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Erschienen in: CardioVascular and Interventional Radiology 1/2008

01.01.2008 | Clinical Investigation

Frequency and Risk Factors of Various Complications After Computed Tomography–Guided Radiofrequency Ablation of Lung Tumors

verfasst von: Tomohisa Okuma, Toshiyuki Matsuoka, Akira Yamamoto, Yoshimasa Oyama, Masami Toyoshima, Kenji Nakamura, Yuichi Inoue

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 1/2008

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Abstract

Objective

To retrospectively determine the frequency and risk factors of various side effects and complications after percutaneous computed tomography–guided radiofrequency (RF) ablation of lung tumors.

Methods

We reviewed and analyzed records of 112 treatment sessions in 57 of our patients (45 men and 12 women) with unresectable lung tumors treated by ablation. Risk factors, including sex, age, tumor diameter, tumor location, history of surgery, presence of pulmonary emphysema, electrode gauge, array diameter, patient position, maximum power output, ablation time, and minimum impedance during ablation, were analyzed using univariate and multivariate analyses.

Results

Total rates of side effects and minor and major complications occurred in 17%, 50%, and 8% of treatment sessions, respectively. Side effects, including pain during ablation (46% of sessions) and pleural effusion (13% of sessions), occurred with RF ablation. Minor complications, including pneumothorax not requiring chest tube drainage (30% of sessions), subcutaneous emphysema (16% of sessions), and hemoptysis (9% of sessions) also occurred after the procedure. Regarding major complications, three patients developed fever >38.5°C; three patients developed abscesses; two patients developed pneumothorax requiring chest tube insertion; and one patient had air embolism and was discharged without neurologic deficit. Univariate and multivariate analyses suggested that a lesion located ≤1 cm of the chest wall was significantly related to pain (p < 0.01, hazard index 5.76). Risk factors for pneumothorax increased significantly with previous pulmonary surgery (p < 0.05, hazard index 6.1) and presence of emphysema (p <0.01, hazard index 13.6).

