Radiofrequency ablation of lung tumours Michelle Muller Consultant Radiologist Freeman Hospital

What is radiofrequency ablation? RF energy passes through an electrode and produces heat Heat coagulates and destroys cells in the target area

RFA in lung tumours RFA needle placed using CT guidance 3cm ablation zone

Evidence Rapture Trial – multicentre, prospective 1 year cancer specific survival >90%; 2 year survival 70%

Who? Primary or secondary Curative intent Patients unsuitable for conventional radical treatment NICE approved procedure

Who? Patient fit for procedure No untreatable extrathoracic disease Size: <3.5cm Number: <3 Position: Accessible by percutaneous route >1cm from major structures

The procedure CT guidance Conscious sedation 12 minute treatment Overnight stay Follow-up 3; 6; 9; 12 months

Complications Pneumothorax [drain 20%] Pleural effusion Bleeding Infection

Newcastle experience 5 cases -3 colorectal metastases -1 small cell lung cancer -1 PET positive presumed lung cancer -No major complications

Case 1 68 year old Colorectal metastasis

Case 2 65 year old Colorectal metastasis

Case 3 89 year old Proven Small cell – no distant disease

Case 4 51 year old 3 Colorectal metastases

Case 5 80 year old PET +ve nodule, presumed NSCLC

The future Patient follow-up Data analysis Consider alternative ablation techniques

References Rapture study, Lencioni et al. Lancet 2008 Lung cancer and RFA. Rose et al. JVIR 2006 Percutaneous RFA for primary or secondary lung cancers (IPG 372). National Institute for Health and Clinical Excellence. Dec 2010.