link
Bookmarks
Ablation Procedures
Sonia L. Betancourt-Cuellar, MD
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Subscribe
0
0
3
0

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Thermal ablation (TA)
                • Radiofrequency ablation (RFA)
                • Microwave ablation (MWA)
              • Cryoablation (CA)
            • Synonyms

              • Percutaneous lung ablation
            • Definitions

              • TATissue injury produced by increased tissue temperature: Used to treat limited-stage lung malignancy in medically inoperable patients, oligometastases (< 3-5) and recurrent malignancy after radiation or surgery; CT and CT fluoroscopy used for percutaneous probe placement
                • Heat sink: Cooling effect of flowing blood and air in well-perfused lung may lower ablation temperature and impair tumor destruction
                • RFA
                  • Uses electrical current system
                  • Current frequency: 400-500 kHz
                  • Single treatment typically lasts 10-12 minutes
                  • Tissue heating ≥ 60°C → protein denaturation → cell death
                  • Treatment time 12-15 minutes
                • MWA
                  • Uses electromagnetic radiation
                  • Frequency: 915 MHz to 2.45 GHz; generates higher temperatures
                  • Single treatment typically lasts 10 minutes
                  • Treatment time 2-5 minutes
              • CA: Uses compressed argon gas to induce intracellular ice formation and extracellular ice crystals
                • Temperatures as low as -140°C within extracellular space → cell dehydration → cell membrane rupture → cell death
                • Ice ball may be imaged with CT during procedure; allows assessment of treatment zone
                • Longer procedure time: Freeze-thaw cycles

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      • Nuclear Medicine Findings

                        • Image-Guided Biopsy

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          Selected References

                                          1. Halpenny D et al: Imaging of novel oncologic treatments in lung cancer part 2: local ablative therapies. J Thorac Imaging. 35(1):37-48, 2020
                                          2. Abtin F et al: Updates on current role and practice of lung ablation. J Thorac Imaging. 34(4):266-77, 2019
                                          3. Palussière J et al: Radiofrequency ablation of stage IA non-small cell lung cancer in patients ineligible for surgery: results of a prospective multicenter phase II trial. J Cardiothorac Surg. 13(1):91, 2018
                                          4. Yao W et al: Comparison between microwave ablation and lobectomy for stage I non-small cell lung cancer: a propensity score analysis. Int J Hyperthermia. 34(8):1329-36, 2018
                                          5. Chou H et al: Percutaneous cryoablation for inoperable malignant lung tumors: Midterm results. Cryobiology. 70(1):60-5, 2014
                                          6. Hinshaw JL et al: Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation--what should you use and why? Radiographics. 34(5):1344-62, 2014
                                          Related Anatomy
                                          Loading...
                                          Related Differential Diagnoses
                                          Loading...
                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Thermal ablation (TA)
                                                        • Radiofrequency ablation (RFA)
                                                        • Microwave ablation (MWA)
                                                      • Cryoablation (CA)
                                                    • Synonyms

                                                      • Percutaneous lung ablation
                                                    • Definitions

                                                      • TATissue injury produced by increased tissue temperature: Used to treat limited-stage lung malignancy in medically inoperable patients, oligometastases (< 3-5) and recurrent malignancy after radiation or surgery; CT and CT fluoroscopy used for percutaneous probe placement
                                                        • Heat sink: Cooling effect of flowing blood and air in well-perfused lung may lower ablation temperature and impair tumor destruction
                                                        • RFA
                                                          • Uses electrical current system
                                                          • Current frequency: 400-500 kHz
                                                          • Single treatment typically lasts 10-12 minutes
                                                          • Tissue heating ≥ 60°C → protein denaturation → cell death
                                                          • Treatment time 12-15 minutes
                                                        • MWA
                                                          • Uses electromagnetic radiation
                                                          • Frequency: 915 MHz to 2.45 GHz; generates higher temperatures
                                                          • Single treatment typically lasts 10 minutes
                                                          • Treatment time 2-5 minutes
                                                      • CA: Uses compressed argon gas to induce intracellular ice formation and extracellular ice crystals
                                                        • Temperatures as low as -140°C within extracellular space → cell dehydration → cell membrane rupture → cell death
                                                        • Ice ball may be imaged with CT during procedure; allows assessment of treatment zone
                                                        • Longer procedure time: Freeze-thaw cycles

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              • Nuclear Medicine Findings

                                                                • Image-Guided Biopsy

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  Selected References

                                                                                  1. Halpenny D et al: Imaging of novel oncologic treatments in lung cancer part 2: local ablative therapies. J Thorac Imaging. 35(1):37-48, 2020
                                                                                  2. Abtin F et al: Updates on current role and practice of lung ablation. J Thorac Imaging. 34(4):266-77, 2019
                                                                                  3. Palussière J et al: Radiofrequency ablation of stage IA non-small cell lung cancer in patients ineligible for surgery: results of a prospective multicenter phase II trial. J Cardiothorac Surg. 13(1):91, 2018
                                                                                  4. Yao W et al: Comparison between microwave ablation and lobectomy for stage I non-small cell lung cancer: a propensity score analysis. Int J Hyperthermia. 34(8):1329-36, 2018
                                                                                  5. Chou H et al: Percutaneous cryoablation for inoperable malignant lung tumors: Midterm results. Cryobiology. 70(1):60-5, 2014
                                                                                  6. Hinshaw JL et al: Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation--what should you use and why? Radiographics. 34(5):1344-62, 2014