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Rofo 2006; 178(9): 852-861
DOI: 10.1055/s-2006-926815
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Radiofrequenz-Ablation von Lungentumoren

Radiofrequency Ablation of Lung TumorsS. Clasen1 , P. L. Pereira1
  • 1Diagnostische Radiologie, Radiologische Klinik, Tübingen
Further Information

Publication History

eingereicht: 13.2.2006

angenommen: 20.4.2006

Publication Date:
07 August 2006 (online)

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Zusammenfassung

Die Radiofrequenz(RF)-Ablation ist eine effektive Therapieoption in der Behandlung von primären und sekundären Lebertumoren. Die perkutane RF-Ablation von primären und sekundären Lungentumoren stellt eine mögliche neue Indikation dar. Der minimalinvasive Charakter der perkutanen RF-Ablation erlaubt einen Einsatz bei Patienten, die einer kurativen radikalen Resektion nicht zugeführt werden können. Darüber hinaus ist die pulmonale RF-Ablation eine viel versprechende palliative Therapieoption. In diesem Zusammenhang wurden in letzter Zeit zunehmend Ergebnisse zur RF-Ablation von Lungentumoren veröffentlicht. In der vorliegenden Übersichtsarbeit werden mögliche Indikationen, Technik, Ergebnisse und das Komplikationsspektrum der pulmonalen RF-Ablation zusammengefasst und diskutiert.

Abstract

Radiofrequency (RF) ablation is an effective therapy option in the treatment of primary and secondary liver tumors. Percutaneous RF ablation of primary and secondary pulmonary tumors is a possible new indication. Due to the minimally invasive character of percutaneous RF ablation, application in patients who are not candidates for curative radical resection is possible. Moreover, pulmonary RF ablation is a promising palliative therapy option. In this context, an increasing number of results regarding RF ablation of lung tumors were recently published. The present review summarizes and discusses the possible indications, techniques, results, and complications of pulmonary RF ablation.

Key words

Metastases - thorax - radiofrequency (RF) ablation - neoplasms - lung - complication

