Transbronchial microwave ablation of lung nodules with Lungpoint navigation bronchoscopy guidance and Dyna-CT monitoring—a novel technique and initial experience with 35 cases

H. Ouyang*^a (Dr)

^a Xi’an International Medical Center hospital, Xi’an, CHINA

* ouyhf@hotmail.com

Background: Microwave ablation can provide a faster, larger and more predictable ablation zone than other energy sources in the local therapy of lung nodules. In addition, bronchoscopic transbronchial ablation has theoretical advantage of fewer pleural-based complications than percutaneous approach. The aim of this study is to determine whether the novel combination of Lungpoint navigated bronchoscopic approach and microwave ablation monitored by Dyna-CT in the management of lung nodules is technically feasible, safe and effective. Methods: We retrospectively analyzed 35 patients with lung nodules who underwent Lungpoint navigation bronchoscopy microwave ablation in Dyna-CT hybrid operating room in Xi’an International Medical Center hospital. Patients had high surgical risks while lung nodules were either proven malignant or radiologically suspicious. Primary endpoints include technical feasibility and safety. Results: 38 lung nodules from 35 patients were treated. Mean nodule size was 13.8 mm, and bronchus directly leads to the nodules (bronchus sign positive) in 19 lung nodules. Lungpoint-TBNA with Flexneedle was performed in remaining 19 nodules. Technical success rate was 100%, only 1 nodule required double ablation for adequate coverage. Mean minimal ablation margin was 5.32 mm. The mean actual ablation zone volume was +5.6% compared to predicted. There was no significant heat sink effect. Mean procedural time was 68.6 min (40.6-122.1). There was no presentation of pneumothorax, pleural effusion or hemoptysis. After median follow up of 6 months, none of the nodules had evidence of progression. Conclusions: Lungpoint navigation bronchoscopic transbronchial microwave ablation monitored by Dyna-CT is safe and feasible for treatment of malignant lung nodules. A prospective study on clinical application of this novel technique is warranted.

Disclosure of funding source(s): none