Description of morphological evolution of lung tumors treated by percutaneous radiofrequency ablation: long term follow-up of 100 lesions with chest CT

Paul Habert (1, 2, 3) , Mathieu Di Bisceglie (1, 2, 3) , Axel Bartoli (1, 4) , Alexis Jacquier (1, 4) , Pauline Brige (2, 3) , Vincent Vidal (1, 2, 3) , Jean-François Hak (2, 3, 5) , Farouk Tradi (1, 2, 3) , Jean-Yves Gaubert (1, 2, 3)

1 Département de Radiologie [Hôpital de la Timone - APHM]
2 LIIE - Laboratoire d'Imagerie Interventionnelle Expérimentale
3 CERIMED - Centre Européen de Recherche en Imagerie médicale
4 CEMEREM - Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM]
5 TIMONE - Hôpital de la Timone [CHU - APHM]

Purpose: Radiofrequency ablation (RFA) is a safe and effective minimally invasive treatment for pulmonary tumors. Patterns on chest computed tomography (CT) after RFA are classified into five types; however, the follow-up has not been fully described. The objectives of this study were to describe (1) the CT pattern 3 years after RFA and (2) its evolution over 7 years. Materials and methods: Lesions treated with RFA between 2009 and 2017 and with !3 years of follow-up CT data were included. Lesions with local recurrences were excluded from the study. The morphology of the ablation zone was classified as nodular, fibrotic, atelectatic, cavitary, and disappeared. Other initial anatomical parameters were recorded. Kruskal-Wallis or Chi-square tests were used to compare the groups. Results: One hundred lung RFA scars were included, and a retrospective longitudinal study was performed. Three years after RFA, nodular, fibrotic, atelectatic, and cavitary scars, and disappearance were observed in 49%, 36%, 5%, 3%, and 6% of the scars, respectively. Evolution over 7 years showed that the fibrosis, atelectasis, and disappearance remained stable over time, whereas 28% of nodular scars evolved into fibrotic scars. Additionally, 45% of cavitary scars evolved into nodular scars. Pleural contact was associated with disappearance, and the use of a 20-mm needle was associated with atelectasis. Conclusion: Follow-up after RFA showed that fibrosis, disappearance, and atelectasis remained stable over time. Nodular scars could evolve into fibrotic scars, and cavitary scars could evolve into nodular scars.

Mots clés: Interventional radiology; lung metastases; primary lung tumor; radiofrequency ablation; computed tomography; follow-up

Domaines: Cancer; Pneumologie et système respiratoire; Imagerie

Paul Habert, Mathieu Di Bisceglie, Axel Bartoli, Alexis Jacquier, Pauline Brige, et al.. Description of morphological evolution of lung tumors treated by percutaneous radiofrequency ablation: long term follow-up of 100 lesions with chest CT. International Journal of Hyperthermia, 2021, 38 (1), pp.786-794. ⟨10.1080/02656736.2021.1928773⟩. ⟨hal-03603360⟩