Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors

Authors

Maya Abrishami Kashani, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.Follow
Mark C. Murphy, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.Follow
Jonathan A. Saenger, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.Follow
Maria M. Wrobel, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Ismail Tahir, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.Follow
Sofiane Mrah, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Stefan Ringer, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.Follow
Alexander C. Bunck, Department of Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Stuart G. Silverman, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.Follow
Paul B. Shyn, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.
Dessislava A. Pachamanova, Division of Mathematics and Science, Babson College, Wellesley, MA, USA.
Florian J. Fintelmann, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. fintelmann@mgh.harvard.edu.Follow

Document Type

Article

Publication Title

European radiology

Abstract

OBJECTIVES: To compare the incidence of persistent air leak (PAL) following cryoablation vs MWA of lung tumors when the ablation zone includes the pleura. METHODS: This bi-institutional retrospective cohort study evaluated consecutive peripheral lung tumors treated with cryoablation or MWA from 2006 to 2021. PAL was defined as an air leak for more than 24 h after chest tube placement or an enlarging postprocedural pneumothorax requiring chest tube placement. The pleural area included by the ablation zone was quantified on CT using semi-automated segmentation. PAL incidence was compared between ablation modalities and a parsimonious multivariable model was developed to assess the odds of PAL using generalized estimating equations and purposeful selection of predefined covariates. Time-to-local tumor progression (LTP) was compared between ablation modalities using Fine-Gray models, with death as a competing risk. RESULTS: In total, 260 tumors (mean diameter, 13.1 mm ± 7.4; mean distance to pleura, 3.6 mm ± 5.2) in 116 patients (mean age, 61.1 years ± 15.3; 60 women) and 173 sessions (112 cryoablations, 61 MWA) were included. PAL occurred after 25/173 (15%) sessions. The incidence was significantly lower following cryoablation compared to MWA (10 [9%] vs 15 [25%]; p = .006). The odds of PAL adjusted for the number of treated tumors per session were 67% lower following cryoablation (odds ratio = 0.33 [95% CI, 0.14-0.82]; p = .02) vs MWA. There was no significant difference in time-to-LTP between ablation modalities (p = .36). CONCLUSIONS: Cryoablation of peripheral lung tumors bears a lower risk of PAL compared to MWA when the ablation zone includes the pleura, without adversely affecting time-to-LTP. KEY POINTS: • The incidence of persistent air leaks after percutaneous ablation of peripheral lung tumors was lower following cryoablation compared to microwave ablation (9% vs 25%; p = .006). • The mean chest tube dwell time was 54% shorter following cryoablation compared to MWA (p = .04). • Local tumor progression did not differ between lung tumors treated with percutaneous cryoablation compared to microwave ablation (p = .36).

First Page

5740

Last Page

5751

DOI

10.1007/s00330-023-09499-y

Publication Date

8-1-2023

Recommended Citation

Abrishami Kashani, Maya; Murphy, Mark C.; Saenger, Jonathan A.; Wrobel, Maria M.; Tahir, Ismail; Mrah, Sofiane; Ringer, Stefan; Bunck, Alexander C.; Silverman, Stuart G.; Shyn, Paul B.; Pachamanova, Dessislava A.; and Fintelmann, Florian J., "Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors" (2023). Radiology. 6.
https://scholar.bridgeporthospital.org/radiology/6

Identifier

36892641 (pubmed); 10.1007/s00330-023-09499-y (doi); 10.1007/s00330-023-09499-y (pii)