Image-guided ablation treatment for lung cancer patients

Abstract

The majority of lung cancer patients are not surgical candidates, either to advanced disease or comorbidities. Radiotherapy has been the traditional fallback treatment for localizeddisease with improved results due to the newer stereotactic techniques. Thermal ablation is a minimally invasive CT-guided percutaneous treatment that is commonly used with this group of patients, and the published results are very promising. Currently, the most widely used ablation technique in the treatment of lung malignancies is radiofrequency ablation (RFA), followed by microwave ablation (MWA) and cryoablation (CA). Recent studies with MWA and CA have shown some advantages particularly with larger tumors. Further research with these thermal techniques is necessary to determine the clinical indications, treatment strategy, and follow-up. This chapter will cover the application of thermal ablation in the thorax, patient selection, basic aspects of the procedure and techniques, imaging follow-up, and patient outcomes.