Comparative study of three different catheters for CT imaging-bronchoscopy-guided radiofrequency ablation as a potential and novel interventional therapy for lung cancer.

BACKGROUND: We previously reported that bronchoscopy-guided, internally cooled radiofrequency ablation (RFA) in normal sheep lung was a safe, effective, and feasible procedure without major complications.

PURPOSES: The aim of this study was to evaluate the safety, effectiveness, and feasible conditions of bronchoscopy-guided, internally cooled RFA as a clinical application for non-small cell lung cancer (NSCLC).

METHODS: Ten patients pathologically diagnosed with NSCLC and the clinical stage of T1N0M0 were enrolled in the study. Three types of internally cooled electrode catheter tips were prepared using different procedure conditions involving ablation time: an internally cooled electrode with a 5-mm cylindrical active tip at a power output of 20 W, flow rate of 50 mL/min, and an ablation time of 30 s (n = 3), an electrode with an 8-mm active tip with four beads at 20 W, 50 mL/min, and 40 s (n = 3), and an electrode with a 10-mm active tip with five beads at 20 W, 50 mL/min, and 50 s (n = 4). CT image-guided, bronchoscopy-guided, internally cooled RFA was performed, and the patients underwent standard lung resection therapy. The resected lung tissue was examined histopathologically to assess the ablated areas.

RESULTS: Ablated areas pathologically evaluated with the 10-mm active tip were significantly larger than those with the 5-mm tip. Thus, the ablated areas were enlarged depending on the tip length and prolonged ablation time. There were no complications during RFA, such as bronchial bleeding or pneumothorax.

CONCLUSIONS: CT imaging-bronchoscopy-guided, internally cooled RFA in humans is a safe and feasible procedure that could become a potential therapeutic tool for local control in medically inoperable patients with stage I NSCLC.