Microwave Ablation of Lung Nodule

Abstract

We present a clinical case of a 71-year-old man with history of rectal adenocarcinoma cT3N1M0, previously treated with neoadjuvant chemotherapy/radiotherapy and anterior resection of the rectum. During imaging follow-up, a new growing pulmonary nodule was identified in the left upper lobe. After two biopsies of this nodule yielded insufficient material, the patient refused a third attempt. This nodule is intensely hypermetabolic on PET-CT, suggestive of metastasis. The decision by a multidisciplinary team was to treat the pulmonary nodule with microwave ablation. Image-guided thermal ablation is a technique in the field of Interventional Radiology that has emerged as a minimally invasive option for treating tumors in multiple organs, with various indications and excellent results. A good understanding of the (un)expected imaging characteristics after thermal ablation, also presented in this article, is crucial for effective patient surveillance and management.