SIR 2024
Interventional Oncology
Stephanie L. McNamara, PhD, MS (she/her/hers)
Medical Student
Harvard Medical School
Financial relationships: Full list of relationships is listed on the CME information page.
Shelly Uppal, DO
Interventional Radiology Fellow
Beth Israel Deaconess Medical Center
Disclosure information not submitted.
Salomao Faintuch, MD
Interventional Radiologist
Beth Israel Deaconess Medical Center - Harvard Medical School
Disclosure information not submitted.
A cohort of 152 patients was identified with a total of 176 lung nodules. Despite patient-to-patient variability, a trend of larger ablation zone size with higher ablation power was observed. Multivariate regression was used to generate a predictive table of ablation zone size in lung compared to commercially available charts in liver (AMICA, Mermaid Medical). The most frequent treatment was 60 W for 5 minutes, resulting in lung ablation zones on average 21.9% longer and 12.3% wider than in liver. Ablation zone analysis in follow-up scans revealed a reduction in ablation zone volume and sphericity index over time. Regarding complications, 40% of patients had post-procedure pneumothorax, with higher frequency in patients with emphysema (48% vs. 28%) and those with nodules located more centrally. Finally, 12% of patients had local disease recurrence, occurring an average of 13.6 months post-treatment.
Conclusion: MWA has been shown to be an effective treatment in multiple organs, but further data is needed to optimize its use in lung. In a cohort of 152 patients with primary lung cancer, ablation zones were found to be significantly larger than those predicted in liver. Thus, there is a need to develop MWA procedural planning algorithms specific to lung. Patient- and nodule-specific factors, such as emphysema and nodule location, correlated with post-procedure pneumothorax, and local recurrence was seen in 12% of this cohort.