An Interventional Radiologist's Guide to Lung Cancer

Abstract

Lung cancer continues to be the third leading cause of cancer and the leading cause of cancer deaths. As the field of interventional oncology continues to grow, interventional radiologists are increasingly treating lung cancer patients. Involvement begins with tissue diagnosis for which biomarkers and immunohistochemistry are used to guide selective and advanced medical therapies. An interventional radiologist must be aware of the rationale behind tissue diagnosis and techniques to minimize biopsy complications. Staging is an important part of tumor board conversations and drives treatment pathways. Surgical therapy remains the gold standard for early-stage disease but with an aging population the need for less invasive treatments such as radiation therapy and ablation continue to grow. The interventionalist must be aware of the indications, techniques, and pre- and posttherapy managements for percutaneous ablation. Endovascular therapy is broadly divided into therapeutic treatment of lung cancer, which is gaining traction, and treatment of lung cancer complications such as hemoptysis. This review aims to provide a good basis for interventional radiologists treating lung cancer patients.

Keywords

lung cancer - percutaneous ablation - bronchial artery embolization - pulmonary - artery pseudoaneurysms - lung cancer hemoptysis - interventional radiology

Publikationsverlauf

Artikel online veröffentlicht:
10. Juli 2024

• References

• 1 Thai AA, Solomon BJ, Sequist LV, Gainor JF, Heist RS. Lung cancer. Lancet 2021; 398 (10299): 535-554
• 2 Howlader N, Forjaz G, Mooradian MJ. et al. The effect of advances in lung-cancer treatment on population mortality. N Engl J Med 2020; 383 (07) 640-649
• 3 Miller KD, Nogueira L, Devasia T. et al. Cancer treatment and survivorship statistics, 2022. CA Cancer J Clin 2022; 72 (05) 409-436
• 4 Aberle DR, Adams AM, Berg CD. et al; National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011; 365 (05) 395-409
• 5 Postmus PE, Kerr KM, Oudkerk M. et al; ESMO Guidelines Committee. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017; 28 (Suppl. 04) iv1-iv21
• 6 Mouli SK, Kurilova I, Sofocleous CT, Lewandowski RJ. The role of percutaneous image-guided thermal ablation for the treatment of pulmonary malignancies. AJR Am J Roentgenol 2017; 209 (04) 740-751
• 7 Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG. Introduction to the 2015 World Health Organization Classification of tumors of the lung, pleura, thymus, and heart. J Thorac Oncol 2015; 10 (09) 1240-1242
• 8 Singal G, Miller PG, Agarwala V. et al. Association of patient characteristics and tumor genomics with clinical outcomes among patients with non-small cell lung cancer using a clinicogenomic database. JAMA 2019; 321 (14) 1391-1399
• 9 Bensch F, van der Veen EL, Lub-de Hooge MN. et al. ⁸⁹Zr-atezolizumab imaging as a non-invasive approach to assess clinical response to PD-L1 blockade in cancer. Nat Med 2018; 24 (12) 1852-1858
• 10 Kalemkerian GP, Narula N, Kennedy EB. et al. Molecular testing guideline for the selection of patients with lung cancer for treatment with targeted tyrosine kinase inhibitors: American Society of Clinical Oncology Endorsement of the College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology Clinical Practice Guideline Update. J Clin Oncol 2018; 36 (09) 911-919
• 11 Lynch TJ, Bell DW, Sordella R. et al. Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med 2004; 350 (21) 2129-2139
• 12 Zugazagoitia J, Ramos I, Trigo JM. et al. Clinical utility of plasma-based digital next-generation sequencing in patients with advance-stage lung adenocarcinomas with insufficient tumor samples for tissue genotyping. Ann Oncol 2019; 30 (02) 290-296
• 13 Wu Y, Li P, Zhang H. et al. Diagnostic value of fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography for the detection of metastases in non-small-cell lung cancer patients. Int J Cancer 2013; 132 (02) E37-E47
• 14 Goldstraw P, Chansky K, Crowley J. et al; International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions, International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee Advisory Boards and Participating Institutions. The IASLC Lung Cancer Staging Project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol 2016; 11 (01) 39-51