Literatur

  • 1 Tacke J. Perkutane Radiofrequenz-Ablation - klinische Indikationen und Ergebnisse.  Fortschr Röntgenstr. 2003;  175 156-168
    PubMedGoogle Scholar
  • 2 Livraghi T, Goldberg S N, Lazzaroni S. et al . Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection.  Radiology. 1999;  210 655-661
    CrossrefPubMedGoogle Scholar
  • 3 Rosenthal D I, Hornicek F J, Torriani M. et al . Osteoid osteoma: percutaneous treatment with radiofrequency energy.  Radiology. 2003;  229 171-175
    CrossrefPubMedGoogle Scholar
  • 4 Vogl T J, Straub R, Lehnert T. et al . Perkutane Thermoablation von Lungenmetastasen - Erfahrungen mit dem Einsatz der LITT, der Radiofrequenz-Ablation (RFA) und Literaturübersicht.  Fortschr Röntgenstr. 2004;  176 1658-1666
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Boss A, Clasen S, Kuczyk M. et al . Radiofrequenz-Ablation des Nierenzellkarzinoms unter MR-Bildgebung: Erste Ergebnisse.  Fortschr Röntgenstr. 2005;  177 1139-1145
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Jakobs T F, Hoffmann R T, Vick C. et al . RFA von Tumoren des Knochens und der Weichteile.  Radiologe. 2004;  44 370-375
    CrossrefPubMedGoogle Scholar
  • 7 Goldberg S N, Gazelle G S, Compton C C. et al . Radiofrequency tissue ablation in the rabbit lung: efficacy and complications.  Acad Radiol. 1995;  2 776-784
    PubMedGoogle Scholar
  • 8 Goldberg SN, Gazelle G S, Compton C C. et al . Radio-frequency tissue ablation of VX2 tumor nodules in the rabbit lung.  Acad Radiol. 1996;  3 929-935
    CrossrefPubMedGoogle Scholar
  • 9 Miao Y, Ni Y, Bosmans H. et al . Radiofrequency ablation for eradication of pulmonary tumor in rabbits.  J Surg Res. 2001;  99 265-271
    CrossrefPubMedGoogle Scholar
  • 10 Dupuy D E, Zagoria R J, Akerley W. et al . Percutaneous radiofrequency ablation of malignancies in the lung.  AJR Am J Roentgenol. 2000;  174 57-59
    PubMedGoogle Scholar
  • 11 Kang S, Luo R, Liao W. et al . Single group study to evaluate the feasibility and complications of radiofrequency ablation and usefulness of post treatment position emission tomography in lung tumours.  World J Surg Oncol. 2004;  2 30
    CrossrefPubMedGoogle Scholar
  • 12 King J, Glenn D, Clark W. et al . Percutaneous radiofrequency ablation of pulmonary metastases in patients with colorectal cancer.  Br J Surg. 2004;  91 217-223
    CrossrefPubMedGoogle Scholar
  • 13 Macha H N. Bronchialkarzinom. Epidemiologie, Diagnostik und Therapie.  Internist. 2003;  44 28-34
    CrossrefPubMedGoogle Scholar
  • 14 Hoffmann P C, Mauer A M, Vokes E E. Lung cancer.  The Lancet. 2000;  355 479-485
    PubMedGoogle Scholar
  • 15 Mountain C F. Revisions in the International System for Staging Lung Cancer.  Chest. 1997;  111 1710-1717
    CrossrefPubMedGoogle Scholar
  • 16 Dienemann H, Hof H, Deus J. et al . Lungenmetastasen.  Onkologe. 2004;  10 458-473
    CrossrefPubMedGoogle Scholar
  • 17 Reitmeier F, Busch T, Herse B. et al . Die chirurgische Behandlung von Lungenmetastasen extrapulmonaler Primärtumoren - eine retrospektive Analyse von 1982 bis 1995.  Z Herz Thorax Gefäßchir. 1999;  13 S37-S41
    PubMedGoogle Scholar
  • 18 Pastorino U, Buyse M, Godehard F. et al . JB for the International Registry of Lung Metastases. Long-term results of lung metastasectomy. Prognostic analyses based on 5206 cases.  J Thorac Cardiovasc Surg. 1997;  113 37-49
    CrossrefPubMedGoogle Scholar
  • 19 Matsuzaki Y, Shimizu T, Edagawa M. et al . „The Law of 3”: prognostic parameters for resected metastatic pulmonary tumors.  Ann Thorac Cardiovasc Surg. 2003;  9 290-294
