肺恶性肿瘤热消融治疗后的CT影像学演变

目的探讨肺恶性肿瘤热消融术后的CT影像学演变,以便准确评估其疗效和预后,及时发现肿瘤残存或复发。方法搜集2015年1月~2018年12月于浙江省肿瘤医院行CT引导下肺肿瘤热消融治疗的72例患者85个病灶,分析对比其消融术后即时、1个月、3个月、6个月、12个月的CT影像学特征。结果所有患者热消融术后病灶周围即刻出现磨玻璃样改变,其中3个病灶(3.5%)出现小空泡影;术后1个月62个病灶(88.5%)体积较消融前增大,1个病灶(2.2%)出现厚边强化;术后3个月,51个病灶(72.9%)较上一次评估时缩小,5个病灶(11.1%)出现厚边强化;术后6个月,40个病灶(59.7%)较上一次评估时缩小,8个病灶(17.0%)出现厚边强化;术后12个月,30个病灶(55.6%)较上一次评估时缩小,12个病灶(32.5%)出现厚边强化。最终39个病灶(45.9%)完全消融,26个病灶(30.6%)不完全消融。结论肺肿瘤热消融术后3个月以后病灶体积开始持续缩小或保持稳定,且无厚边强化,提示肿瘤完全消融;病灶体积持续增大或先缩小后增大,并伴厚边强化,提示肿瘤不完全消融。     

超声引导联合CT监视在特殊部位肝癌射频治疗中的应用价值

目的探讨超声引导联合CT监视在特殊部位肝癌射频治疗中的应用价值。方法采用超声引导联合CT监视经皮射频治疗45例(75个病灶)特殊部位肝癌患者。统计消融术中、术后的并发症情况。1个月后复查CT、MRI资料,观察病灶的消融情况。结果消融术中无严重并发症,15例(33.3%)术后出现一过性发热;16例(35.6%)出现腹痛;3例顽固性咯呃逆;6例(13.3%)出现恶心。射频治疗后1个月随访显示,邻近膈肌13个病灶,其中病灶完全消融12个(92.31%);邻近胆囊8个病灶,完全消融6个(75%);邻近肠管5个病灶,完全消融5个(100%);邻近大血管9个病灶,其中病灶完全消融8个(88.89%),邻近胆管14个,其中病灶完全消融13个(92.86%)。45例患者仅1例靠近胆囊患者出现肝内肿瘤新生,无一例出现肝外转移。结论超声引导联合CT监视射频治疗特殊部位肝癌疗效满意,并发症发生率低,值得临床推广。     

肝癌电磁波热凝治疗消融术后的CT表现分析

目的:分析肝癌电磁波热凝治疗(微波固化或射频消融)后的常见和特殊CT表现,提高对电磁波热凝治疗消融后肝脏形态改变和局部并发症的认识。方法:26例消融治疗后的肝癌患者,术后2周行CT扫描,3个月内复查CT,结合临床症状和实验室检查指标,分析射频消融治疗后肝脏形态的一般变化和出现局部并发症时的特殊征象。结果:电磁波热凝治疗消融后18例病灶呈术后正常改变,CT平扫为边界清楚、均质的低密度区,增强扫描无强化,而坏死区周边可见薄的环形强化,病灶范围较治疗前稍大,随治疗后的时间延长坏死区周边的环形强化逐渐减弱至消失,而中心坏死区仍为低密度,无强化,病灶较前逐渐缩小。消融后复发4例,CT表现为消融治疗区域周边的新发低密度灶。胆道损伤2例,CT表现为消融治疗区域周边肝内胆管扩张。肝内假性囊肿形成1例,CT示消融治疗区旁边缘锐利无强化的囊性灶;皮肤瘘道形成并胸腔积液1例,CT表现为消融治疗的针道不愈合,肝脏内病灶坏死区与体表相连通。结论:CT可准确地反映原发性肝癌电磁波热凝治疗消融后肝脏的形态学改变,有效观察局部并发症的发生情况,有助于提高对电磁波热凝治疗术后征象的认识。     

The Value of Radiofrequency Ablation in the Special Sites of the Liver Cancer by Combining Ultrasound Guided with CT Monitoring

