Application of DynaCT combined with 3D iGuide puncture technique to microwave ablation of lung cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FAN Chen , TANG Haohuan , ZHOU Qi , SUN Feihu , DING Wei , SUN Lei , WANG Weitao , XU Ping ,  WANG Weidong

Department of Intervention, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, Jiangsu, P. R. China;

Corresponding author：

WANG Weidong, Email: Wdoc@sina.com

Keywords：

DynaCT; lung cancer; microwave ablation; intervention therapy

DOI：

10.7507/1007-4848.202102052

Video：

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Objective To investigate the feasibility and safety of DynaCT microwave ablation (MWA) guided by 3D iGuide puncture technology for lung cancer.Methods The clinical data of 19 patients with primary or metastatic lung cancer who underwent DynaCT MWA from June 2019 to December 2020 in our hospital were retrospectively analyzed, including 15 males and 4 females with an average age of 64.9±11.7 years. The technical success rates, adverse reactions and complications, postoperative hospital stay, and local therapeutic efficacy were recorded.Results Technical success rate was 100.0%. The mean time required to target and place the needle was 15.7±3.7 min and the mean ablation time was 5.7±1.6 min. Thirteen patients underwent biopsy synchronously before the ablation, and 10 (76.9%) patients had positive pathological results. The main adverse reactions were pain (7/19, 36.8%), post-ablation syndrome (4/19, 21.1%) and cough (2/19, 10.5%). The minor complications were pneumothorax (6/19, 31.6%), hemorrhage (5/19, 26.3%), pleural effusion (2/19, 10.5%) and cavity (1/19, 5.3%). Three patients had moderate pneumothorax and received closed thoracic drainage. The median hospitalization time after ablation was 2.0 (2.0, 3.0) d, and no patient died during the perioperative period. The initial complete ablation rate was 89.5% (17 patients) and the incomplete ablation rate was 10.5% (2 patients) at 1-month follow-up, and no local progression was observed.Conclusion DynaCT MWA of lung cancer under the guidance of 3D iGuide system is safe and feasible with a high short-term local control rate, but the long-term efficacy remains to be further observed.

Citation： FAN Chen, TANG Haohuan, ZHOU Qi, SUN Feihu, DING Wei, SUN Lei, WANG Weitao, XU Ping, WANG Weidong. Application of DynaCT combined with 3D iGuide puncture technique to microwave ablation of lung cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(2): 221-225. doi: 10.7507/1007-4848.202102052 Copy

1.	邹小农, 贾漫漫, 王鑫, 等. 《2020 全球癌症报告》要点解读. 中国胸心血管外科临床杂志, 2021, 28(1): 11-18.
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4.	Cazzato RL, Battistuzzi JB, Catena V, et al. Cone-beam computed tomography (CBCT) versus CT in lung ablation procedure: Which is faster? Cardiovasc Intervent Radiol, 2015, 38(5): 1231-1236.
5.	袁宏军, 刘凤永, 李鑫, 等. 3D iGuide 穿刺技术在 DynaCT 引导射频消融治疗大肝癌中的应用. 中华介入放射学电子杂志, 2018, 6(2): 113-117.
6.	曹碧辉, 陈德基, 梁宝霞, 等. 锥形束 CT 联合 iGuide 引导系统在经皮经胸肺穿刺活检术中的应用. 中国介入影像与治疗学, 2018, 15(4): 213-216.
7.	Ahmed M, Solbiati L, Brace CL, et al. Image-guided tumor ablation: Standardization of terminology and reporting criteria—A 10-year update. Radiology, 2014, 273(1): 241-260.
8.	Howington JA, Blum MG, Chang AC, et al. Treatment of stageⅠandⅡnon-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e278S-e313S.
9.	Gillams A. Ablation of lung tumours. Cancer Imaging, 2012, 12(2): 361-362.
10.	Lin M, Eiken P, Blackmon S. Image guided thermal ablation in lung cancer treatment. J Thorac Dis, 2020, 12(11): 7039-7047.
11.	Tafti BA, Genshaft S, Suh R, et al. Lung ablation: Indications and techniques. Semin Intervent Radiol, 2019, 36(3): 163-175.
12.	Abtin F, De Baere T, Dupuy DE, et al. Updates on current role and practice of lung ablation. J Thorac Imaging, 2019, 34(4): 266-277.
13.	Macchi M, Belfiore MP, Floridi C, et al. Radiofrequency versus microwave ablation for treatment of the lung tumours: LUMIRA (lung microwave radiofrequency) randomized trial. Med Oncol, 2017, 34(5): 96.
14.	Chi J, Ding M, Shi Y, et al. Comparison study of computed tomography-guided radiofrequency and microwave ablation for pulmonary tumors: A retrospective, case-controlled observational study. Thorac Cancer, 2018, 9(10): 1241-1248.
15.	Yuan Z, Wang Y, Zhang J, et al. A meta-analysis of clinical outcomes after radiofrequency ablation and microwave ablation for lung cancer and pulmonary metastases. J Am Coll Radiol, 2019, 16(3): 302-314.
16.	Prud'homme C, Deschamps F, Moulin B, et al. Image-guided lung metastasis ablation: A literature review. Int J Hyperthermia, 2019, 36(2): 37-45.
17.	Grasso RF, Cazzato RL, Luppi G, et al. Percutaneous lung biopsies: Performance of an optical CT-based navigation system with a low-dose protocol. Eur Radiol, 2013, 23(11): 3071-3076.
18.	Wang D, Li B, Bie Z, et al. Synchronous core-needle biopsy and microwave ablation for highly suspicious malignant pulmonary nodule via a coaxial cannula. J Cancer Res Ther, 2019, 15(7): 1484-1489.
19.	Rotolo N, Floridi C, Imperatori A, et al. Comparison of cone-beam CT-guided and CT fluoroscopy-guided transthoracic needle biopsy of lung nodules. Eur Radiol, 2016, 26(2): 381-389.