    PubMedGoogle Scholar
  • 20 Ginsberg R J, Rubinstein L V. Lung Cancer Study Group . Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer.  Ann Thorac Surg. 1995;  60 615-622
    CrossrefPubMedGoogle Scholar
  • 21 Mery C M, Pappas A N, Bueno R. et al . Similar long-term survival of elderly patients with non-small cell lung cancer treated with lobectomy or wedge resection within the surveillance, epidemiology, and end results database.  Chest. 2005;  128 237-245
    CrossrefPubMedGoogle Scholar
  • 22 Ewert R, Opitz C. Beurteilung der Lungenfunktion vor ablativen Therapien.  Radiologe. 2004;  44 708-710
    PubMedGoogle Scholar
  • 23 Dienemann H, Hoffmann H. Chancen der endoskopischen Thoraxchirurgie und ihre Grenzen.  Chirurg. 2003;  74 324-332
    CrossrefPubMedGoogle Scholar
  • 24 Covey A M, Gandhi R, Brody L A. et al . Factors associated with pneumothorax and pneumothorax requiring treatment after percutaneous lung biopsy in 443 consecutive patients.  J Vasc Interv Radiol. 2004;  15 479-480
    CrossrefPubMedGoogle Scholar
  • 25 Suh R D, Wallace A B, Sheehan R E. et al . Unresectable pulmonary malignancies: CT-guided percutaneous radiofrequency ablation-preliminary results.  Radiology. 2003;  229 821-829
    CrossrefPubMedGoogle Scholar
  • 26 Jin G Y, Lee J M, Lee Y C. et al . Primary and secondary lung malignancies treated with percutaneous radiofrequency ablation: evaluation with follow-up helical CT.  AJR Am J Roentgenol. 2004;  183 1013-1020
    CrossrefPubMedGoogle Scholar
  • 27 Lee J M, Jin G Y, Goldberg S N. et al . Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report.  Radiology. 2004;  230 125-134
    CrossrefPubMedGoogle Scholar
  • 28 Belfiore G, Moggio G, Tedeschi E. et al . CT-guided radiofrequency ablation: a potential complementary therapy for patients with unresectable primary lung cancer-a preliminary report of 33 patients.  AJR Am J Roentgenol. 2004;  183 1003-1011
    CrossrefPubMedGoogle Scholar
  • 29 van Sonnenberg E, Shankar S, Morrison P R. et al . Radiofrequency ablation of thoracic lesions: part 2, initial clinical experience-technical and multidisciplinary considerations in 30 patients.  AJR Am J Roentgenol. 2005;  184 381-390
    PubMedGoogle Scholar
  • 30 Schaefer O, Lohrmann C, Ghanem N. et al . CT-guided radiofrequency heat ablation of malignant lung tumors.  Med Sci Monit. 2003;  9 127-131
    PubMedGoogle Scholar
  • 31 Kishi K, Nakamura H, Sudo A. et al . Tumor debulking by radiofrequency ablation in hypertrophic pulmonary osteoarthropathy associated with pulmonary carcinoma.  Lung Cancer. 2002;  38 317-320
    CrossrefPubMedGoogle Scholar
  • 32 Yasui K, Kanazawa S, Sano Y. et al . Thoracic tumors treated with CT-guided radiofrequency ablation: initial experience.  Radiology. 2004;  231 850-857
    CrossrefPubMedGoogle Scholar
  • 33 Herrera L J, Fernando H C, Perry Y. et al . Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates.  J Thorac Cardiovasc Surg. 2003;  125 929-937
    CrossrefPubMedGoogle Scholar
  • 34 Nguyen C L, Scott W J, Young N A. et al . Radiofrequency ablation of primary lung cancer: results from an ablate and resect pilot study.  Chest. 2005;  128 3507-3511
    CrossrefPubMedGoogle Scholar
  • 35 Gadaleta C, Mattioli V, Colucci G. et al . Radiofrequency ablation of 40 lung neoplasms: preliminary results.  AJR Am J Roentgenol. 2004;  183 361-368
    CrossrefPubMedGoogle Scholar
  • 36 Jungraithmayr W, Schafer O, Stoelben E. et al . Radiofrequenz-Ablation maligner Lungentumore. Eine sinnvolle Methode?.  Chirurg. 2005;  76 887-893