目的 探讨超声引导联合CT监视在特殊部位肝癌射频治疗中的应用价值.方法 采用超声引导联合CT监视经皮射频治疗45例(75个病灶)特殊部位肝癌患者.统计消融术中、术后的并发症情况.1个月后复查CT、MRI资料,观察病灶的消融情况.结果 消融术中无严重并发症,15例(33.3％)术后出现一过性发热;16例(35.6％)出现腹痛;3例顽固性咯呃逆;6例(13.3％)出现恶心.射频治疗后1个月随访显示,邻近膈肌13个病灶,其中病灶完全消融12个(92.31％);邻近胆囊8个病灶,完全消融6个(75％);邻近肠管5个病灶,完全消融5个(100％);邻近大血管9个病灶,其中病灶完全消融8个(88.89％),邻近胆管14个,其中病灶完全消融13个(92.86％).45例患者仅1例靠近胆囊患者出现肝内肿瘤新生,无一例出现肝外转移.结论 超声引导联合CT监视射频治疗特殊部位肝癌疗效满意,并发症发生率低,值得临床推广.     

肺肿瘤热消融治疗的CT影像演变与疗效评价

【摘要】　目的　分析肺肿瘤热消融治疗的CT影像表现及演变过程,探讨早期疗效评价的最佳时期和标准。方法　收集2017年1月至2020年6月浙江省肿瘤医院行肺肿瘤热消融治疗41例患者的临床资料,将患者分为完全消融组和不完全消融组。比较两组患者术后即刻、1、3、6、12个月的CT影像学特征,分析肺肿瘤热消融治疗后CT早期疗效评价的最佳时期和标准。结果　热消融术后即刻所有消融灶体积均较术前增大,病灶周围可见磨玻璃样阴影。完全消融组和不完全消融组患者磨玻璃样阴影最小宽度差异有统计学意义（P＜0.05）,诊断界值为3.9 mm时,AUC为0.871,敏感度为75.0%,特异度为90.3%。随时间延长,完全消融组患者消融灶体积逐渐缩小,最终表现为纤维条索、空洞、结节;不完全消融组患者消融灶体积先缩小后增大,呈结节或肿块样。两组患者术后1、3个月消融灶大小差异无统计学意义（P＞0.05）,术后6、12个月差异有统计学意义（P＜0.05）。两组患者术后即刻平扫CT值均较术前降低,术后1、3个月消融灶增强后CT强化幅度差异无统计学意义（P＞0.05）;术后6、12个月差异有统计学意义（P＜0.05）,完全消融组表现为轻度强化（＜10 HU）,不完全消融组表现为不均匀明显强化（＞15 HU）。结论　热消融术后即刻病灶周围磨玻璃样阴影最小宽度对疗效评价有较大的预测意义;消融灶大小变化和强化幅度是判断病灶治疗效果的主要影像指标;术后6个月是早期评价热消融治疗效果的最佳时期。     

超声引导下微小乳头状癌射频消融临床应用

目的探讨甲状腺微小乳头状癌患者采用超声引导下射频消融治疗的临床效果。方法收集本院甲状腺微小乳头状癌27例患者,所有患者均于超声引导下进行射频消融治疗。术后对患者进行为期1年的随访观察,经超声检查观察患者治疗后不同时间的消融灶变化、甲状腺实质与颈部淋巴结状况,以评估患者的临床疗效。结果本组27例患者术后均行为期1年的随访观察,超声检查显示患者的结节不断变小,治疗后首月、3月、半年及1年时患者的结节体积缩小率分别为22.22%、51.85%、85.19%、92.59%。治疗3月时消融灶消失者1例,治疗后半年时消融灶消失者2例,治疗后1年时消融灶消失者6例;其中有26例(96.3%)患者首次治疗后就达到了无瘤生存。治疗后1例患者出现局部复发,1例患者出现淋巴结转移,术后均未出现皮肤气道烫伤与喉返神经损伤等严重的并发症。结论甲状腺微小乳头状癌患者采用超声引导下射频消融治疗疗效显著,安全性较好,值得进一步推广。     

