Standardizing percutaneous Microwave Ablation in the treatment of Lung Tumors: a prospective multicenter trial (MALT study)

Roberto Iezzi, Stefano Margaritora, Vincenzo Valentini, Riccardo Manfredi, Roberto Cioni, Domenico Basile, Nevio Tosoratti, Marco Busso, Carla Cappelli, Marcello Carlo Ambrogi, Rossella Scandiffio, Marco Calandri, Laura Crocetti, Andrea Veltri

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3 Citations (Scopus)


Objectives: To prospectively assess reproducibility, safety, and efficacy of microwave ablation (MWA) in the treatment of unresectable primary and secondary pulmonary tumors. Methods: Patients with unresectable primary and metastatic lung tumors up to 4 cm were enrolled in a multicenter prospective clinical trial and underwent CT-guided MWA. Treatments were delivered using pre-defined MW power and duration settings, based on target tumor size and histology classifications. Patients were followed for up to 24 months. Treatment safety, efficacy, and reproducibility were assessed. Ablation volumes were measured at CT scan and compared with ablation volumes obtained on ex vivo bovine liver using equal treatment settings. Results: From September 2015 to September 2017, 69 MWAs were performed in 54 patients, achieving technical success in all cases and treatment completion without deviations from the standardized protocol in 61 procedures (88.4%). Immediate post-MWA CT scans showed ablation dimensions smaller by about 25% than in the ex vivo model; however, a remarkable volumetric increase (40%) of the treated area was observed at 1 month post-ablation. No treatment-related deaths nor complications were recorded. Treatments of equal power and duration yielded fairly reproducible ablation dimensions at 48-h post-MWA scans. In comparison with the ex vivo liver model, in vivo ablation sizes were systematically smaller, by about 25%. Overall LPR was 24.7%, with an average TLP of 8.1 months. OS rates at 12 and 24 months were 98.0% and 71.3%, respectively. Conclusions: Percutaneous CT-guided MWA is a reproducible, safe, and effective treatment for malignant lung tumors up to 4 cm in size. Key Points: • Percutaneous MWA treatment of primary and secondary lung tumors is a repeatable, safe, and effective therapeutic option. • It provides a fairly reproducible performance on both the long and short axis of the ablation zone. • When using pre-defined treatment duration and power settings according to tumor histology and size, LPR does not increase with increasing tumor size (up to 4 cm) for both primary and metastatic tumors.
Original languageEnglish
Pages (from-to)2173-2182
Number of pages10
JournalEuropean Radiology
Publication statusPublished - 2021


  • Animals
  • Catheter Ablation
  • Cattle
  • Humans
  • Lung
  • Lung Neoplasms
  • Microwave
  • Microwaves
  • Neoplasms
  • Prospective Studies
  • Radiofrequency Ablation
  • Radiofrequency ablation
  • Reproducibility of Results
  • Safety
  • Treatment Outcome


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