title: Radiofrequency ablation of pulmonary tumors near the diaphragm.
abstract: OBJECTIVE
  To retrospectively evaluate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) of lung tumors located near the diaphragm.
  
  
  METHODS
  A total of 26 patients (15 men, 11 women; mean age, 61.5 years±13.0 [SD]) with a total of 29 lung tumors near the diaphragm (i.e., distance<10mm) were included. Mean tumor diameter was 11.0mm±5.3 (SD) (range, 2-23mm). Efficacy of RFA, number of adverse events and number of adverse events with a grade≥3, based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0, were compared between patients with lung tumors near the diaphragm and a control group of patients with more distally located lung tumors (i.e., distance≥10mm).
  
  
  RESULTS
  RFA was technically feasible for all tumors near the diaphragm. Four grade 3 adverse events (1 pneumothorax requiring pleurodesis and 3 phrenic nerve injuries) were observed. No grade≥4 adverse events were reported. The median follow-up period for tumors near the diaphragm was 18.3 months. Local progression was observed 3.3 months after RFA in 1 tumor. The technique efficacy rates were 96.2% at 1 year and 96.2% at 2 years and were not different, from those observed in control subjects (186 tumors; P=0.839). Shoulder pain (P<0.001) and grade 1 pleural effusion (P<0.001) were more frequently observed in patients with lung tumor near the diaphragm. The rates of grade≥3 adverse events did not significantly differ between tumors near the diaphragm (4/26 sessions) and the controls (7/133 sessions) (P=0.083).
  
  
  CONCLUSIONS
  RFA is a feasible and effective therapeutic option for lung tumors located near the diaphragm. However, it conveys a higher rate of shoulder pain and asymptomatic pleural effusion by comparison with more distant lung tumors.
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku, Okayama 700-8558, Japan. Electronic address: iguchi@ba2.so-net.ne.jp.
authors.forename: T
authors.initials: T
authors.lastname: Iguchi
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku, Okayama 700-8558, Japan. Electronic address: takaoh@tc4.so-net.ne.jp.
authors.forename: T
authors.initials: T
authors.lastname: Hiraki
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku, Okayama 700-8558, Japan. Electronic address: gobara@cc.okayama-u.ac.jp.
authors.forename: H
authors.initials: H
authors.lastname: Gobara
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku, Okayama 700-8558, Japan. Electronic address: hirofujiwar@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Center for Innovative Clinical Medicine, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku, Okayama 700-8558, Japan. Electronic address: sakurai-jun@okayama-u.ac.jp.
authors.forename: J
authors.initials: J
authors.lastname: Sakurai
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku, Okayama 700-8558, Japan. Electronic address: y-matsui@okayama-u.ac.jp.
authors.forename: Y
authors.initials: Y
authors.lastname: Matsui
authors.affiliation: Center for Innovative Clinical Medicine, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku, Okayama 700-8558, Japan. Electronic address: sankyoh@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Mitsuhashi
authors.affiliation: Department of General Thoracic Surgery, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku, Okayama 700-8558, Japan; Department of Clinical Genomic Medicine, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku, Okayama 700-8558, Japan. Electronic address: shintoyooka@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Toyooka
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku, Okayama 700-8558, Japan. Electronic address: susumu@cc.okayama-u.ac.jp.
authors.forename: S
authors.initials: S
authors.lastname: Kanazawa
keywords: Diaphragm; Interventional imaging; Lung; Lung cancer; Radiofrequency ablation