• 15 Schneider F, Smith MA, Lane MC, Pantanowitz L, Dacic S, Ohori NP. Adequacy of core needle biopsy specimens and fine-needle aspirates for molecular testing of lung adenocarcinomas. Am J Clin Pathol 2015; 143 (02) 193-200 , quiz 306
• 16 Deng CJ, Dai FQ, Qian K. et al. Clinical updates of approaches for biopsy of pulmonary lesions based on systematic review. BMC Pulm Med 2018; 18 (01) 146
• 17 Chung C, Kim Y, Park D. Transthoracic needle biopsy: how to maximize diagnostic accuracy and minimize complications. Tuberc Respir Dis (Seoul) 2020; 83 (Suppl. 01) S17-S24
• 18 Kim GR, Hur J, Lee SM. et al. CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: a prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol 2011; 21 (02) 232-239
• 19 Lee MH, Lubner MG, Hinshaw JL, Pickhardt PJ. Ultrasound guidance versus CT guidance for peripheral lung biopsy: performance according to lesion size and pleural contact. AJR Am J Roentgenol 2018; 210 (03) W110-W117
• 20 Najafi A, Al Ahmar M, Bonnet B. et al. The PEARL approach for CT-guided lung biopsy: assessment of complication rate. Radiology 2022; 302 (02) 473-480
• 21 Lim E, Harris RA, McKeon HE. et al. Impact of video-assisted thoracoscopic lobectomy versus open lobectomy for lung cancer on recovery assessed using self-reported physical function: VIOLET RCT. Health Technol Assess 2022; 26 (48) 1-162
• 22 Palussière J, Cazayus M, Cousin S. et al. Is there a role for percutaneous ablation for early stage lung cancer? What is the evidence?. Curr Oncol Rep 2021; 23 (07) 81
• 23 Ball D, Mai GT, Vinod S. et al; TROG 09.02 CHISEL Investigators. Stereotactic ablative radiotherapy versus standard radiotherapy in stage 1 non-small-cell lung cancer (TROG 09.02 CHISEL): a phase 3, open-label, randomised controlled trial. Lancet Oncol 2019; 20 (04) 494-503
• 24 Ettinger DS, Wood DE, Aisner DL. et al. Non-small cell lung cancer, version 3.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2022; 20 (05) 497-530
• 25 Nezami N, Khorshidi F, Mansur A, Habibollahi P, Camacho JC. Primary and metastatic lung cancer: rationale, indications, and outcomes of thermal ablation. Clin Lung Cancer 2023; 24 (05) 389-400
• 26 Genshaft SJ, Suh RD, Abtin F. et al. Society of Interventional Radiology Multidisciplinary Position Statement on percutaneous ablation of non-small cell lung cancer and metastatic disease to the lungs: endorsed by the Canadian Association for Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, and the Society of Interventional Oncology. J Vasc Interv Radiol 2021; 32 (08) 1241.e1-1241.e12
• 27 Venturini M, Cariati M, Marra P, Masala S, Pereira PL, Carrafiello G. CIRSE Standards of Practice on thermal ablation of primary and secondary lung tumours. Cardiovasc Intervent Radiol 2020; 43 (05) 667-683
• 28 Prud'homme C, Deschamps F, Moulin B. et al. Image-guided lung metastasis ablation: a literature review. Int J Hyperthermia 2019; 36 (02) 37-45
• 29 Patel IJ, Rahim S, Davidson JC. et al. Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions-Part II: Recommendations: endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe. J Vasc Interv Radiol 2019; 30 (08) 1168-1184.e1
• 30 Iguchi T, Hiraki T, Gobara H. et al. Percutaneous radiofrequency ablation of lung tumors close to the heart or aorta: evaluation of safety and effectiveness. J Vasc Interv Radiol 2007; 18 (06) 733-740
• 31 Hong K, Georgiades C. Radiofrequency ablation: mechanism of action and devices. J Vasc Interv Radiol 2010; 21 (8, Suppl): S179-S186
• 32 Wright AS, Sampson LA, Warner TF, Mahvi DM, Lee Jr FT. Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology 2005; 236 (01) 132-139
• 33 Tafti BA, Genshaft S, Suh R, Abtin F. Lung ablation: indications and techniques. Semin Intervent Radiol 2019; 36 (03) 163-175
• 34 Lubner MG, Brace CL, Hinshaw JL, Lee Jr FT. Microwave tumor ablation: mechanism of action, clinical results, and devices. J Vasc Interv Radiol 2010; 21 (8, Suppl): S192-S203
• 35 Sun Y, Wang Y, Ni X. et al. Comparison of ablation zone between 915- and 2,450-MHz cooled-shaft microwave antenna: results in in vivo porcine livers. AJR Am J Roentgenol 2009; 192 (02) 511-514
• 36 Brace CL. Radiofrequency and microwave ablation of the liver, lung, kidney, and bone: what are the differences?. Curr Probl Diagn Radiol 2009; 38 (03) 135-143
• 37 Gage AA, Baust J. Mechanisms of tissue injury in cryosurgery. Cryobiology 1998; 37 (03) 171-186