肝动脉化疗栓塞术联合CT引导下射频消融治疗大肝癌的疗效和安全性

 目的 评价肝动脉化疗栓塞术(transcatheter arterial chemoembolization, TACE)联合CT引导下经皮穿刺射频消融治疗大肝癌的疗效及安全性。方法 回顾性分析52例经穿刺病理或影像学诊断的大肝癌患者临床资料,患者均先行1次TACE术,术后2周复查增强CT,对碘油沉积欠缺的区域在CT导向下进行射频消融治疗,术后复查甲胎蛋白(AFP)、增强MRI或CT评价肿瘤体积缩小及坏死情况,随访时间为12个月。结果 52例 (56个病灶)手术均获得成功。TACE术前病灶最大径为(12.7±2.7)cm,射频术后1个月病灶最大径为(6.1±1.9)cm,肿瘤大小较术前均有不同程度缩小(t=14.416,P<0.05)。TACE术前AFP值为(4156±689)ng/ml,射频术后1个月为(256±178)ng/ml,AFP值明显下降(t=39.485,P<0.05)。其中完全消融(CR)26例,大部分消融(PR)21例,稳定(SD)4例,进展(PD)1例,总体有效率为90.4%,12个月生存率为92.3%。结论 TACE联合CT导向下射频消融治疗大肝癌是一种安全、有效、微创的治疗方法。     

经腹腔镜肝脏海绵状血管瘤射频消融术后的螺旋CT随访

目的利用螺旋CT评价经腹腔镜射频消融(RFA)治疗肝脏海绵状血管瘤(HCH)的效果。方法27例共50个病灶在全麻下行腹腔镜RFA治疗。术前1周内、术后1个月及6个月,分别进行全肝螺旋CT平扫及三期增强扫描,分析其CT表现。结果50个病灶均位于肝脏表面或邻近胆囊等空腔脏器,瘤体直径2.5~11.0cm,平均5.5cm。腹腔镜RFA治疗后1个月,86%(43/50)病灶直径增大,14%(7/50)病灶直径无明显变化。治疗后6个月,所有病灶均缩小,病灶区直径为原病灶直径的60%,病灶周围环状增强均消失。7例较大病灶RFA治疗后出现膈下及右侧胸腔少量积液。未发现肝内胆管扩张、肝段局部萎缩、门静脉血栓形成及肝动脉-门静脉瘘等并发症。结论HCH经腹腔镜RFA治疗后具有特定的CT表现,螺旋CT三期增强扫描可以准确评价腹腔镜RFA治疗后的疗效。     

集束电极射频治疗肝恶性肿瘤疗效和并发症的CT评价

目的　探讨经皮射频消融术 (RFA)治疗肝肿瘤CT检查的价值。方法　回顾性地分析 5 0例肝肿瘤 (原发性肝癌 36例 ,肝转移癌 14例 )共 76个病灶RFA术前和术后复查随访CT表现 ,CT检查分别于治疗后 1、3周及以后间隔 3～ 6个月不等进行 ,均采用平扫和增强扫描。结果　获得完全消融的病灶为 35例 49个 (6 4.5 % ) ,不完全消融的病灶为 18例 2 7个 (35 .5 % )。经RFA治疗的 76个病灶中 9个出现病灶内出血 ;1个发生脓肿 ;3例出现腹腔内出血 ;6例发生右侧反应性胸腔积液和 1例出现少量气胸。结论　增强CT检查对肝恶性肿瘤RFA治疗的效果评估以及局部复发和并发症发现具有很大的诊断价值     

CT引导下经皮穿刺射频消融补救性治疗晚期肾癌

目的探讨射频消融治疗肾细胞癌（RCC）的有效性及安全性。 方法收集56例不适宜外科切除治疗的RCC患者。肿瘤直径为2.6～8.6 cm,平均（5.6±1.2）cm。CT引导下行经皮穿刺射频消融术。随访评估临床效果、肾功能和并发症状况。 结果本组56例患者中,病灶直径<4 cm的35患者射频治疗后1、3、6个月复查时均未见病灶强化,病灶直径>4 cm的21例,在术后3个月复查时13例出现治疗边缘强化,活检证实为复发病灶,再次行射频消融治疗。截止随访时间内,50例存活,6例死于非肿瘤原因。射频治疗前后肾功能变化差异无统计学意义。并发症轻微,无肾脏出血、感染、肾盂损伤等严重并发症。 结论经皮穿刺射频消融治疗可使无外科手术机会的RCC患者生存获益,并能很好的保护患者肾功能,同时并发症轻微,可作为一种重要的治疗手段。     

CT imaging findings of pulmonary neoplasms after treatment with radiofrequency ablation: results in 32 tumors