    CrossrefPubMedGoogle Scholar
  • 37 Steinke K, Glenn D, King J. et al . Percutaneous imaging-guided radiofrequency ablation in patients with colorectal pulmonary metastases: 1-year follow-up.  Ann Surg Oncol. 2004;  11 207-212
    CrossrefPubMedGoogle Scholar
  • 38 Kim T S, Lim H K, Kim H. Excessive hyperthermic necrosis of a pulmonary lobe after hypertonic saline-enhanced monopolar radiofrequency ablation.  Cardiovasc Intervent Radiol. 2006;  29 160-163
    CrossrefPubMedGoogle Scholar
  • 39 Lee J M, Kim S W, Li C A. et al . Saline-enhanced radiofrequency thermal ablation of the lung: a feasibility study in rabbits.  Korean J Radiol. 2002;  3 245-253
    PubMedGoogle Scholar
  • 40 Ahmed M, Liu Z, Afzal K S. et al . Radiofrequency ablation: effect of surrounding tissue composition on coagulation necrosis in a canine tumor model.  Radiology. 2004;  230 761-767
    CrossrefPubMedGoogle Scholar
  • 41 Highland A M, Mack P, Breen D J. Radiofrequency thermal ablation of a metastatic lung nodule.  Eur Radiol. 2002;  12 166-170
    CrossrefPubMedGoogle Scholar
  • 42 Hosten N, Stier A, Weigel C. et al . Laser-induzierte Thermotherapie (LITT) von Lungenmetastasen: Beschreibung eines miniaturisierten Applikators, Optimierung und erste Patientenbehandlungen.  Fortschr Röntgenstr. 2003;  175 393-400
    Article in Thieme ConnectPubMedGoogle Scholar
  • 43 Knappe V, Mols A. Lasertherapie in der Lunge: Biophysikalischer Hintergrund.  Radiologe. 2004;  44 677-683
    PubMedGoogle Scholar
  • 44 Goldberg S N, Grassi C J, Cardella J F. et al . Image-guided tumor ablation: standardization of terminology and reporting criteria.  Radiology. 2005;  235 728-739
    CrossrefPubMedGoogle Scholar
  • 45 Oshima F, Yamakado K, Akeboshi M. et al . Lung radiofrequency ablation with and without bronchial occlusion: experimental study in porcine lungs.  J Vasc Interv Radiol. 2004;  15 1451-1456
    PubMedGoogle Scholar
  • 46 Mulier S, Mulier P, Ni Y. et al . Complications of radiofrequency coagulation of liver tumours.  Br J Surg. 2002;  89 1206-1222
    CrossrefPubMedGoogle Scholar
  • 47 Yamakado K, Akeboshi M, Nakatsuka A. et al . Tumor seeding following lung radiofrequency ablation: a case report.  Cardiovasc Intervent Radiol. 2005;  28 530-532
    CrossrefPubMedGoogle Scholar
  • 48 Tominaga J, Miyachi H, Takase K. et al . Time-related Changes in Computed Tomographic Appearance and Pathologic Findings after Radiofrequency Ablation of the Rabbit Lung: Preliminary Experimental Study.  J Vasc Interv Radiol. 2005;  16 1719-1726
    PubMedGoogle Scholar
  • 49 Yamamoto A, Nakamura K, Matsuoka T. et al . Radiofrequency ablation in a porcine lung model: correlation between CT and histopathologic findings.  AJR Am J Roentgenol. 2005;  185 1299-1306
    CrossrefPubMedGoogle Scholar
  • 50 Perlmutt L M, Braun S D, Newman G E. et al . Timing of chest film follow-up after transthoracic needle aspiration.  AJR Am J Roentgenol. 1986;  146 1049-1050
    PubMedGoogle Scholar
  • 51 Yamamoto A, Matsuoka T, Toyoshima M. et al . Assessment of cerebral microembolism during percutaneous radiofrequency ablation of lung tumors using diffusion-weighted imaging.  AJR Am J Roentgenol. 2004;  183 1785-1789
    CrossrefPubMedGoogle Scholar
  • 52 Akeboshi M, Yamakado K, Nakatsuka A. et al . Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response.  J Vasc Interv Radiol. 2004;  15 463-470
    CrossrefPubMedGoogle Scholar
  • 53 Steinke K, King J, Glenn D. et al . Radiologic appearance and complications of percutaneous computed tomography-guided radiofrequency-ablated pulmonary metastases from colorectal carcinoma.  J Comput Assist Tomogr. 2003;  27 750-757
