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Simultaneous Computed Tomography-Guided Biopsy and Radiofrequency Ablation of Solitary Pulmonary Malignancy in High-Risk Patients

Schneider, T. ; Puderbach, M. ; Kunz, J. ; Bischof, A. ; Giesel, F.L. ; Dienemann, H. ; Herth, F.J.F. ; Schnabel, P.A. ; Safi, S. ; Hoffmann, H. ; Heussel, C.P.

In: Respiration, 84 (2012), Nr. 6. pp. 501-508. ISSN 0025-7931 (Print-Ausg.), 1423-0356 (Online-Ausg.)

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BACKGROUND: In recent years experience has been accumulated in percutaneous radiofrequency ablation (RFA) of lung malignancies in nonsurgical patients. Objectives: In this study, we retrospectively evaluated a simultaneous diagnostic and therapeutic approach including CT-guided biopsy followed immediately by RFA of solitary malignant pulmonary lesions.

METHODS: CT-guided transthoracic core needle biopsy of solitary pulmonary lesions suspicious for malignancy was performed and histology was proven based on immediate frozen sections. RFA probes were placed into the pulmonary tumors under CT guidance and the ablation was performed subsequently. The procedure-related morbidity was analyzed. Follow-up included a CT scan and pulmonary function parameters.

RESULTS: A total of 33 CT-guided biopsies and subsequent RFA within a single procedure were performed. Morbidity of CT-guided biopsy included pulmonary hemorrhage (24%) and a mild pneumothorax (12%) without need for further interventions. The RFA procedure was not aggravated by the previous biopsy. The rate of pneumothorax requiring chest tube following RFA was 21%. Local tumor control was achieved in 77% with a median follow-up of 12 months. The morbidity of the CT-guided biopsy had no statistical impact on the local recurrence rate.

CONCLUSIONS: The simultaneous diagnostic and therapeutic approach including CT-guided biopsy followed immediately by RFA of solitary malignant pulmonary lesions is a safe procedure. The potential of this combined approach is to avoid unnecessary therapies and to perform adequate therapies based on histology. Taking the local control rate into account, this approach should only be performed in those patients who are unable to undergo or who refuse surgery.

Item Type: Article
Journal or Publication Title: Respiration
Volume: 84
Number: 6
Publisher: Karger
Place of Publication: Basel
Date Deposited: 21 Oct 2019 10:21
Date: 2012
ISSN: 0025-7931 (Print-Ausg.), 1423-0356 (Online-Ausg.)
Page Range: pp. 501-508
Faculties / Institutes: Medizinische Fakultät Heidelberg > Radiologische Universitätsklinik
Medizinische Fakultät Heidelberg > Pathologisches Institut
Medizinische Fakultät Heidelberg > Thoraxklinik Heidelberg gGmbH
Subjects: 610 Medical sciences Medicine
Uncontrolled Keywords: biopsy , chest CT , chest interventions , interventional radiology , lung cancer treatment , pulmonary nodules
Additional Information: Dieser Beitrag ist aufgrund einer (DFG-geförderten) Allianz bzw. Nationallizenz frei zugänglich. This publication is freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
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