MR imaging-guided percutaneous cryotherapy for lung tumors: initial experience

J Vasc Interv Radiol. 2014 Sep;25(9):1456-62. doi: 10.1016/j.jvir.2014.04.025. Epub 2014 Jun 27.

Abstract

Purpose: To evaluate prospectively the initial clinical experience of magnetic resonance (MR) imaging-guided percutaneous cryotherapy of lung tumors.

Materials and methods: MR imaging-guided percutaneous cryotherapy was performed in 21 patients with biopsy-proven lung tumors (12 men, 9 women; age range, 39-79 y). Follow-up consisted of contrast-enhanced chest computed tomography (CT) scan performed at 3-month intervals to assess tumor control; CT scanning was carried out for 12 months or until death.

Results: Cryotherapy procedures were successfully completed in all 21 patients. Pneumothorax occurred in 7 (33.3%) of 21 patients. Chest tube placement was required in one (4.8%) case. Hemoptysis was exhibited by 11 (52.4%) patients, and pleural effusion occurred in 6 (28.6%) patients. Other complications were observed in 14 (66.7%) patients. The mean follow-up period was 10.5 months (range, 9-12 mo) in patients who died. At month 12 of follow-up, 7 (33.3%) patients had a complete response to therapy, and 10 (47.6%) patients showed a partial response. In addition, two patients had stable disease, and two patients developed progressive disease; one patient developed a tumor in the liver, and the other developed a tumor in the brain. The 1-year local control rate was 81%, and 1-year survival rate was 90.5%.

Conclusions: MR imaging-guided percutaneous cryotherapy appears feasible, effective, and minimally invasive for lung tumors.

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Cryotherapy / adverse effects
  • Cryotherapy / methods*
  • Cryotherapy / mortality
  • Disease Progression
  • Feasibility Studies
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Magnetic Resonance Imaging, Interventional*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Postoperative Complications / mortality
  • Prospective Studies
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome