Recurrence of Lung Cancer After Radiofrequency Ablation Detected by PET/CT and Contrast Enhanced CT Scan

摘要

82-year-old female with a history ofcough for three months had a CT ofthe chest which revealed a 1.5 cm rightupper lobe pulmonary nodule. (Figure1) The patient underwent a CT guidedpercutaneous biopsy which on histologywas consistent with adenocarcinoma ofthe lung. The patient then underwent apositron emission tomography/computedtomography (PET/CT) scan (Figure2) with 18F-fluorodeoxyglucose(F-18 FDG) for staging whichshowed intense uptake in the rightupper lobe adenocarcinoma withoutevidence of metastatic disease. Thepatient was not a surgical candidatedue to poor pulmonary reserve andsubsequently underwent percutaneousradiofrequency ablation (RFA)of the right upper lobe adenocarcinoma.After RFA, a follow-upPET/CT (Figure 3) six months latershowed curvilinear activity aroundthe ablation site with slightly moreintense activity anteriorly. A contrastenhancedCT scan (Figure 4) showed focalenhancement in the anterior aspect of theablation cavity corresponding to the areaof more focal intense activity seen on thefollow-up PET/CT. Percutaneous CTguided biopsy of this region confirmedsuspicion of residual or recurrent adenocarcinoma.The patient was retreated withRFA. (Figure 5) Repeat CT scan (Figure6) performed at four months after reablationshowed no evidence of residual tumor(not shown).