Image-guided lung metastasis ablation: a literature review

Purpose: To review the available options of percutaneous ablation of lung metastasis. Methods: General indications, prognostic factors, and image guidance of percutaneous lung ablations were reviewed. Specificities, technical aspects, advantages and limitations of each technic were highlighted. Comp...

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Main Authors: Clara Prud’homme, Frederic Deschamps, Benjamin Moulin, Antoine Hakime, Marc Al-Ahmar, Salma Moalla, Charles Roux, Christophe Teriitehau, Thierry de Baere, Lambros Tselikas
Format: Article
Language:English
Published: Taylor & Francis Group 2019-10-01
Series:International Journal of Hyperthermia
Subjects:
Online Access:http://dx.doi.org/10.1080/02656736.2019.1647358
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author Clara Prud’homme
Frederic Deschamps
Benjamin Moulin
Antoine Hakime
Marc Al-Ahmar
Salma Moalla
Charles Roux
Christophe Teriitehau
Thierry de Baere
Lambros Tselikas
author_facet Clara Prud’homme
Frederic Deschamps
Benjamin Moulin
Antoine Hakime
Marc Al-Ahmar
Salma Moalla
Charles Roux
Christophe Teriitehau
Thierry de Baere
Lambros Tselikas
author_sort Clara Prud’homme
collection DOAJ
description Purpose: To review the available options of percutaneous ablation of lung metastasis. Methods: General indications, prognostic factors, and image guidance of percutaneous lung ablations were reviewed. Specificities, technical aspects, advantages and limitations of each technic were highlighted. Complications and follow up where also reviewed. Results: Image-guided, percutaneous ablation is of interest for patients with a limit number (<3–5) small metastases (<2–3 cm). Other predictive factors have been reported such as the disease-free interval, the primary tumor, or the proximity with large vessels or bronchus. Radiofrequency ablation (RFA) is the most reported technic, with local control rate >90% for small tumors, and a very low complication rate. Microwave (MWA) and cryoablation are alternative technics developed in the last 15 years to overcome RFA limitations, with encouraging results. Larger ablations zones and less heat sink effect have been described with MWA. On the other hand, cryoablation allows painless treatments under conscious sedation and/or local anesthesia, high accessibility of difficult locations and promising results on prospective multicenter series. Although irreversible electroporation (IRE) could be used for lesions close to main blood vessels as it is not limited by the heat sink effect and does not have significant effects on connective tissue, allowing to treat lesions near to vital organs, preliminary results for lung metastasis are disappointing. Conclusion: Percutaneous ablation of lung metastases, whatever technic is used, is feasible, with high local control rate, and acceptable complication rate. Although indications seem clear enough, validation through controlled trials is mandatory.
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spelling doaj.art-45078820aa2f4f24923b57a7d61b37972022-12-21T21:09:54ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572019-10-01362374510.1080/02656736.2019.16473581647358Image-guided lung metastasis ablation: a literature reviewClara Prud’homme0Frederic Deschamps1Benjamin Moulin2Antoine Hakime3Marc Al-Ahmar4Salma Moalla5Charles Roux6Christophe Teriitehau7Thierry de Baere8Lambros Tselikas9Gustave Roussy Cancer CampusGustave Roussy Cancer CampusGustave Roussy Cancer CampusGustave Roussy Cancer CampusGustave Roussy Cancer CampusGustave Roussy Cancer CampusGustave Roussy Cancer CampusGustave Roussy Cancer CampusGustave Roussy Cancer CampusGustave Roussy Cancer CampusPurpose: To review the available options of percutaneous ablation of lung metastasis. Methods: General indications, prognostic factors, and image guidance of percutaneous lung ablations were reviewed. Specificities, technical aspects, advantages and limitations of each technic were highlighted. Complications and follow up where also reviewed. Results: Image-guided, percutaneous ablation is of interest for patients with a limit number (<3–5) small metastases (<2–3 cm). Other predictive factors have been reported such as the disease-free interval, the primary tumor, or the proximity with large vessels or bronchus. Radiofrequency ablation (RFA) is the most reported technic, with local control rate >90% for small tumors, and a very low complication rate. Microwave (MWA) and cryoablation are alternative technics developed in the last 15 years to overcome RFA limitations, with encouraging results. Larger ablations zones and less heat sink effect have been described with MWA. On the other hand, cryoablation allows painless treatments under conscious sedation and/or local anesthesia, high accessibility of difficult locations and promising results on prospective multicenter series. Although irreversible electroporation (IRE) could be used for lesions close to main blood vessels as it is not limited by the heat sink effect and does not have significant effects on connective tissue, allowing to treat lesions near to vital organs, preliminary results for lung metastasis are disappointing. Conclusion: Percutaneous ablation of lung metastases, whatever technic is used, is feasible, with high local control rate, and acceptable complication rate. Although indications seem clear enough, validation through controlled trials is mandatory.http://dx.doi.org/10.1080/02656736.2019.1647358Lung neoplasmslung metastasispercutaneous ablationradiofrequencycryoablationmicrowave
spellingShingle Clara Prud’homme
Frederic Deschamps
Benjamin Moulin
Antoine Hakime
Marc Al-Ahmar
Salma Moalla
Charles Roux
Christophe Teriitehau
Thierry de Baere
Lambros Tselikas
Image-guided lung metastasis ablation: a literature review
International Journal of Hyperthermia
Lung neoplasms
lung metastasis
percutaneous ablation
radiofrequency
cryoablation
microwave
title Image-guided lung metastasis ablation: a literature review
title_full Image-guided lung metastasis ablation: a literature review
title_fullStr Image-guided lung metastasis ablation: a literature review
title_full_unstemmed Image-guided lung metastasis ablation: a literature review
title_short Image-guided lung metastasis ablation: a literature review
title_sort image guided lung metastasis ablation a literature review
topic Lung neoplasms
lung metastasis
percutaneous ablation
radiofrequency
cryoablation
microwave
url http://dx.doi.org/10.1080/02656736.2019.1647358
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