Percutaneous Cryoablation of Lung Tumors: Feasibility and Safety

CT-guided percutaneous cryoablation of central lung tumors

“…The cause of delayed pneumothoraces following two separate procedures in one patient is unknown, but it was probably related to the patient rather than the procedure. Similar to other series (70%, 70.5%) (21,23), pleural effusions were common but inconsequential, unless pulmonary function was already compromised. Hemoptysis was also common but transient.…”

“…(19-21, 23, 34-36), and was likely related to the size and number of the applicators. However, the rate at which patients required catheter placement was slightly higher in our series (33%) relative to others (12%-18%) (19,21,23). Others have typically treated small pneumothoraces with needle aspiration rather than catheter insertion; this approach could have been used in our patients as well.…”

“…Prior reports have focused on the feasibility, safety, and local control rate of CT-guided cryoablation of lung tumors in general; however, these reports provided no detailed information regarding tumor location and did not discuss the issues relevant to the treatment of central tumors (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Wang et al (19) placed straight cryoablation applicators into tumors tandem to a guidance needle outside the CT gantry, as their CT gantry could not accommodate the entire length of straight cryoablation applicators.…”

“…In addition to allowing visualization of the ice ball, peritumoral lung opacification also increases thermal conductivity of lung tissue and allows for more rapid freezing and possibly larger ablation zones (28). Based on these observations, some authors have suggested an initial short freeze to create peritumoral opacification followed by two additional freezes to treat the tumor (20,21,23). One study showed that double-and triple-freeze protocols provided comparable ablation zones in a porcine model but the triple-freeze protocol resulted in earlier visualization of the ice ball.…”

“…Heat-based ablation methods may not be safe in the treatment of central lung tumors because of a possibility of bronchial disruption or perforation, which may result in bronchopleural fistula formation (19). Although cryoablation has been used to treat lung malignancies (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31), there are limited data on the safety and effectiveness of percutaneous cryoablation of central lung tumors. In this study, we describe our experience with CT-guided percutaneous cryoablation of central lung tumors and the role of ice ball monitoring.…”