OBJECTIVE: The purpose of this study is to describe the CT appearance of thoracic neoplasms after treatment with radiofrequency ablation (RFA). MATERIALS AND METHODS: Thirty-two thoracic neoplasms in 26 patients had pulmonary RFA and imaging follow-up. Fourteen neoplasms were primary lung cancer and 18 were metastases. The mean pretreatment neoplasm size was 3.1 cm (range, 1.0-7.0 cm), and the average number of neoplasms treated per patient was 1.2 (range, 1-3). The mean follow-up was 10.1 months (range, 1-30 months). Imaging findings on CT were evaluated by three radiologists and documented by consensus. RESULTS: The most common finding immediately after treatment was peripheral ground-glass opacity surrounding the treated neoplasm, seen in 27 of 32 tumors (84%). This rapidly resolved in all but one patient by the end of the first month. Cavitation was seen in 10 of 32 tumors (31%) on follow-up CT and was most common in neoplasms in the inner two thirds of the lung and adjacent to a segmental bronchus. Sixty percent of the cavitations decreased in size on follow-up scans. Ten of 32 tumors (31%) that did not develop cavitation developed bubble lucencies on follow-up CT. Pleural thickening was found in 12 of 22 (55%) parenchymal neoplasms, and linear opacifications were seen between the treated lesion and adjacent pleura in 14 of 22 parenchymal tumors (64%). Pleural effusions were seen in four patients (15%). Fourteen of 22 tumors (64%) with follow-up imaging at 1 month enlarged from pretreatment CT scans. At 3 and 6 months after RFA, the majority remained stable in size. CONCLUSION: Peripheral ground-glass opacity, cavitation, bubble lucencies, and pleural changes are common findings on CT after RFA. Many treated neoplasms increase in size from baseline on 1- to 3-month follow-up CT scans and then remain stable thereafter. Enlargement of a treated tumor after 6 months is felt to represent local recurrence. Stability of a treated lesion beyond 6 months does not guarantee continued stability.     

小儿卵巢肿瘤的CT诊断价值

目的：利用多层螺旋CT分析小儿卵巢肿瘤的影像特点。方法：经手术病理确诊的27例女性患儿共34个卵巢肿瘤病例资料,年龄1.1-18.0岁,平均（11.7±5.1）岁;使用Philips Brilliance 6层螺旋CT进行平扫和增强扫描;1例肿瘤扭转的急腹症患儿仅行平扫。结果：CT表现为单纯囊性肿瘤11个（11/34,占32.35%）,实性肿瘤有9个（9/34,占26.47%）,囊实性肿块14个（14/34,占41.18%）。增强扫描后有29个卵巢肿瘤可见卵巢血管蒂征,占87.88%。12例可见腹水,4例有腹膜种植。9例淋巴结肿大,5例出现肝肺等远处转移。钙化15个,13个畸胎瘤均见钙化,同时可见钙化及脂肪成分者11个,2个畸胎瘤未见确切脂肪成分。结论：CT扫描易于显示肿瘤囊实性、钙化及脂肪成分以及卵巢静脉的走行等征象,对于小儿卵巢肿瘤的定位、定性及协助分期等有重要价值。     

腹腔镜射频消融治疗原发性肝癌的研究

目的：评价腹腔镜射频消融（RFA）治疗原发性肝癌的可行性、安全性及疗效。方法：51例原发性肝癌在全麻下行腹腔镜RFA治疗,共72个瘤体,平均最大肿瘤直径（3．4±1．0）cm。合并肝硬化49例、慢性结石性胆囊炎5例,糖尿病4例,凝血功能障碍10例。结果：51例均顺利完成腹腔镜RFA治疗,12例行腹腔镜胆囊切除术。未出现严重并发症。肿瘤完全坏死率为95．8％。随访12～58个月（平均35个月）,6例发现肝内新病灶,11例射频治疗部位复发,再次采用经皮RFA治疗9例,12例死于肿瘤复发或肝功能衰竭。结论：腹腔镜RFA治疗原发性肝癌安全可行,治疗效果可靠,但应选择瘤体位于肝脏表面或临近胆囊而且不宜手术切除的病例进行治疗。     

