Laser ablation of lung metastases: results according to diameter and location

Abstract

Lung tumour ablation with a thin-calibre laser applicator system was evaluated. We quantified feasibility, technical success and complication rates in relation to lesion diameter and location. Forty-two patients with 64 lung tumours were treated (39 patients with metastases and three with primary tumours). Mean follow-up was 7.6 months (range 6 weeks to 39 months). Eighty-six percent of treatments were technically successful in the first session. Pneumothorax was the main complication and occurred in 50% of the first 20 patients and in 35% of the rest. Two patients required a chest tube. Fourteen lesions were central and 50 were peripheral. It took several weeks for the effect of the therapy to become apparent on follow-up CT. Thirty-nine percent of all lesions increased in size immediately after treatment. Gross reduction in size with scar formation was seen in 50% of the lesions and cavitation in 13%. Local tumour control was achieved in 51 lesions. Progression after therapy was seen in 9% of lesions <1.5 cm but in more than 11% of larger lesions. Progression was also more frequent in lesions located in the basal parts of the lung (47%). Sixteen patients died due to systemic progression. Our results suggest that successful laser ablation of lung lesions is possible with a miniaturized applicator.

Safety and efficacy of thermal ablation for subpleural lung cancers

“…Phrenic nerve injury was assumed as the cause of increased diaphragmatic level after ablation, while injury to the recurrent laryngeal nerve results in a hoarse voice or a brassy cough . Tumors located in the basal parts of the lungs were the most difficult to successfully ablate because of the greatest excursions during the respiratory cycle . In our study, the successful ablation rate was 71.4%, which was lower than in other locations.…”

Interstitial laser-induced thermotherapy of the lung: evaluation of the influence of ablation continuity on ablation size in a swine model

“…However, statistical analysis did not show a significant effect of pleural contact of the ablation zones with respect to diameter, length or volume in our study. In addition, no statistically significant difference in progress between central and peripheral lesions has been reported in laser ablation of lung metastases [ 5 ] . The lack of randomization has to be considered as a further limitation, because the continuous and intermittent laser ablation protocols were applied in different pigs instead of applying both protocols in one pig.…”

Assessing Early Vascular Changes and Treatment Response After Laser-Induced Thermotherapy of Pulmonary Metastases With Perfusion CT: Initial Experience

“…Decreasing enhancement of the lesion on contrast-enhanced CT images obtained immediately after ablation and during follow-up suggests that measurement of tumor vascularization might be a promising tool for the evaluation of the early effects of treatment after laser ablation [5,6].…”

“…The vascular changes were spatially heterogeneous. One day after treatment, native CT images showed typical enlargement of the ablation zone surrounded by ground-glass opacity [5,8]. However, in the color parametric maps, the center of the ablation zone-that is, the coagulation zoneshowed little perfusion, but the periablational …”