CT-guided cryoablation of primary and metastatic lung tumors: low recurrence and complication rates

Objective To evaluate the use of ultra-low-dose computed tomography (ULDCT) for CT-guided lung biopsy versus standard-dose CT (SDCT). Methods CT-guided lung biopsies from 115 patients (50 ULDCT, 65 SDCT) were analyzed retrospectively. SDCT settings were 120 kVp with automatic mAs modulation. ULDCT settings were 80 kVp with fixed exposure (20 mAs). Two radiologists evaluated image quality (i.e., needle artifacts, lesion contouring, vessel recognition, visibility of interlobar fissures). Complications and histological results were also evaluated. Results ULDCT was considered feasible for all lung interventions, showing the same diagnostic accuracy as SDCT. Its mean total radiation dose (dose–length product) was significantly reduced to 34 mGy-cm (SDCT 426 mGy-cm). Image quality and complication rates ( P = 0.469) were consistent. Conclusions ULDCT for CT-guided lung biopsies appears safe and accurate, with a significantly reduced radiation dose. We therefore recommend routine clinical use of ULDCT for the benefit of patients and interventionalists.

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A Case of Metastatic Lung Cancer Accompanied by Needle Tract Seeding after CT Guided Fine Needle Aspiration Biopsy.

Haigan ◽

10.2482/haigan.34.931 ◽

1994 ◽

Vol 34 (6) ◽

pp. 931-936

Author(s):

Tadafumi Shimizu ◽

Kensuke Ashina ◽

Miwako Doi ◽

Ritsuo Matsui ◽

Kozo Sueyoshi ◽

...

Keyword(s):

Lung Cancer ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Biopsy ◽

Needle Aspiration ◽

Metastatic Lung Cancer ◽

Ct Guided ◽

Fine Needle ◽

Needle Tract ◽

Needle Tract Seeding ◽

Metastatic Lung

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Evaluation of Gross Tumor Volume Changes Prior to the First Delivered Fraction in Primary and Metastatic Lung Tumors Treated By Stereotactic Body Radiation Therapy: Does Time from Simulation to Start Matter?

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2017.06.170 ◽

2017 ◽

Vol 99 (2) ◽

pp. S70

Author(s):

S. King ◽

S.S. Sood ◽

M.J. Tennapel ◽

R.K. Badkul ◽

N. Aguilera ◽

...

Keyword(s):

Radiation Therapy ◽

Gross Tumor Volume ◽

Tumor Volume ◽

Stereotactic Body Radiation Therapy ◽

Lung Tumors ◽

Volume Changes ◽

Stereotactic Body Radiation ◽

Metastatic Lung

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Feasibility and safety of percutaneous computed tomography guided radiofrequency ablation of lymph nodes in oligometastatic patients: a single center’s experience

British Journal of Radiology ◽

10.1259/bjr.20200445 ◽

2021 ◽

Vol 94 (1121) ◽

pp. 20200445

Author(s):

Dimitrios Filippiadis ◽

George Charalampopoulos ◽

Athanasios Tsochatzis ◽

Lazaros Reppas ◽

Argyro Mazioti ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Lymph Nodes ◽

Clinical Success ◽

Complete Response ◽

Tumor Control ◽

Complication Rates ◽

Ct Guided ◽

Female Ratio ◽

Contrast Enhanced Ct ◽

The Mean

Objectives: To retrospectively evaluate feasibility and safety of CT-guided percutaneous radiofrequency ablation (RFA) of metastatic lymph nodes (LN) in terms of achieving local tumor control. Methods: Institutional database research identified 16 patients with 24 metastatic LNs who underwent percutaneous CT-guided radiofrequency ablation. Mean patient age was 66.6 ± 15.70 years (range 40–87) and male/female ratio was 8/8. Contrast-enhanced CT or MRI was used for post-ablation follow-up. Patient and tumor characteristics and RFA technique were evaluated. Technical and clinical success on per tumor and per patient basis as well as complication rates were recorded. Results: Mean size of the treated nodes was 1.78 ± 0.83 cm. The mean number of tumors per patient was 1.5 ± 0.63. The mean procedure time was 56.29 ± 24.27 min including local anesthesia, electrode(s) placement, ablation and post-procedural CT evaluation. Median length of hospital stay was 1.13 ± 0.34 days. On a per lesion basis, the overall complete response post-ablation according to the mRECIST criteria applied was 75% (18/24) of evaluable tumors. Repeat treatment of an index tumor was performed on two patients (three lesions) with complete response achieved in 87.5% (21/24) of evaluable tumors following a second RFA. On a per patient basis, disease progression was noted in 10/16 patients at a mean of 13.9 ± 6.03 months post the ablation procedure. Conclusion: CT-guided percutaneous RFA for oligometastatic LNs is a safe and feasible therapy. Advances in knowledge: With this percutaneous therapeutic option, metastatic LNs can be eradicated with a very low complication rate.