    CrossrefPubMedGoogle Scholar
  • 54 Fernando H C, De Hoyos A, Landreneau R J. et al . Radiofrequency ablation for the treatment of non-small cell lung cancer in marginal surgical candidates.  J Thorac Cardiovasc Surg. 2005;  129 639-644
    CrossrefPubMedGoogle Scholar
  • 55 Rossi S, Dore R, Cascina A. et al . Percutaneous computed tomography-guided radiofrequency thermal ablation of small unresectable lung tumours.  Eur Respir J. 2006;  27 556-563
    CrossrefPubMedGoogle Scholar
  • 56 Kishi K, Nakamura H, Kobayashi K. et al . Percutaneous CT-guided radiofrequency ablation of pulmonary malignant tumors: preliminary report.  Intern Med. 2006;  45 65-72
    CrossrefPubMedGoogle Scholar
  • 57 Kim T S, Lim H K, Lee K S. et al . Imaging-guided percutaneous radiofrequency ablation of pulmonary metastatic nodules caused by hepatocellular carcinoma: preliminary experience.  AJR Am J Roentgenol. 2003;  181 491-494
    PubMedGoogle Scholar
  • 58 Swensen S J, Viggiano R W, Midthun D E. et al . Lung nodule enhancement at CT: multicenter study.  Radiology. 2000;  214 73-80
    CrossrefPubMedGoogle Scholar
  • 59 Dupuy D E, Mayo-Smith W W, Abbott G F. et al . Clinical applications of radio-frequency tumor ablation in the thorax.  Radiographics. 2002;  22 S259-S269
    CrossrefPubMedGoogle Scholar
  • 60 Steinke K, Sewell P E, Dupuy D. et al . Pulmonary radiofrequency ablation-an international study survey.  Anticancer Res. 2004;  24 339-343
    PubMedGoogle Scholar
  • 61 Lacasse Y, Wong E, Guyatt G H. et al . Transthoracic needle aspiration biopsy for the diagnosis of localised pulmonary lesions: a meta-analysis.  Thorax. 1999;  54 884-893
    PubMedGoogle Scholar
  • 62 Vaughn C, Mychaskiw G 2nd, Sewell P. Massive hemorrhage during radiofrequency ablation of a pulmonary neoplasm.  Anesth Analg. 2002;  94 1149-1151
    CrossrefPubMedGoogle Scholar
  • 63 Steinke K, King J, Glenn D W. et al . Percutaneous radiofrequency ablation of lung tumors with expandable needle electrodes: tips from preliminary experience.  AJR Am J Roentgenol. 2004;  183 605-611
    PubMedGoogle Scholar
  • 64 Jin G Y, Lee J M, Lee Y C. et al . Acute cerebral infarction after radiofrequency ablation of an atypical carcinoid pulmonary tumor.  AJR Am J Roentgenol. 2004;  182 990-992
    CrossrefPubMedGoogle Scholar
  • 65 Steinke K, King J, Glenn D. et al . Radiofrequenz-Ablation (RFA) von Lungenmetastasen kolorektaler Karzinome (KRK) - Ergebnisse nach einem Jahr.  Radiologe. 2004;  44 687-692
    PubMedGoogle Scholar
  • 66 Jain S K, Dupuy D E, Cardarelli G A. et al . Percutaneous radiofrequency ablation of pulmonary malignancies: combined treatment with brachytherapy.  AJR Am J Roentgenol. 2003;  181 711-715
    CrossrefPubMedGoogle Scholar
  • 67 Lee J M, Jin G Y, Li C A. et al . Percutaneous radiofrequency thermal ablation of lung VX2 tumors in a rabbit model using a cooled tip-electrode: feasibility, safety, and effectiveness.  Invest Radiol. 2003;  38 129-139
    CrossrefPubMedGoogle Scholar
  • 68 Steinke K, Haghighi K S, Wulf S. et al . Effect of vessel diameter on the creation of ovine lung radiofrequency lesions in vivo: preliminary results.  J Surg Res. 2005;  124 85-91
    CrossrefPubMedGoogle Scholar

Dr. Stephan Clasen

Diagnostische Radiologie, Radiologische Klinik

Hoppe-Seyler Str. 3

72076 Tübingen

Phone: ++49/70 71/2 98 66 77

Fax: ++49/70 71/2 98 56 94

Email: stephan.clasen@med.uni-tuebingen.de

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