CT-guided thin needles percutaneous cryoablation (PCA) in patients with primary and secondary lung tumors: A preliminary experience

Percutaneous cryoablation for inoperable malignant lung tumors: Midterm results

“…Even though few reports revealed lung RFA resulting in pseudoaneurysm formation and massive hemoptysis [33], hemoptysis rate is higher in cryoablation (37-62%) than in heat-based ablation such as RFA or microwave ablation (0-16%) [29]. Interestingly, presence of hemoptysis had better LTC rate than those without hemoptysis in our current study, we speculated that this might indicate the complete necrosis and expelling of the ablated tumor [25,35]. Therefore, hemorrhage and moderate bleeding could be the common complications of PC for concern, the remaining vessels in the ablation region are eventually destroyed by cascading inflammation, ischemia, apoptosis, and coagulating necrosis in about 2 weeks [19].…”

“…Patients with COPD and diabetes mellitus have more hemothorax rate in our study (p = 0.042 and 0.031), which may need further evaluation to explore whether there is causal relationship [6,26]. Pleural effusion occurred in more than half of sessions (56% vs. 14-70% in other studies) [25,34], but most of them were minor which further intervention was not needed. Tumor size is an important factor in local tumor treatment, and LTC is significantly increased with size less than 2 cm in diameter [35].…”

“…The complications were classified with Common Terminology Criteria for Adverse Events (CTCAE) v.4.0. Local tumor progression was recorded either when the size meet progression criteria of Response Evaluation Criteria in Solid Tumors (RECIST) v.1.1 or tumor enhancement with at least increase 15 Hounsfield Units (HU) between pre-and post-contrast phases of CT scan for curative intent cases [13,24,25]. Radiographic evaluation was reviewed by two radiologists who had more than 6 years' experiences in thoracic imaging.…”

CT-guided percutaneous cryoablation of central lung tumors

“…Prior reports have focused on the feasibility, safety, and local control rate of CT-guided cryoablation of lung tumors in general; however, these reports provided no detailed information regarding tumor location and did not discuss the issues relevant to the treatment of central tumors (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Wang et al (19) placed straight cryoablation applicators into tumors tandem to a guidance needle outside the CT gantry, as their CT gantry could not accommodate the entire length of straight cryoablation applicators.…”

“…Heat-based ablation methods may not be safe in the treatment of central lung tumors because of a possibility of bronchial disruption or perforation, which may result in bronchopleural fistula formation (19). Although cryoablation has been used to treat lung malignancies (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31), there are limited data on the safety and effectiveness of percutaneous cryoablation of central lung tumors. In this study, we describe our experience with CT-guided percutaneous cryoablation of central lung tumors and the role of ice ball monitoring.…”