Transosseous route for CT fluoroscopy-guided radiofrequency ablation of lung tumors

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Abstract

Purpose To retrospectively evaluate radiofrequency (RF) ablation of lung tumors performed via the transosseous approach. Materials and Methods Twelve lung tumors (mean diameter, 1.0 cm; range, 0.4-1.6 cm) in 12 patients were treated by RF ablation via a transscapular and/or transrib route with the use of a bone biopsy needle under computed tomographic fluoroscopy guidance. Therapeutic outcomes evaluated included feasibility, safety, and local efficacy. Complications were assessed based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Results The transosseous route was successfully employed in all patients, and the electrode was successfully advanced into all tumors with this approach. The mean distance of penetrated bone was 0.57 cm (range, 0.19-1.16 cm). Complications occurred in eight RF ablation sessions, including six grade 1 events (two cases of pneumothorax and one case each of asymptomatic rib fracture 6 mo after treatment, neuralgia, pulmonary hemorrhage, and hemothorax), two grade 2 events (pneumonia and high fever), and one grade 3 event (pneumothorax requiring pleurodesis). No adverse events of grade ≥ 4 occurred. The mean and median tumor follow-up periods were 19.5 and 15.2 mo (range, 3.0-41.5 mo). Local progression occurred in two cases at 3 and 12 mo after treatment and was successfully treated with a second RF ablation procedure. The technique efficacy rates were 91.7% at 6 mo, 81.5% at 1 y, and 81.5% at 2 y. Conclusions The transosseous approach was feasible in computed tomographic fluoroscopy-guided RF ablation of select lung tumors when no other option was available.

Original languageEnglish
Pages (from-to)1694-1698
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume26
Issue number11
DOIs
Publication statusPublished - Nov 1 2015

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Fluoroscopy
Lung
Pneumothorax
Neoplasms
Pleurodesis
Rib Fractures
Hemothorax
Bone and Bones
National Cancer Institute (U.S.)
Neuralgia
Needle Biopsy
Terminology
Pneumonia
Electrodes
Fever
Therapeutics
Hemorrhage
Safety

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{be0c5f6f247f4bc08775f129e6c1dd0a,
title = "Transosseous route for CT fluoroscopy-guided radiofrequency ablation of lung tumors",
abstract = "Purpose To retrospectively evaluate radiofrequency (RF) ablation of lung tumors performed via the transosseous approach. Materials and Methods Twelve lung tumors (mean diameter, 1.0 cm; range, 0.4-1.6 cm) in 12 patients were treated by RF ablation via a transscapular and/or transrib route with the use of a bone biopsy needle under computed tomographic fluoroscopy guidance. Therapeutic outcomes evaluated included feasibility, safety, and local efficacy. Complications were assessed based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Results The transosseous route was successfully employed in all patients, and the electrode was successfully advanced into all tumors with this approach. The mean distance of penetrated bone was 0.57 cm (range, 0.19-1.16 cm). Complications occurred in eight RF ablation sessions, including six grade 1 events (two cases of pneumothorax and one case each of asymptomatic rib fracture 6 mo after treatment, neuralgia, pulmonary hemorrhage, and hemothorax), two grade 2 events (pneumonia and high fever), and one grade 3 event (pneumothorax requiring pleurodesis). No adverse events of grade ≥ 4 occurred. The mean and median tumor follow-up periods were 19.5 and 15.2 mo (range, 3.0-41.5 mo). Local progression occurred in two cases at 3 and 12 mo after treatment and was successfully treated with a second RF ablation procedure. The technique efficacy rates were 91.7{\%} at 6 mo, 81.5{\%} at 1 y, and 81.5{\%} at 2 y. Conclusions The transosseous approach was feasible in computed tomographic fluoroscopy-guided RF ablation of select lung tumors when no other option was available.",
author = "Toshihiro Iguchi and Takao Hiraki and Hiroaki Ishii and Hideo Gobara and Hiroyasu Fujiwara and Yusuke Matsui and Susumu Kanazawa",
year = "2015",
month = "11",
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doi = "10.1016/j.jvir.2015.08.012",
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pages = "1694--1698",
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T1 - Transosseous route for CT fluoroscopy-guided radiofrequency ablation of lung tumors

AU - Iguchi, Toshihiro

AU - Hiraki, Takao

AU - Ishii, Hiroaki

AU - Gobara, Hideo

AU - Fujiwara, Hiroyasu

AU - Matsui, Yusuke

AU - Kanazawa, Susumu

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Purpose To retrospectively evaluate radiofrequency (RF) ablation of lung tumors performed via the transosseous approach. Materials and Methods Twelve lung tumors (mean diameter, 1.0 cm; range, 0.4-1.6 cm) in 12 patients were treated by RF ablation via a transscapular and/or transrib route with the use of a bone biopsy needle under computed tomographic fluoroscopy guidance. Therapeutic outcomes evaluated included feasibility, safety, and local efficacy. Complications were assessed based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Results The transosseous route was successfully employed in all patients, and the electrode was successfully advanced into all tumors with this approach. The mean distance of penetrated bone was 0.57 cm (range, 0.19-1.16 cm). Complications occurred in eight RF ablation sessions, including six grade 1 events (two cases of pneumothorax and one case each of asymptomatic rib fracture 6 mo after treatment, neuralgia, pulmonary hemorrhage, and hemothorax), two grade 2 events (pneumonia and high fever), and one grade 3 event (pneumothorax requiring pleurodesis). No adverse events of grade ≥ 4 occurred. The mean and median tumor follow-up periods were 19.5 and 15.2 mo (range, 3.0-41.5 mo). Local progression occurred in two cases at 3 and 12 mo after treatment and was successfully treated with a second RF ablation procedure. The technique efficacy rates were 91.7% at 6 mo, 81.5% at 1 y, and 81.5% at 2 y. Conclusions The transosseous approach was feasible in computed tomographic fluoroscopy-guided RF ablation of select lung tumors when no other option was available.

AB - Purpose To retrospectively evaluate radiofrequency (RF) ablation of lung tumors performed via the transosseous approach. Materials and Methods Twelve lung tumors (mean diameter, 1.0 cm; range, 0.4-1.6 cm) in 12 patients were treated by RF ablation via a transscapular and/or transrib route with the use of a bone biopsy needle under computed tomographic fluoroscopy guidance. Therapeutic outcomes evaluated included feasibility, safety, and local efficacy. Complications were assessed based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Results The transosseous route was successfully employed in all patients, and the electrode was successfully advanced into all tumors with this approach. The mean distance of penetrated bone was 0.57 cm (range, 0.19-1.16 cm). Complications occurred in eight RF ablation sessions, including six grade 1 events (two cases of pneumothorax and one case each of asymptomatic rib fracture 6 mo after treatment, neuralgia, pulmonary hemorrhage, and hemothorax), two grade 2 events (pneumonia and high fever), and one grade 3 event (pneumothorax requiring pleurodesis). No adverse events of grade ≥ 4 occurred. The mean and median tumor follow-up periods were 19.5 and 15.2 mo (range, 3.0-41.5 mo). Local progression occurred in two cases at 3 and 12 mo after treatment and was successfully treated with a second RF ablation procedure. The technique efficacy rates were 91.7% at 6 mo, 81.5% at 1 y, and 81.5% at 2 y. Conclusions The transosseous approach was feasible in computed tomographic fluoroscopy-guided RF ablation of select lung tumors when no other option was available.

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