Conclusion

The total complication rate for all treatment sessions was 58%, and 25% of patients did not have any complications after RF ablation. Although major complications can occur, RF ablation of lung tumors can be considered a safe and minimally invasive procedure.
Literatur
1.
Zurück zum Zitat Gazelle GS, Goldberg SN, Solbiati L, et al. (2000) Tumor ablation with radiofrequency energy. Radiology 217:633–646PubMed Gazelle GS, Goldberg SN, Solbiati L, et al. (2000) Tumor ablation with radiofrequency energy. Radiology 217:633–646PubMed
2.
Zurück zum Zitat Dupuy DE, Goldberg SN (2001) Image-guided radiofrequency tumor ablation: Challenges and opportunities―Part 2. J Vasc Interv Radiol 12:1135–1148PubMedCrossRef Dupuy DE, Goldberg SN (2001) Image-guided radiofrequency tumor ablation: Challenges and opportunities―Part 2. J Vasc Interv Radiol 12:1135–1148PubMedCrossRef
3.
Zurück zum Zitat Dupuy DE, Zagoria RJ, Akerley W, et al. (2000) Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 174:57–59PubMed Dupuy DE, Zagoria RJ, Akerley W, et al. (2000) Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 174:57–59PubMed
4.
Zurück zum Zitat Nishida T, Inoue K, Kawata Y, et al. (2002) Percutaneous radiofrequency ablation of lung neoplasms: A minimally invasive strategy for inoperable patients. J Am Coll Surg 195:426–430PubMedCrossRef Nishida T, Inoue K, Kawata Y, et al. (2002) Percutaneous radiofrequency ablation of lung neoplasms: A minimally invasive strategy for inoperable patients. J Am Coll Surg 195:426–430PubMedCrossRef
5.
Zurück zum Zitat Steinke K, King J, Glenn D, et al. (2003) Radiologic appearance and complications of percutaneous computed tomography-guided radiofrequency-ablated pulmonary metastases from colorectal carcinoma. J Comput Assist Tomogr 27:750–757PubMedCrossRef Steinke K, King J, Glenn D, et al. (2003) Radiologic appearance and complications of percutaneous computed tomography-guided radiofrequency-ablated pulmonary metastases from colorectal carcinoma. J Comput Assist Tomogr 27:750–757PubMedCrossRef
6.
Zurück zum Zitat Akeboshi M, Yamakado K, Nakatsuka A, et al. (2004) Percutaneous radiofrequency ablation of lung neoplasms: Initial therapeutic response. J Vasc Interv Radiol 15:463–470PubMed Akeboshi M, Yamakado K, Nakatsuka A, et al. (2004) Percutaneous radiofrequency ablation of lung neoplasms: Initial therapeutic response. J Vasc Interv Radiol 15:463–470PubMed
7.
Zurück zum Zitat Yamagami T, Kato T, Hirota T, et al. (2006) Pneumothorax as a complication of percutaneous radiofrequency ablation for lung neoplasms. J Vasc Interv Radiol 17:1625–1629PubMed Yamagami T, Kato T, Hirota T, et al. (2006) Pneumothorax as a complication of percutaneous radiofrequency ablation for lung neoplasms. J Vasc Interv Radiol 17:1625–1629PubMed
8.
Zurück zum Zitat Hiraki T, Tajiri N, Mimura H, et al. (2006) Pneumothorax, pleural effusion and chest tube placement after radiofrequency ablation of lung tumors: Incidence and risk factors. Radiology 241:275–273PubMedCrossRef Hiraki T, Tajiri N, Mimura H, et al. (2006) Pneumothorax, pleural effusion and chest tube placement after radiofrequency ablation of lung tumors: Incidence and risk factors. Radiology 241:275–273PubMedCrossRef
9.
Zurück zum Zitat Rose SC, Thistlethwaite PA, Sewell PE, et al. (2006) Lung cancer and radiofrequency ablation. J Vasc Interv Radiol 17:927–951PubMedCrossRef Rose SC, Thistlethwaite PA, Sewell PE, et al. (2006) Lung cancer and radiofrequency ablation. J Vasc Interv Radiol 17:927–951PubMedCrossRef
10.
Zurück zum Zitat Goldberg SN, Grassi CJ, Cardell JF, et al. (2005) Image-guided tumor ablation: Standardization of terminology and reporting criteria. Radiology 235:728–739PubMedCrossRef Goldberg SN, Grassi CJ, Cardell JF, et al. (2005) Image-guided tumor ablation: Standardization of terminology and reporting criteria. Radiology 235:728–739PubMedCrossRef
11.
Zurück zum Zitat Hoffmann RT, Jakobs TF, Lubienski A, et al. (2006) Percutaneous radiofrequency ablation of pulmonary tumors―Is there a difference between treatment under general anaesthesia and under conscious sedation? Eur J Radiol 59:168–174PubMedCrossRef Hoffmann RT, Jakobs TF, Lubienski A, et al. (2006) Percutaneous radiofrequency ablation of pulmonary tumors―Is there a difference between treatment under general anaesthesia and under conscious sedation? Eur J Radiol 59:168–174PubMedCrossRef
12.
Zurück zum Zitat Yasui K, Kanazawa S, Sano Y, et al. (2004) Thoracic tumors treated with CT-guided radiofrequency ablation: Initial experience. Radiology 231:850–857PubMedCrossRef Yasui K, Kanazawa S, Sano Y, et al. (2004) Thoracic tumors treated with CT-guided radiofrequency ablation: Initial experience. Radiology 231:850–857PubMedCrossRef