CT引导经皮射频消融术对肺部肿瘤的治疗效果

目的评价CT引导经皮射频消融术（RFA）对肺部肿瘤的近期治疗效果,并阐述CT扫描在疗效评价中的作用。方法 34例经临床和病理证实的肺部肿瘤患者,包括原发性肺癌23例（25个病灶）和转移瘤11例（17个病灶）,起初均经CT引导经皮RFA治疗,随后对所有患者的RFA近期疗效利用螺旋CT平扫与增强扫描进行了逐例随访与评价。结果在34例的42个病灶中,RFA导致了35个病灶完全坏死,增强CT表现为肿瘤去血管化,近期随访无复发;7个病灶未完全坏死,增强CT表现为残留肿瘤强化,近期随访有进展。本组患者中未发生与操作有关的严重并发症。结论 RFA对肺肿瘤的治疗具有确切而明显的近期疗效,是一种侵袭性小且安全的方法,而CT平扫与增强扫描可为疗效评价提供可靠信息。     

甲型H1N1流感肺炎CT演变特点

目的:探讨甲型H1N1流感肺炎近中期CT演变特点。方法:回顾性分析35例临床确诊的甲型H1N1流感肺炎患者发热后1个月内86次CT资料,分析其肺部病变出现、进展及吸收时间和影像特点。结果:肺部病变发生时CT表现主要为肺部磨玻璃密度影或实变,胸腔积液等。CT复查表现分为3组:完全吸收组4例,表现为肺部磨玻璃密度影或实变在6～13d(平均11.25d)吸收;明显减轻组29例,表现为磨玻璃密度影及实变减轻或缩小,胸腔积液减少或消失;进展组2例,1例发热后第10天进展为ARDS,另1例合并真菌感染,复查后表现为实变及空洞扩大。2例远期复查中1例第73天仍浅淡磨玻璃密度影,1例第90d遗留少许磨玻璃密度影、小叶间隔增厚、小叶性结节及少许索条影。结论:甲型H1N1流感肺炎肺部病变多在发热后3天内出现,2周左右完全或部分吸收,部分病例中期复查可见间质性病变,危重症患者早中期CT即可见病变迅速进展。     

3.0 T MRI动态增强扫描对肝细胞肝癌介入治疗疗效的评价

目的:评价3.0T MRI动态增强扫描监测肝细胞肝癌(HCC)经肝动脉化疗栓塞(TACE)及射频消融(RFA)治疗后肿瘤残存或复发的价值。方法:选择40例经TACE或RFA治疗后的HCC患者,于TACE或RFA治疗后2～3个月内行MRI检查,MRI检查后2～4d内行DSA检查,观察MRI动态增强扫描各时相病灶的MRI征象和时间-信号强度曲线,判断原发病灶有无肿瘤残存或复发以及有无新发病灶,并与DSA、临床资料对照。结果:40例HCC患者共发现88个病灶,MRI动态增强扫描显示48个坏死灶,40个病灶有肿瘤残存或复发;DSA结合临床检查显示47个病灶为肿瘤坏死,41个病灶有肿瘤残存或复发。与DSA结合临床检查相比,MRI动态增强扫描发现肿瘤残存或复发的一致性好(Kappa值=0.931,P<0.05),敏感性97.9%,特异性95.1%,阳性预测值95.8%,阴性预测值97.5%,诊断正确率96.6%。结论:3.0T MRI动态增强扫描能清楚显示HCC经TACE或RAF治疗后原发病灶残存或复发,是评价HCC介入治疗疗效的理想方法。     

螺旋CT对射频消融治疗肝脏恶性肿瘤的疗效评价

目的　探讨螺旋CT在肝脏恶性肿瘤射频消融治疗后随访过程中的价值。方法　对 3 6例超声引导下经皮穿刺射频消融治疗的肝脏恶性肿瘤患者 (2 9例原发性肝癌和 7例转移性肝癌 )定期进行螺旋CT双期增强扫描检查 ,观察射频消融的效果及肿瘤复发的情况。结果　肿瘤残留或原位复发的主要征象是消融区的边缘呈带状或结节样强化 ,或在随访CT复查中 ,肿瘤的体积不断增大。在射频消融治疗后的首次CT复查中 ,2 8例 (77.8% )肿瘤出现完全坏死。在随后的CT随访复查中 ,2例 (5.6% )出现肝内原位复发 ,4例 (11.1% )出现肝内异位复发。结论　对于合适的肝脏恶性肿瘤 ,射频消融是一种疗效确切的肿瘤局部治疗方法 ,在其疗效评价和长期随访过程中 ,螺旋CT双期增强扫描是有效的影像检查手段     