• 38 Cooper IS. Cryobiology as viewed by the surgeon. Cryobiology 1964; 51: 44-51
• 39 de Baère T, Aupérin A, Deschamps F. et al. Radiofrequency ablation is a valid treatment option for lung metastases: experience in 566 patients with 1037 metastases. Ann Oncol 2015; 26 (05) 987-991
• 40 Mansur A, Garg T, Shrigiriwar A. et al. Image-guided percutaneous ablation for primary and metastatic tumors. Diagnostics (Basel) 2022; 12 (06) 12
• 41 Páez-Carpio A, Gómez FM, Isus Olivé G. et al. Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art. Insights Imaging 2021; 12 (01) 57
• 42 Li G, Xue M, Chen W, Yi S. Efficacy and safety of radiofrequency ablation for lung cancers: A systematic review and meta-analysis. Eur J Radiol 2018; 100: 92-98
• 43 Zhao Q, Wang J, Fu YL, Hu B. Radiofrequency ablation for stage <IIB non-small cell lung cancer: opportunities, challenges, and the road ahead. Thorac Cancer 2023; 14 (32) 3181-3190
• 44 Grieco CA, Simon CJ, Mayo-Smith WW, DiPetrillo TA, Ready NE, Dupuy DE. Percutaneous image-guided thermal ablation and radiation therapy: outcomes of combined treatment for 41 patients with inoperable stage I/II non-small-cell lung cancer. J Vasc Interv Radiol 2006; 17 (07) 1117-1124
• 45 Timmerman RD, Hu C, Michalski JM. et al. Long-term results of stereotactic body radiation therapy in medically inoperable stage I non-small cell lung cancer. JAMA Oncol 2018; 4 (09) 1287-1288
• 46 Laeseke P, Ng C, Ferko N. et al. Stereotactic body radiation therapy and thermal ablation for treatment of NSCLC: a systematic literature review and meta-analysis. Lung Cancer 2023; 182: 107259
• 47 Macchi M, Belfiore MP, Floridi C. et al. Radiofrequency versus microwave ablation for treatment of the lung tumours: LUMIRA (lung microwave radiofrequency) randomized trial. Med Oncol 2017; 34 (05) 96
• 48 Ni Y, Ye X, Yang X. et al. Microwave ablation as local consolidative therapy for patients with extracranial oligometastatic EGFR-mutant non-small cell lung cancer without progression after first-line EGFR-TKIs treatment. J Cancer Res Clin Oncol 2020; 146 (01) 197-203
• 49 Moore W, Talati R, Bhattacharji P, Bilfinger T. Five-year survival after cryoablation of stage I non-small cell lung cancer in medically inoperable patients. J Vasc Interv Radiol 2015; 26 (03) 312-319
• 50 Xu Z, Wang X, Ke H, Lyu G. Cryoablation is superior to radiofrequency ablation for the treatment of non-small cell lung cancer: a meta-analysis. Cryobiology 2023; 112: 104560
• 51 Mabud TS, Swilling D, Guichet P. et al. Pulmonary cryoablation outcomes in octogenarians and nonagenarians with primary lung cancer. J Vasc Interv Radiol 2023; 34 (11) 2006-2011
• 52 Tian Y, Qi X, Jiang X, Shang L, Xu K, Shao H. Cryoablation and immune synergistic effect for lung cancer: a review. Front Immunol 2022; 13: 950921
• 53 Feng J, Guiyu D, Xiongwen W. The clinical efficacy of argon-helium knife cryoablation combined with nivolumab in the treatment of advanced non-small cell lung cancer. Cryobiology 2021; 102: 92-96
• 54 Yuan Z, Wang Y, Zhang J, Zheng J, Li W. A meta-analysis of clinical outcomes after radiofrequency ablation and microwave ablation for lung cancer and pulmonary metastases. J Am Coll Radiol 2019; 16 (03) 302-314
• 55 Kashima M, Yamakado K, Takaki H. et al. Complications after 1000 lung radiofrequency ablation sessions in 420 patients: a single center's experiences. AJR Am J Roentgenol 2011; 197 (04) W576-80
• 56 Jiang B, Mcclure MA, Chen T, Chen S. Efficacy and safety of thermal ablation of lung malignancies: a network meta-analysis. Ann Thorac Med 2018; 13 (04) 243-250
• 57 Hori S, Nakamura T, Kennoki N, Dejima I, Hori A. Transarterial management of advance lung cancer. Jpn J Clin Oncol 2021; 51 (06) 851-856
• 58 Walter FM, Rubin G, Bankhead C. et al. Symptoms and other factors associated with time to diagnosis and stage of lung cancer: a prospective cohort study. Br J Cancer 2015; 112 (Suppl. 01) S6-S13
• 59 Syha R, Benz T, Hetzel J. et al. Bronchial artery embolization in hemoptysis: 10-year survival and recurrence-free survival in benign and malignant etiologies - a retrospective study. Röfo Fortschr Geb Röntgenstr Neuen Bildgeb Verfahr 2016; 188 (11) 1061-1066
• 60 Le Tat T, Carlier R, Zhang N. et al. Endovascular management of life-threatening hemoptysis in primary lung cancer: a retrospective study. Cardiovasc Intervent Radiol 2023; 46 (07) 891-900