Imaging of Interventional Therapies in Oncology: Computed Tomography

Abstract

Percutaneous ablation techniques have emerged as a viable treatment option for primary and secondary lung malignancies. Utilizing minimally invasive image-guided approaches, these techniques allow for the precise placement of ablation devices with the goal of total tumor necrosis and local control, offering in some instances curative potential. The different ablative technologies used in the thorax are based on application of thermal energies, chemical lysis, and alteration of cell permeability, the thermal energies most extensively studied thus far. These ablative tech- niques provide a valuable stand-alone alternative to conventional surgical resection or an adjunct to surgery, chemotherapy, or radiotherapy. The development of these and additional novel therapies has resulted in a multidisciplinary approach for the treatment of primary and secondary pulmonary malignancies with percutaneous ablative techniques proving to be a robust therapeutic option. To date, radiofrequency ablation (RFA) is the best developed and most widely used thermal ablation technique in the lung. Using radiofrequency ablation as a model for thermal ablation, this chapter will outline the principles of thermal ablation, the role of thermal ablation in the treatment of primary and secondary pulmonary malignan- cies, the procedural-related complications of thermal ablation within the lung, post-ablation follow-up and treatment results, as well as a brief discussion and comparison of the different ablative technologies.