title: Single-session radiofrequency ablation of bilateral lung metastases.
abstract: OBJECTIVE
  This retrospective study examined the feasibility and efficacy of bilateral lung radiofrequency ablation (RFA) performed in a single session.
  
  
  METHODS
  From 2002-2009, patients with bilateral lung metastases were treated by RFA, where possible in a single session under general anesthesia with CT guidance. The second lung was punctured only if no complications occurred after treatment of the first lung. Five lung metastases maximum per patient were treated by RFA and prospectively followed. The primary endpoint was the evaluation of acute and delayed complications. Secondary endpoints were calculation of hospitalization duration, local efficacy, median survival, and median time to tumor progression. Local efficacy was evaluated on CT or positron emission tomography (PET) CT.
  
  
  RESULTS
  Sixty-seven patients were treated for bilateral lung metastases with RFA (mean age, 62 years). Single-session treatment was not possible in 40 due to severe pneumothoraces (n = 24), bilateral pleural contact (n = 14), and operational exclusions (n = 2). Twenty-seven (41%) received single-session RFA of lesions in both lungs for 66 metastases overall. Fourteen unilateral and four bilateral pneumothoraces occurred (18 overall, 66.7%). Unilateral (n = 13) and bilateral (n = 2) chest tube drainage was required. Median hospitalization was 3 (range, 2-8) days. Median survival was 26 months (95% confidence interval (CI), 19-33). Four recurrences on RFA sites were observed (4 patients). Median time to tumor progression was 9.5 months (95% CI, 4.2-23.5).
  
  
  CONCLUSIONS
  Although performing single-session bilateral lung RFA is not always possible due to pneumothoraces after RFA of first lung, when it is performed, this technique is safe and effective.
authors.affiliation: Department of Radiology, Regional Cancer Centre, Institut Bergonié, Bordeaux, France. palussiere@bergonie.org
authors.forename: Jean
authors.initials: J
authors.lastname: Palussière
authors.forename: Fernando
authors.initials: F
authors.lastname: Gómez
authors.forename: Matthieu
authors.initials: M
authors.lastname: Cannella
authors.forename: Stéphane
authors.initials: S
authors.lastname: Ferron
authors.forename: Edouard
authors.initials: E
authors.lastname: Descat
authors.forename: Marianne
authors.initials: M
authors.lastname: Fonck
authors.forename: Véronique
authors.initials: V
authors.lastname: Brouste
authors.forename: Antoine
authors.initials: A
authors.lastname: Avril
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D007479:Iopamidol; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D015641:Radiography, Interventional; D019275:Radiopharmaceuticals; D019233:Retreatment; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D007472:Iohexol; C038192:iopromide; D007479:Iopamidol