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Safety and feasibility of a novel externally cooled bronchoscopic radiofrequency ablation catheter for ablation of peripheral lung tumours: a first-in-human dose escalation study

D Steinfort, P Antippa, K Rangamuwa, L Irving, M Christie, E Chan, D Tanaka, K Yoneda, J Christie, F Herth, S Raina
European Respiratory Journal 2022 60: 4398; DOI: 10.1183/13993003.congress-2022.4398
D Steinfort
1The Royal Melbourne Hospital, Melbourne, Australia
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P Antippa
1The Royal Melbourne Hospital, Melbourne, Australia
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K Rangamuwa
1The Royal Melbourne Hospital, Melbourne, Australia
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L Irving
1The Royal Melbourne Hospital, Melbourne, Australia
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M Christie
1The Royal Melbourne Hospital, Melbourne, Australia
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E Chan
2Alfred Health, Melbourne, Australia
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D Tanaka
3EOLO MEDICAL, Cupertino, USA
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K Yoneda
4UC Davis Health, Sacramento, USA
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J Christie
1The Royal Melbourne Hospital, Melbourne, Australia
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F Herth
5University of Heidelberg, Heidelberg, Germany
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S Raina
6Zidan Medical, Santa Clara, USA
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Abstract

Background: Surgical lobectomy remains preferred therapy for early-stage non-small cell lung cancer (NSCLC). Comorbidities and advanced age preclude resection in many patients. Radiofrequency ablation (RFA) is an effective modality for percutaneous ablation of NSCLC. We have developed a novel RFA Catheter with externally cooled electrode for ablation of pulmonary lesions.

Methods: Single arm treat-and-resect study. Biopsy-confirmed NSCLC. Procedures were performed under general anaesthesia with neuromuscular blockade. The RFA catheter was delivered bronchoscopically to peripheral parenchymal NSCLC lesions, guided by radial EBUS, and intra-procedural cone beam CT. Participants underwent lobectomy 7 days post-ablation. Pre-op CT chest and histologic examination of resected specimens established distribution/uniformity of ablation and efficacy of tumour ablation.

Results: Seven patients underwent RFA of NSCLC (median size 2.5cm, range 1.7-3.1cm) with sequential dose escalation. Uniform ablation was achieved within ablation zones, including tumour in all cases. Gravity-dependent extension of ablation was frequently seen. Proportion of tumour ablated ranged from 8-72%, a dose-response (energy-ablation volume) relationship was observed.

Conclusion: Bronchoscopic RFA using externally cooled catheter is safe, feasible, and achieves uniform ablation within treatment zones at relatively low energy levels. Use of increased energy levels, and improved targeting/overlap of ablation zone to target lesion is expected to improve ablative efficacy. Future studies with a modified catheter are planned.

  • Experimental approaches
  • Treatments
  • Bronchoscopy

Footnotes

Cite this article as Eur Respir J 2022; 60: Suppl. 66, 4398.

This article was presented at the 2022 ERS International Congress, in session “-”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2022
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Safety and feasibility of a novel externally cooled bronchoscopic radiofrequency ablation catheter for ablation of peripheral lung tumours: a first-in-human dose escalation study
D Steinfort, P Antippa, K Rangamuwa, L Irving, M Christie, E Chan, D Tanaka, K Yoneda, J Christie, F Herth, S Raina
European Respiratory Journal Sep 2022, 60 (suppl 66) 4398; DOI: 10.1183/13993003.congress-2022.4398

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Safety and feasibility of a novel externally cooled bronchoscopic radiofrequency ablation catheter for ablation of peripheral lung tumours: a first-in-human dose escalation study
D Steinfort, P Antippa, K Rangamuwa, L Irving, M Christie, E Chan, D Tanaka, K Yoneda, J Christie, F Herth, S Raina
European Respiratory Journal Sep 2022, 60 (suppl 66) 4398; DOI: 10.1183/13993003.congress-2022.4398
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