Role of thermal ablation in management of pulmonary tumors

Background Image-guided percutaneous thermal ablation is an effective therapeutic alternative for patients with inoperable primary and secondary lung malignancies. These techniques induce localized coagulative necrosis of tumor cells via thermal energy. Aims To evaluate the safety and efficacy of CT-guided thermal ablation in the management of pulmonary tumors. Methods A prospective study was conducted on 40 patients with primary or secondary lung neoplasms who underwent CT-guided thermal ablation, utilizing either microwave ablation (MWA) or radiofrequency ablation (RFA) between February 2020 and February 2022. Patients were followed up at 3-, 6-, and 12-month post-procedure to assess treatment response. Results A total of 64 lesions were treated. Twenty-five patients (38 lesions) were treated with MWA, achieving an overall success rate of 84.2%. Fifteen patients (26 lesions) were treated with RFA, with an overall success rate of 84.6%. No statistically significant difference in outcome was observed between the two modalities. No incidents of mortality or major complications were reported. In the MWA group, minor complications occurred more frequently; however, the difference was not statistically significant. Notably, this group included larger, more centrally located lesions, particularly within the hilar and para-hilar regions. Conclusion CT-guided percutaneous thermal ablation is a safe and effective minimally invasive treatment for selected patients with pulmonary tumors, with both MWA and RFA demonstrating high and comparable success rates. Further large-scale randomized trials are warranted to confirm these findings.