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Computed Tomography-Guided Radiofrequency Thermocoagulation of the Gasserian Ganglion Using an Alternative to Hartel Anterior Approach: A Bicentral Study

January 2018 - Pain Physician ◽

10.36076/ppj.2020/23/293 ◽

2020 ◽

Vol 3;23 (6;3) ◽

pp. 293-298 ◽

Cited By ~ 1

Author(s):

Dimitrios K. Filippiadis

Keyword(s):

Computed Tomography ◽

Pain Relief ◽

Anterior Approach ◽

Anatomic Variation ◽

Control Group ◽

Complication Rates ◽

Gasserian Ganglion ◽

Ct Guided ◽

Radiofrequency Thermocoagulation ◽

Number Of Patients

Background: Trigeminal neuralgia (TN) is associated with multiple mechanisms involving peripheral and central nervous system pathologies. Among percutaneous treatments offered, radiofrequency thermocoagulation (RFT) is associated with longer duration of pain relief. Mostly due to anatomic variation, cannulation of the foramen ovale using the Hartel approach has a failure rate of 5.17%. Objectives: To report safety and efficacy of continuous RFT with an alternative to Hartel anterior approach under computed tomography (CT) guidance in patients with classic TN. Study Design: Retrospective institutional database review; bicentral study. Setting: Although this was a retrospective database research, institutional review board approval was obtained. Methods: Institutional database review identified 10 patients (men 8, women 2) who underwent CT-guided RFT of the Gasserian ganglion. Preoperational evaluation included physical examination and magnetic resonance imaging. Under anesthesiology control and local sterility measures, a radiofrequency needle was advanced, and its approach was evaluated with sequential CT scans. Motor and sensory electrostimulation tests evaluated correct electrode location. Pain prior, 1 week, 1, 3, and 6 months after were compared by means of a numeric visual scale (NVS) questionnaire. Results: Mean self-reported pain NVS score prior to RFT was 9.2 ± 0.919 units. One week after the RFT mean NVS score was 1.10 ± 1.287 units (pain reduction mean value of 8.1 units). At 3 and 6 months after thermocoagulation the mean NVS score was 2.80 ± 1.549 units and 2.90 ± 1.370 units, respectively. There were no postoperative complications. Three patients experienced facial numbness, which gradually resolved over a period of 1 month. Limitations: Retrospective nature; small number of patients; lack of a control group undergoing a different treatment of TN. Conclusions: Percutaneous CT-guided RFT of the Gasserian ganglion constitutes a safe and efficacious technique for the treatment of TN, with significant pain relief and minimal complication rates improving life quality in this group of patients. Key words: Trigeminal nerve, neuralgia, pain, radiofrequency, ablation, percutaneous, computed tomography, imaging

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Primary and Metastatic Lung Tumors in the Pediatric Population: A Review and 25-Year Experience at a Large Children's Hospital

Archives of Pathology & Laboratory Medicine ◽

10.5858/2008-132-1079-pamlti ◽

2008 ◽

Vol 132 (7) ◽

pp. 1079-1103 ◽

Cited By ~ 36

Author(s):

Megan K. Dishop ◽

Supriya Kuruvilla

Keyword(s):

Medical Literature ◽

Pediatric Population ◽

Case Series ◽

Lung Tumors ◽

Malignant Neoplasms ◽

Primary Tumors ◽

Children's Hospital ◽

Pathologic Features ◽

Metastatic Lung ◽

Children’S Hospital

Abstract Context.—Primary lung neoplasms are rare in children, but they comprise a broad and interesting spectrum of lesions, some of which are familiar from other tissue sites, and some of which are unique to the pediatric lung. Objective.—To determine the relative incidence of primary and metastatic lung tumors in children and adolescents through a single-institution case series, to compare these data to reports in the medical literature, to discuss the clinical and pathologic features of primary tumors of the tracheobronchial tree and lung parenchyma in children, and to provide recommendations for handling pediatric lung cysts and tumors. Data Sources.—A 25-year single institutional experience with pediatric lung tumors, based on surgical biopsies and resections at Texas Children's Hospital from June 1982 to May 2007, an additional 40 lung tumors referred in consultation, and a review of the medical literature. Conclusions.—A total of 204 pediatric lung tumors were diagnosed at our institution, including 20 primary benign lesions (9.8%), 14 primary malignant lesions (6.9%), and 170 secondary lung lesions (83.3%). The ratio of primary benign to primary malignant to secondary malignant neoplasms is 1.4:1:11.6. The common types of lung cancer in adults are exceptional occurrences in the pediatric population. The most common primary lung malignancies in children are pleuropulmonary blastoma and carcinoid tumor. Other primary pediatric lung tumors include congenital peribronchial myofibroblastic tumor and other myofibroblastic lesions, sarcomas, carcinoma, and mesothelioma. Children with primary or acquired immunodeficiency are at risk for Epstein-Barr virus–related smooth muscle tumors, lymphoma, and lymphoproliferative disorders. Metastatic lung tumors are relatively common in children and also comprise a spectrum of neoplasia distinct from the adult population.

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