Diagnostic yield of a biopsy performed immediately after lung radiofrequency ablation.
OBJECTIVE
To evaluate the diagnostic performance of lung biopsies performed immediately after radiofrequency ablation (RFA).


METHODS
Twenty consecutive patients were treated with lung RFA. A biopsy was performed immediately after RFA, through the cannula used to insert the RFA probe to avoid hampering the RFA probe placement. Biopsies were analysed for diagnostic of malignancy and tumour morphological characteristics. Recurrence of RFA and procedure-related complications are reported.


RESULTS
Mean tumour size was 17.3 mm (±6.2 mm). Ninety per cent (18/20) of biopsies were able to help diagnose malignancy. Cancer subtype and origin were determined in 70 % (14/20) of tumours, including 12 metastases and two primary lung cancers. During a median follow-up of 24 months, one tumour demonstrated local progression (5 %). The overall survival, lung disease-free survival and progression-free survival rates at 12 months were 100 %, 75 % and 65 %, respectively. Adverse events of the procedure including RFA and biopsy were five pneumothoraces requiring chest tube placement (25 %), seven minor pneumothoraces (35 %) and one subsegmental intrapulmonary haemorrhage (5 %) not requiring any treatment.


CONCLUSIONS
A biopsy performed immediately after lung RFA allowed diagnosis of malignancy in 90 % of cases. This diagnosis is obtained without the need for additional puncture and does not hamper the accuracy of the initial RF probe placement.


CONCLUSIONS
• Treatment and biopsy are feasible during the same procedure, avoiding multiple punctures. • The best puncture path can be preserved to treat the lung tumour. • Malignancy can be determined on a post-RFA biopsy in 90 % of cases. • Cancer classification can be assessed in 70 % of cases after lung RFA.
Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, F-94805, Villejuif, France. lambros.tselikas@gustaveroussy.fr.
Lambros
L
Tselikas
Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, F-94805, Villejuif, France.
Thierry
T
de Baere
Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, F-94805, Villejuif, France.
Frederic
F
Deschamps
Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, F-94805, Villejuif, France.
Antoine
A
Hakimé
Medical Oncology Department, Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Benjamin
B
Besse
Interventional Radiology Unit, Medical Imaging Department, Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, F-94805, Villejuif, France.
Christophe
C
Teriitehau
Department of Pathology, Institut d'Oncologie Thoracique, Centre Chirurgical Marie Lannelongue, 92350, Le Plessis Robinson, France.
Vincent
V
de Montpreville
Department of Pathology, Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Julien
J
Adam
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D017115:Catheter Ablation / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology*; D011182:Postoperative Care / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome
Coagulation necrosis; Lung biopsy; Pathological analysis; Post-radiofrequency ablation biopsy; Radiofrequency ablation