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Program

Radiology - Diagnostic

Training Level

Resident PGY 1

Institution

Henry Ford Hospital

Abstract

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.

Publication Date

5-2019

CT Guided Cryoablation of Primary and Metastatic Lung Tumors: Low Recurrence and Complication Rates

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