13.
Zurück zum Zitat Westcott JL, Rao N, Colley DP (1997) Transthoracic needle biopsy of small pulmonary nodules. Radiology 202:97–103PubMed Westcott JL, Rao N, Colley DP (1997) Transthoracic needle biopsy of small pulmonary nodules. Radiology 202:97–103PubMed
14.
Zurück zum Zitat Covey AM, Gandhi R, Brody LA, et al. (2004) Factors associated with pneumothorax and pneumothorax requiring treatment after percutaneous lung biopsy in 443 consecutive patients. J Vasc Interv Radiol 15:479–483PubMed Covey AM, Gandhi R, Brody LA, et al. (2004) Factors associated with pneumothorax and pneumothorax requiring treatment after percutaneous lung biopsy in 443 consecutive patients. J Vasc Interv Radiol 15:479–483PubMed
15.
Zurück zum Zitat Saji H, Nakamura H, Tsuchida T, et al. (2002) The incidence and the risk of pneumothorax and chest tube placement after percutaneous CT-guided lung biopsy. Chest 121:1251–1526CrossRef Saji H, Nakamura H, Tsuchida T, et al. (2002) The incidence and the risk of pneumothorax and chest tube placement after percutaneous CT-guided lung biopsy. Chest 121:1251–1526CrossRef
16.
Zurück zum Zitat Kazerooni EA, Lim FT, Mikhail A, Martinez FJ (1996) Risk of pneumothorax in CT-guided transthoracic needle aspiration biopsy of the lung. Radiology 198:371–375PubMed Kazerooni EA, Lim FT, Mikhail A, Martinez FJ (1996) Risk of pneumothorax in CT-guided transthoracic needle aspiration biopsy of the lung. Radiology 198:371–375PubMed
17.
Zurück zum Zitat Laurent F, Michel P, Latrabe V, et al. (1999) Pneumothoraces and chest tube placement after CT-guided transthoracic lung biopsy using a coaxial technique: Incidence and risk factors. AJR Am J Roentgenol 172:1049–1053PubMed Laurent F, Michel P, Latrabe V, et al. (1999) Pneumothoraces and chest tube placement after CT-guided transthoracic lung biopsy using a coaxial technique: Incidence and risk factors. AJR Am J Roentgenol 172:1049–1053PubMed
18.
Zurück zum Zitat Yeow KM, Su IH, Pan KT, et al. (2004) Risk factors of pneumothorax and bleeding: Multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest 126:748–754PubMedCrossRef Yeow KM, Su IH, Pan KT, et al. (2004) Risk factors of pneumothorax and bleeding: Multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest 126:748–754PubMedCrossRef
19.
Zurück zum Zitat Jin GY, Lee JM, Lee YC, et al. (2004) Primary and secondary lung malignancies treated with percutaneous radiofrequency ablation: evaluation with follow-up helical CT. AJR Am J Roentgenol 183:1013–1020PubMed Jin GY, Lee JM, Lee YC, et al. (2004) Primary and secondary lung malignancies treated with percutaneous radiofrequency ablation: evaluation with follow-up helical CT. AJR Am J Roentgenol 183:1013–1020PubMed
20.
Zurück zum Zitat Lee JM, Jin GY, Goldberg SN, et al. (2004) Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: Preliminary report. Radiology 230:125–134PubMedCrossRef Lee JM, Jin GY, Goldberg SN, et al. (2004) Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: Preliminary report. Radiology 230:125–134PubMedCrossRef
21.
Zurück zum Zitat Suh RD, Wallace AB, Sheehan RE, et al. (2003) Unresectable pulmonary malignancies: CT-guided percutaneous radiofrequency ablation-preliminary results. Radiology 229:821–829PubMedCrossRef Suh RD, Wallace AB, Sheehan RE, et al. (2003) Unresectable pulmonary malignancies: CT-guided percutaneous radiofrequency ablation-preliminary results. Radiology 229:821–829PubMedCrossRef
22.
Zurück zum Zitat Gadaleta C, Mattioli V, Colucci G, et al. (2004) Radiofrequency ablation of 40 lung neoplasms: Preliminary results. AJR Am J Roentgenol 183:361–368PubMed Gadaleta C, Mattioli V, Colucci G, et al. (2004) Radiofrequency ablation of 40 lung neoplasms: Preliminary results. AJR Am J Roentgenol 183:361–368PubMed
23.
Zurück zum Zitat Belfiore G, Moggio G, Tedeschi E, et al. (2004) CT-guided radiofrequency ablation: A potential complementary therapy for patients with unresectable primary lung cancer―A preliminary report of 33 patients. AJR Am J Roentgenol 183:1003–1011PubMed Belfiore G, Moggio G, Tedeschi E, et al. (2004) CT-guided radiofrequency ablation: A potential complementary therapy for patients with unresectable primary lung cancer―A preliminary report of 33 patients. AJR Am J Roentgenol 183:1003–1011PubMed
24.
