lung ablation. J Thorac Imaging 34:266–277CrossRefPubMed

11.

Prud'homme C, Deschamps F, Moulin B et al (2019) Image-guided lung metastasis ablation: a literature review. Int J Hyperthermia 36:37–45CrossRefPubMed

12.

Wei Z, Ye X, Yang X et al (2015) Microwave ablation in combination with chemotherapy for the treatment of advanced non-small cell lung cancer. Cardiovasc Intervent Radiol 38:135–142CrossRefPubMed

13.

Herrera LJ, Fernando HC, Perry Y et al (2003) Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates. J Thorac Cardiovasc Surg 125:929–937CrossRefPubMed

14.

Lyons GR, Askin G, Pua BB (2018) Clinical outcomes after pulmonary cryoablation with the use of a triple freeze protocol. J Vasc Interv Radiol 29:714–721CrossRefPubMed

15.

Vogl TJ, Naguib NN, Gruber-Rouh T, Koitka K, Lehnert T, Nour-Eldin N-EA (2011) Microwave ablation therapy: clinical utility in treatment of pulmonary metastases. Radiology 261:643–651CrossRefPubMed

16.

Al-Hakim RA, Abtin FG, Genshaft SJ, Kutay E, Suh RD (2016) Defining new metrics in microwave ablation of pulmonary tumors: ablation work and ablation resistance score. J Vasc Interv Radiol 27:1380–1386CrossRefPubMed

17.

Deandreis D, Leboulleux S, Dromain C et al (2011) Role of FDG PET/CT and chest CT in the follow-up of lung lesions treated with radiofrequency ablation. Radiology 258:270–276CrossRefPubMed

18.

Abtin FG, Eradat J, Gutierrez AJ, Lee C, Fishbein MC, Suh RD (2012) Radiofrequency ablation of lung tumors: imaging features of the postablation zone. Radiographics 32:947–969CrossRefPubMedPubMedCentral

19.

Sharma A, Digumarthy SR, Kalra MK, Lanuti M, Shepard JA (2010) Reversible locoregional lymph node enlargement after radiofrequency ablation of lung tumors. AJR Am J Roentgenol 194:1250–1256CrossRefPubMed

20.

Wolf FJ, Grand DJ, Machan JT, DiPetrillo TA, Mayo-Smith WW, Dupuy DE (2008) Microwave ablation of lung malignancies: effectiveness, CT findings, and safety in 50 patients. Radiology 247:871–879CrossRefPubMed

21.

Wrobel MM, Bourgouin PP, Abrishami Kashani M et al (2021) Active versus passive thaw following percutaneous cryoablation of pulmonary tumors: effect on incidence, grade, and onset of hemoptysis. AJR Am J Roentgenol. https://doi.org/10.2214/AJR.21.25872

22.

Bourgouin PP, Wrobel MM, Mercaldo ND et al (2021) Comparison of percutaneous image-guided microwave ablation and cryoablation for sarcoma lung metastases: a 10-year experience. AJR Am J Roentgenol. https://doi.org/10.2214/AJR.21.26551:1-11

23.

Ahmed M, Technology Assessment Committee of the Society of Interventional R (2014) Image-guided tumor ablation: standardization of terminology and reporting criteria--a 10-year update: supplement to the consensus document. J Vasc Interv Radiol 25:1706–1708CrossRefPubMed

24.

Hanley JA, Negassa A, Edwardes MD, Forrester JE (2003) Statistical analysis of correlated data using generalized estimating equations: an orientation. Am J Epidemiol 157:364–375CrossRefPubMed

25.

Puijk RS, Ahmed M, Adam A et al (2021) Consensus guidelines for the definition of time-to-event end points in image-guided tumor ablation: results of the SIO and DATECAN initiative. Radiology. https://doi.org/10.1148/radiol.2021203715:203715

26.

Zhao X, Zhao Q, Sun J, Kim JS (2008) Generalized log-rank tests for partly interval-censored failure time data. Biom J 50:375–385CrossRefPubMed

27.

Luke SG (2017) Evaluating significance in linear mixed-effects models in R. Behav Res Methods 49:1494–1502CrossRefPubMed

28.

Koo TK, Li MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 15:155–163CrossRefPubMedPubMedCentral

29.

Das JP, Barry C, Schoder H, Camacho JC, Ginsberg MS, Halpenny DF (2021) Imaging following thermal ablation of early lung cancers: expected post-treatment findings and tumour recurrence. Clin Radiol. https://doi.org/10.1016/j.crad.2021.07.009

30.

Ahrar K, Tam AL, Kuban JD, Wu CC (2021) Imaging of the thorax after percutaneous thermal ablation of lung malignancies. Clin Radiol. https://doi.org/10.1016/j.crad.2021.07.007

31.

Wang H, Littrup PJ, Duan Y, Zhang Y, Feng H, Nie Z (2005) Thoracic masses treated with percutaneous cryotherapy: initial experience with more than 200 procedures. Radiology 235:289–298CrossRefPubMed

32.

Riquet M, Hidden G, Debesse B (1989) Direct lymphatic drainage of lung segments to the mediastinal nodes. J Thoracic Cardiovasc Surg 97:623–632CrossRef

Titel: Comparison of expected imaging findings following percutaneous microwave and cryoablation of pulmonary tumors: ablation zones and thoracic lymph nodes
verfasst von: Maria M. Wrobel
Alexis M. Cahalane
Dessislava Pachamanova
Konstantin S. Leppelmann
Stuart G. Silverman
Amita Sharma
Paul B. Shyn
Nathaniel D. Mercaldo
Florian J. Fintelmann
Publikationsdatum: 15.06.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 12/2022
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-022-08905-1

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Comparison of expected imaging findings following percutaneous microwave and cryoablation of pulmonary tumors: ablation zones and thoracic lymph nodes