Technical Evaluation Of CT-guided Percutaneous Pulmonary Nodule Puncture Biopsy With Simultaneous RFA

Objective:In this study,we performed a technical evaluation of the safety,recent effectiveness and quality-of-life changes for CT-guided percutaneous biopsy with simultaneous radiofrequency ablation(RFA)in high-risk lung nodules,to provide a basis for the clinical application of RFA in early-stage lung cancer.Methods:This is a retrospective study including patients with high-risk pulmonary nodules detected by HRCT(High resolution computer tomography)and underwent CT-guided percutaneous biopsy with simultaneous RFA who were admitted in the Second Affiliated Hospital of Jilin University from December 2021 to February 2023.The side effects and complications of CT-guided simultaneous percutaneous biopsy RFA of pulmonary nodules were monitored intraoperatively and postoperatively,and pulmonary function was reviewed preoperatively and 3 months after treatment to assess the safety of the technique.HRCT was reviewed 1 month after treatment and 3months after treatment to assess the dynamic changes of the lesions after ablation of pulmonary nodules,and the modified solid tumor evaluation criteria,namely RECIST1.1 solid tumor evaluation criteria,were used to evaluate the presence of local recurrence of the ablated lesions.The recent effectiveness of the technique was evaluated using the Karnofsky physical scales(KPS)functional status score to assess the improvement of life quality.SPSS 26.0 statistical software was applied for data analysis.Results:1.This study included 22 patients,all patients completed the surgery successfully,the success rate of immediate ablation was 100%,and all postoperative pathological findings were non-small cell lung cancer.2.10 patients(45.45%)had different degrees of fever after the operation,which improved after symptomatic treatment.4 patients(18.18%)had pneumothorax after the operation,of which only 1 patient(4.55%)was given thoracentesis for delayed pneumothorax.6 patients(30.00%)had cough after the operation,5 patients(22.73%)had mild pain,symptoms were slowly resolved on their own.One case each of pleural effusion and blood in sputum improved without special treatment.There were no significant differences in the values of the first second exertional respiratory volume(FEV1),first second exertional respiratory volume/exertional spirometry(FEV1/FVC)and pulmonary carbon monoxide diffusion volume(DLCO)in the preoperative and postoperative pulmonary function tests 3 months later.3.The evaluation was performed one month after the operation,0 case was CR,8 cases were PR,14 cases were SD and 0 case was PD.The evaluation was performed three month after the operation,3 case was CR,13 cases were PR,6 cases were SD and 0 case was PD.After 1 month of postoperative observation,the ORR value was36.3%,while the DCR value reached 100%,while the ORR value reached 72.7% and the DCR value reached 100% at 1 month after the operation postoperatively.Statistical analysis by chi-square test showed that there was a significant difference between ORR at 1 month after the operation postoperatively and 3 months postoperatively(p<0.05),while DCR reached 100% at both 1 month postoperatively and 3 months postoperatively,chi-square test could not be conducted.4.After the operation,the patient’s KPS score improved significantly,from78.05±11.56 before the operation,to 81.32±10.07 at 1 month after the operation to84.32±9.36 at 3 months after the operation.The patient’s KPS score were dramatically higher at 3 months postoperatively compared to before the operation(p<0.05).Conclusion:1.No significant adverse reactions and complications were observed during CT-guided percutaneous pulmonary nodule puncture biopsy with simultaneous RFA,and the success rate of ablation immediate technique was high.The common postoperative complications are mostly mild fever and pneumothorax,and there are no serious complications.The lung function is effectively preserved.Therefore,this technique is safe and reliable.2.CT-guided percutaneous pulmonary nodule puncture biopsy with simultaneous RFA could help obtain pathological diagnosis of the nodules and effectively inactive the tumor,with significant recent efficacy and improvement of patients’ quality of life.3.CT-guided percutaneous pulmonary nodule puncture biopsy with simultaneous RFA will be an effective and safe local treatment for early stage NSCLC presenting as pulmonary nodules.