Zurück zum Zitat de Baere T, Palussiere J, Auperin A, et al. (2006) Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: Prospective evaluation. Radiology 240:587–596PubMedCrossRef de Baere T, Palussiere J, Auperin A, et al. (2006) Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: Prospective evaluation. Radiology 240:587–596PubMedCrossRef
25.
Zurück zum Zitat Bojarski JD, Dupuy DE, Mayo-Smith WW (2005) CT imaging findings of pulmonary neoplasms after treatment with radiofrequency ablation: Results in 32 tumors. AJR Am J Roentgenol 185:466–471PubMed Bojarski JD, Dupuy DE, Mayo-Smith WW (2005) CT imaging findings of pulmonary neoplasms after treatment with radiofrequency ablation: Results in 32 tumors. AJR Am J Roentgenol 185:466–471PubMed
26.
Zurück zum Zitat Herrera LJ, Fernando HC, Perry Y, et al. (2003) Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates. J Thorac Cardiovasc Surg 125:929–937PubMedCrossRef Herrera LJ, Fernando HC, Perry Y, et al. (2003) Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates. J Thorac Cardiovasc Surg 125:929–937PubMedCrossRef
27.
Zurück zum Zitat Ghaye B, Bruyere PJ, Dondelinger RF (2006) Nonfetal systematic air embolism during percutaneous radiofrequency ablation of a pulmonary metastasis. AJR Am J Roentgenol 187:W327–W328PubMedCrossRef Ghaye B, Bruyere PJ, Dondelinger RF (2006) Nonfetal systematic air embolism during percutaneous radiofrequency ablation of a pulmonary metastasis. AJR Am J Roentgenol 187:W327–W328PubMedCrossRef
28.
Zurück zum Zitat Okuma T, Matsuoka T, Tutumi S, et al. (2007) Air embolism during needle placement for CT-guided radiofrequency ablation for unresectable lung metastatic lesion. J Vasc Interv Radiol [in press] Okuma T, Matsuoka T, Tutumi S, et al. (2007) Air embolism during needle placement for CT-guided radiofrequency ablation for unresectable lung metastatic lesion. J Vasc Interv Radiol [in press]
29.
Zurück zum Zitat Okuma T, Matsuoka T, Yamamoto A, et al. (2007) Factors contributing to cavitation after computed tomography-guided percutaneous radiofrequency ablation for lung tumors. J Vasc Interv Radiol 18:399–404PubMedCrossRef Okuma T, Matsuoka T, Yamamoto A, et al. (2007) Factors contributing to cavitation after computed tomography-guided percutaneous radiofrequency ablation for lung tumors. J Vasc Interv Radiol 18:399–404PubMedCrossRef
30.
Zurück zum Zitat Yamakado K, Akeboshi M, Nakatsuka A, et al. (2005) Tumor seeding following lung radiofrequency ablation: A case report. Cardiovasc Interv Radiol 28:530–532CrossRef Yamakado K, Akeboshi M, Nakatsuka A, et al. (2005) Tumor seeding following lung radiofrequency ablation: A case report. Cardiovasc Interv Radiol 28:530–532CrossRef
31.
Zurück zum Zitat Vaughn C, Mychaskiw G, Swell P (2002) Massive hemorrhage during radiofrequency ablation of pulmonary neoplasm. Anesth Analg 94:1149–1151PubMedCrossRef Vaughn C, Mychaskiw G, Swell P (2002) Massive hemorrhage during radiofrequency ablation of pulmonary neoplasm. Anesth Analg 94:1149–1151PubMedCrossRef
32.
Zurück zum Zitat Jin GY, Lee JM, Lee YC, Han YM (2004) Acute cerebral infarction after radiofrequency ablation of an atypical carcinoid pulmonary tumor. AJR Am J Roentgenol 182:990–992PubMed Jin GY, Lee JM, Lee YC, Han YM (2004) Acute cerebral infarction after radiofrequency ablation of an atypical carcinoid pulmonary tumor. AJR Am J Roentgenol 182:990–992PubMed
33.
Zurück zum Zitat Fernando HC, De Hoyos A, Landreneau RJ, et al. (2005) Radiofrequency ablation for the treatment of non-small cell lung cancer in marginal surgical candidates. J Thorac Cardiovasc Surg 129:639–644PubMedCrossRef Fernando HC, De Hoyos A, Landreneau RJ, et al. (2005) Radiofrequency ablation for the treatment of non-small cell lung cancer in marginal surgical candidates. J Thorac Cardiovasc Surg 129:639–644PubMedCrossRef
34.
Zurück zum Zitat Steinke K, King J, Glenn DW, et al. (2004) Percutaneous radiofrequency ablation of lung tumors with expandable needle electrodes: Tips from preliminary experience. AJR Am J Roentgenol 183:605–611PubMed Steinke K, King J, Glenn DW, et al. (2004) Percutaneous radiofrequency ablation of lung tumors with expandable needle electrodes: Tips from preliminary experience. AJR Am J Roentgenol 183:605–611PubMed
Metadaten
Titel
Frequency and Risk Factors of Various Complications After Computed Tomography–Guided Radiofrequency Ablation of Lung Tumors
verfasst von
Tomohisa Okuma
Toshiyuki Matsuoka
Akira Yamamoto
Yoshimasa Oyama
Masami Toyoshima
Kenji Nakamura
Yuichi Inoue
Publikationsdatum
01.01.2008
Verlag
Springer-Verlag
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 1/2008
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-007-9225-0

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