1. 邹小农, 贾漫漫, 王鑫, 等. 《2020 全球癌症报告》要点解读. 中国胸心血管外科临床杂志, 2021, 28(1): 11-18.
2. 中华医学会, 中华医学会肿瘤学分会, 华医学会杂志社. 中华医学会肺癌临床诊疗指南(2019 版). 中华肿瘤杂志, 2020, 42(4): 257-258.
3. Ye X, Fan W, Wang H, et al. Expert consensus workshop report: Guidelines for thermal ablation of primary and metastatic lung tumors (2018 edition). J Cancer Res Ther, 2018, 14(4): 730-744.
4. Cazzato RL, Battistuzzi JB, Catena V, et al. Cone-beam computed tomography (CBCT) versus CT in lung ablation procedure: Which is faster? Cardiovasc Intervent Radiol, 2015, 38(5): 1231-1236.
5. 袁宏军, 刘凤永, 李鑫, 等. 3D iGuide 穿刺技术在 DynaCT 引导射频消融治疗大肝癌中的应用. 中华介入放射学电子杂志, 2018, 6(2): 113-117.
6. 曹碧辉, 陈德基, 梁宝霞, 等. 锥形束 CT 联合 iGuide 引导系统在经皮经胸肺穿刺活检术中的应用. 中国介入影像与治疗学, 2018, 15(4): 213-216.
7. Ahmed M, Solbiati L, Brace CL, et al. Image-guided tumor ablation: Standardization of terminology and reporting criteria—A 10-year update. Radiology, 2014, 273(1): 241-260.
8. Howington JA, Blum MG, Chang AC, et al. Treatment of stageⅠandⅡnon-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e278S-e313S.
9. Gillams A. Ablation of lung tumours. Cancer Imaging, 2012, 12(2): 361-362.
10. Lin M, Eiken P, Blackmon S. Image guided thermal ablation in lung cancer treatment. J Thorac Dis, 2020, 12(11): 7039-7047.
11. Tafti BA, Genshaft S, Suh R, et al. Lung ablation: Indications and techniques. Semin Intervent Radiol, 2019, 36(3): 163-175.
12. Abtin F, De Baere T, Dupuy DE, et al. Updates on current role and practice of lung ablation. J Thorac Imaging, 2019, 34(4): 266-277.
13. Macchi M, Belfiore MP, Floridi C, et al. Radiofrequency versus microwave ablation for treatment of the lung tumours: LUMIRA (lung microwave radiofrequency) randomized trial. Med Oncol, 2017, 34(5): 96.
14. Chi J, Ding M, Shi Y, et al. Comparison study of computed tomography-guided radiofrequency and microwave ablation for pulmonary tumors: A retrospective, case-controlled observational study. Thorac Cancer, 2018, 9(10): 1241-1248.
15. Yuan Z, Wang Y, Zhang J, et al. A meta-analysis of clinical outcomes after radiofrequency ablation and microwave ablation for lung cancer and pulmonary metastases. J Am Coll Radiol, 2019, 16(3): 302-314.
16. Prud'homme C, Deschamps F, Moulin B, et al. Image-guided lung metastasis ablation: A literature review. Int J Hyperthermia, 2019, 36(2): 37-45.
17. Grasso RF, Cazzato RL, Luppi G, et al. Percutaneous lung biopsies: Performance of an optical CT-based navigation system with a low-dose protocol. Eur Radiol, 2013, 23(11): 3071-3076.
18. Wang D, Li B, Bie Z, et al. Synchronous core-needle biopsy and microwave ablation for highly suspicious malignant pulmonary nodule via a coaxial cannula. J Cancer Res Ther, 2019, 15(7): 1484-1489.
19. Rotolo N, Floridi C, Imperatori A, et al. Comparison of cone-beam CT-guided and CT fluoroscopy-guided transthoracic needle biopsy of lung nodules. Eur Radiol, 2016, 26(2): 381-389.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of DynaCT combined with 3D iGuide puncture technique to microwave ablation of lung cancer

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