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Radiology - Diagnostic
Resident PGY 1
Henry Ford Hospital
Purpose: To assess technical feasibility, efficacy and complication rates of CT guided cryoablation of lung tumors in multiple locations. Materials and Methods: CT fluoroscopic-guided percutaneous cryoablation was performed in 277 procedures on 378 tumors (116 primary, 262 metastatic tumors) in 158 patients. Tumor and ablation volumes, location, abutting vessels >3mm, recurrences, and PFT’s were reviewed for all patients. Complications were graded by the National Institutes of Health, Common Terminology of Complications and Adverse Events 4.0 (CTCAE). Results: All procedures were performed with conscious sedation. Mean FEV1 and DLCO2 were 80.2 (32-145) and 69.5 (27-110), respectively. Overall tumor and ablation median size was 2.4 cm (0.5 – 12.3 cm) and 4.6 cm (1.7-12.8), respectively. Total major complication rates were only 5.1% (14/277), however major complication rates were significantly lower in tumors ≤3 cm as opposed to ≥3cm, 2.6% (5/196) vs. 10.8% (9/83) (p<0.005) No statistical significance was noted for major complications with central tumors or major vessel proximity. Recurrence rates of 6.3% (24/378) were significantly affected by tumor size (<3cm or >3cm) (p<0.001). Recurrence rates increased for central tumors 9.5% (14/147) compared with peripheral tumors 4.3% (10/231) (p< 0.05). Conclusions: CT guided percutaneous cryoablation in the lung provides a low morbidity alternative with superb efficacy. Complication rates are significantly lower for tumors <3cm and total complications were low. Clinical relevance: Appropriately delivered thoracic cryoablation is affected by vessel location yet still produces low recurrence and complication rates.
Krycia, Mark and Aoun, Hussein D., "CT Guided Cryoablation of Primary and Metastatic Lung Tumors: Low Recurrence and Complication Rates" (2019). Clinical Research. 21.