1. Radiofrequency ablation of lung tumours Michelle Muller Consultant Radiologist Freeman Hospital

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

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

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

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

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

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

8. Complications Pneumothorax [drain 20%] Pleural effusion Bleeding Infection

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

10. Case 1 68 year old Colorectal metastasis

11. Case 2 65 year old Colorectal metastasis

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

13. Case 4 51 year old 3 Colorectal metastases

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

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

16. 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.