Main findings - CT follow up
CT: availability [əˌveɪlə'bɪlətɪ], cost-effective, easy to repeat
Most often used technique for FU after ablation of a lung tumor
Ablation zone: increase in size in the early postoperative period
inflammatory changes, hemorrhagic phenomenon, … and safety margins
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病变 |
术后第二天: inflammatory changes |
安全边界
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safety margins |
消融的直径对生存率有影响。
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651 lung tumors , 12 ± 7 mm (range, 2–42 mm) The difference between electrode array diameter and tumor diameter (DAT) median DAT 12 mm |
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Ihara H. JVIR 2016; 27:87–95
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The difference between electrode array diameter and tumor diameter (DAT) is very important for OS. Ihara H. JVIR 2016; 27:87–95 |
Before 6 months: RF or MW ablation zone is supposed to exceed the size of the initial tumor (complete ablation).
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before |
day 2 |
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M1 |
M3 |
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Month 3 |
Month 6 |
Follow-up after lung ablation
肺癌射频或微波消融后CT的主要发现
After 6 months: the scar decreases in size (complete ablation), But may remain stable. Long term FU: scar equal or bigger than the initial tumor.
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RF |
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48H |
M1 Atelectasis |
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M6 |
M9 |
Palussiere J1, Lagarde P, Aupérin A, Deschamps F, Chomy F, de Baere T. Percutaneous lung thermal ablation of non-surgical clinical N0 non-small cell lung cancer: results of eight years' experience in 87 patients from two centers.Cardiovasc Intervent Radiol. 2015 Feb;38(1):160-6.
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before |
D2 |
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M1 |
M3 |
After 6 months: the scar decreases in size (complete ablation),
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M6 |
M9 |
Long term FU: scar equal or bigger than the initial tumor.
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BEFORE |
M12 |
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D2 |
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M1 |
M3 |
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M3 |
M3 |
FIBROSIS
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M18 |
M18 |
Main issue: Diagnosis of local recurrence
Choice of the reference image is crucial
RECIST evaluation: not effective
Best reference image: one month CT
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