经皮注射平阳霉素碘油乳剂治疗肝海绵状血管瘤

目的：探讨CT引导下经皮注射平阳霉素碘油乳剂治疗肝海绵状血管瘤的疗效及安全性。方法：选择肝海绵状血管瘤患者34例,瘤体直径为3．2～12．0cm,采用CT引导下经皮穿刺,注射平阳霉素碘油乳剂治疗肝海绵状血管瘤,注射剂量为6～20ml。所有病例术后3个月、半年、1年各复查CT1次。结果：经皮注射平阳霉素碘油乳剂后,29例血管瘤瘤体内碘油沉积良好,5例PLE不能完全充盈瘤灶。术后3～6个月,全部病例瘤体均有明显缩小,其中缩小达80％以上者18例,〉50％者14例,缩小〈50％者2例。本组病例未出现肝脏坏死、胆管毁损、胆囊坏死穿孔、急性胰腺炎等严重并发症。结论：经皮注射平阳霉素碘油乳剂治疗肝海绵状血管瘤是一种操作简便且安全高效的治疗方法。     

Percutaneous radiofrequency ablation of lung tumors in a large animal model

PURPOSE: Percutaneous radiofrequency ablation (RFA) is accepted therapy for liver tumors in the appropriate clinical setting, but its use in lung neoplasms remains investigational. We undertook this study to evaluate the feasibility and immediate effectiveness of RFA for treatment of both solitary pulmonary nodules and clusters of lung tumors in a large animal model. MATERIALS AND METHODS: Percutaneous RFA of 14 lung tumors in five dogs was performed under CT guidance. Animals were euthanatized 8-48 hours after the procedure. The lungs and adjacent structures were harvested for gross and histopathologic evaluation. RESULTS: Five solitary pulmonary nodules (range, 17-26 mm) and three clusters of three nodules each (range, 7-17 mm per nodule) were treated with RFA. All ablations were technically successful. Perilesional ground-glass opacity and small asymptomatic pneumothoraces (n = 4) were visualized during the RFA sessions. One dog developed a large pneumothorax treated with tube thoracostomy but was euthanatized 8 hours post-RFA for persistent pneumothorax and continued breathing difficulty. Follow-up CT 48 hours post-RFA revealed opacification of the whole lung segment. Gross and histopathologic evaluation showed complete thermal coagulation necrosis of all treated lesions without evidence of any viable tumor. The region of thermal coagulation necrosis typically extended to the lung surface. Small regions of pulmonary hemorrhage and congestion often surrounded the areas of coagulation necrosis. CONCLUSIONS: RFA can be used to treat both solitary pulmonary nodules and clusters of tumor nodules in the canine lung tumor model. This model may be useful for development of specific RFA protocols for human lung tumors.     

Radiofrequenzablation (RFA) von Lungenmetastasen kolorektaler Karzinome (KRK)—Ergebnisse nach einem Jahr

Assess the safety and evidence of efficacy of RFA for colorectal (CRC) lung metastases with follow up to 1 year. Twenty-three patients had percutaneous RFA for 52 colorectal pulmonary metastases under fluoro-CT. Patients received IV conscious sedation and local analgesia with routine hospitalisation/monitoring for 24 h post RFA. Patients had CT scanning at 1 month and then 3 monthly with serum CEA assessment monthly and 3 monthly. All ablations were technically successful. Tumor diameter ranged from 0.3 to 4.2 cm. Pneumothorax occurred in 43% (10 of 23) of patients. Six patients required intercostal chest drain placement. Six patients had a second RFA, 4 for new lesions and 2 patients had a previously treated lesion retreated. Median admission was 2.0 days (range 1-9). Median follow-up is 428 days (range 173-829), with data reported to 1 year in this paper. Five patients died at 5, 6, 8, 8 and 12 months post RFA from extra-pulmonary (1) or widespread (4) disease. One patient developed malignant pleural effusion at 6 months after RFA. Cavitation was seen in nine treated lesions (17%), all resolved with scar tissue contraction by 12 months. Eighteen patients with CT scan follow-up at one year have 40 lesions classified as: disappeared (17), decreased (5), stable/same size (4), increased (14). Percutaneous imaging-guided RFA of multiple CRC pulmonary metastases is a minimally invasive treatment option with modest morbidity. A significant proportion of patients show good evidence of successful local control at one year.