Percutaneous radiofrequency ablation of lung metastases from colorectal carcinoma under C-arm cone beam CT guidance

G Amouyal; S Pernot; C Déan; B Cholley; F Scotté; M Sapoval; O Pellerin

doi:10.1016/j.diii.2017.05.002

Percutaneous radiofrequency ablation of lung metastases from colorectal carcinoma under C-arm cone beam CT guidance

Diagn Interv Imaging. 2017 Nov;98(11):793-799. doi: 10.1016/j.diii.2017.05.002. Epub 2017 May 29.

Authors

G Amouyal¹, S Pernot², C Déan¹, B Cholley³, F Scotté⁴, M Sapoval⁵, O Pellerin⁶

Affiliations

¹ Vascular and Oncological Interventional Radiology Department, Hôpital Européen George Pompidou, Assistance Publique Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
² Digestive Oncology Department, Hôpital Européen George Pompidou, Assistance Publique Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France.
³ Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Anesthesia-reanimation Care Department, Hôpital Européen George Pompidou, Assistance Publique Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
⁴ Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Supportive care unit Oncology Department, Hôpital Européen George Pompidou, Assistance Publique Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
⁵ Vascular and Oncological Interventional Radiology Department, Hôpital Européen George Pompidou, Assistance Publique Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Supportive care unit Oncology Department, Hôpital Européen George Pompidou, Assistance Publique Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
⁶ Vascular and Oncological Interventional Radiology Department, Hôpital Européen George Pompidou, Assistance Publique Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Supportive care unit Oncology Department, Hôpital Européen George Pompidou, Assistance Publique Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France. Electronic address: olivier.pellerin@aphp.fr.

PMID: 28571704
DOI: 10.1016/j.diii.2017.05.002

Abstract

Purpose: The aim of this study was to assess the feasibility, safety and efficacy of percutaneous radiofrequency ablation of lung metastases from colorectal carcinoma using C-arm cone beam computed tomography (CBCT) guidance.

Material and methods: This single-center prospective observational study was performed from August 2013 to August 2016, and included consecutive patients referred for radiofrequency ablation of lung metastases from colorectal cancer. Radiofrequency ablation procedures were performed under C-arm CBCT guidance. Feasibility was assessed by probe accuracy placement, time to accurate placement and number of C-arm CBCT acquisitions to reach the target lesion. Safety was assessed by the report of adverse event graded using the common terminology criteria for adverse events (CTCAE-V4.0). Efficacy was assessed by metastases response rate using RECIST 1.1 and ¹⁸FDG-PET-CT tumor uptake at 6months.

Results: Fifty-four consecutive patients (32 men, 22 women) with a mean age of 63±8 (SD) years (range: 51-81years) with a total of 56 lung metastasis from colorectal metastases were treated in a single session. The mean tumor diameter was 25.6±4.5 (SD)mm (range: 17-31mm). Median time to insert the needle into the target lesion was 10min (range: 5-25min). Median number of needles repositioning and C-arm CBCT acquisition per patient was 1 (range: 0-3) and 4 (range: 3-6) respectively. The accuracy for radiofrequency ablation probe placement was 2±0.2 (SD)mm (range: 0-9mm). Pneumothorax requiring chest tube placement occurred in one patient (CTCAE-V4.0 grade 3). At 6months, all patients were alive with tumor response rate of -27% and had no significant activity on the ¹⁸FDG-PET CT follow-up.

Conclusion: Percutaneous radiofrequency ablation of lung metastases from colorectal cancer under C-arm CBCT guidance is feasible and safe, with immediate and short-term results similar to those obtained using conventional CT guidance.

Keywords: C-arm CBCT guidance; Colorectal cancer lung metastases; Interventional imaging; Lung metastases; Radiofrequency ablation.

Publication types

Observational Study

MeSH terms

Aged
Aged, 80 and over
Catheter Ablation*
Colorectal Neoplasms / pathology*
Cone-Beam Computed Tomography*
Female
Fluorodeoxyglucose F18
Humans
Lung Neoplasms / diagnostic imaging*
Lung Neoplasms / surgery*
Male
Middle Aged
Positron Emission Tomography Computed Tomography
Prospective Studies
Radiography, Interventional*
Radiopharmaceuticals

Substances

Radiopharmaceuticals
Fluorodeoxyglucose F18