The value of Cone-Beam CT-guided radiofrequency ablation in the treatment of pulmonary malignancies (≤3 cm)

Abstract

The aim of this study is to explore the safety and efficacy of Cone-Beam computed tomography (CBCT) guided radiofrequency ablation (RFA) in the treatment of pulmonary malignancies. Thirty-one patients with pulmonary malignant tumors (≤3 cm in diameter) were enrolled to this study. Total 43 CBCT guided RFA treatments were performed, including 7 patients undergoing multiple treatments. The target tumor puncture success rate, tumor remission rate, postoperative cumulative survival rate, tumor-free survival rate and complication rate were analyzed. All 43 CBCT guided RFA procedures successfully punctured the target tumors. Complications included five cases of pneumothorax and three cases of hemoptysis. For the 31 patients who underwent CBCT guided RFA, the 1- and 2-year cumulative survival rates were 80.6 and 54.8%, respectively. The 1- and 2-year disease-free survival rates were 54.8 and 32.3%, respectively. The 1-, 3- and 6-month remission rates were 78.4, 68.7 and 63.3%, respectively. The average cumulative radiation dose and average effective radiation dose were 194.62 ± 105.51 mGy and 5.41 ± 3.45 mSv, respectively. CBCT help to shorten the operation time, reduce the unnecessary interventions and also reduce the incidence of complications. CBCT guided RFA is one safe and efficacious treatment for pulmonary malignancies.

Radiofrequency ablation guided by cone beam computed tomography for hepatocellular carcinoma: a comparative study of clinical results with the conventional spiral computed tomography-guided procedure

“…In this current study, the mean ± SD cumulative radiation dose of the CBCT group was 243.6 ± 192.6 mGy and the mean ± SD DLP of the s-CT group was 2317 ± 1292 mGycm. According to a previous study, 15 when using CBCT for image guidance, the cumulative radiation dose was 194.62 ± 105.51 mGy, which was similar to this current study. The total operation time of the CBCT group was significantly longer than that of the s-CT group.…”

“…In recent years, RFA guided by CBCT has received increasing attention and application, showing unique technical advantages compared with s-CT guidance, but few published studies have reported on the difference between the two image-guiding modalities, especially in liver cancer. 13–15…”

Complications after 100 sessions of cone-beam computed tomography-guided lung radiofrequency ablation: a single-center, retrospective experience

“…The constant control of the full length of the electrode using fluoroscopy may reduce complications such as pneumothorax. Although the number of samples was small, the frequency of pneumothorax was 11.6% to 12.5% in recent studies on CBCT-guided lung RFA [13,14].…”

“…CBCT has been used for guiding transthoracic procedures such as biopsy and thermal ablation [8][9][10][11][12][13][14]. Some studies reported that there was no significant difference in complications between the CBCT group and MDCT or MDCT-fluoroscopy group for percutaneous transthoracic lung biopsy [10,11].…”

“…However, the reported studies mainly addressed complications of lung RFA using conventional MDCT or MDCT-fluoroscopy. There exist only a few studies on lung RFA under CBCT guidance, and these studies were limited to specific groups or involved small samples [12][13][14]. Therefore, it is difficult to establish a clear true complication rate of the CBCT-guided lung RFA.…”