LAUSR

The widespread use of imaging and the introduction of screening campaigns have dramatically increased the rate of early detection of primary lung cancers and lung metastases, which can be treated with a curative intent [1]. Although historically the treatment of lung tumours has relied on surgery, the increased proportion of patients with comorbidities or other reasons for inoperability has given popularity to less invasive therapeutic options, such as stereotactic radiotherapy (SABR—stereotactic ablative body radiosurgery or SBRT—stereotactic body radiotherapy) and thermal ablation [1, 2]. The rationale of ablative therapies is the focused application of energy to eradicate or substantially destroy focal tumours, which is less invasive than surgical removal. Image-guided percutaneous thermal ablation therapies are established techniques in the local treatment of hepatic, renal or osseous tumours [3–8] and thyroid or uterine benign nodules [9, 10]. These therapies produce irreversible tumour tissue destruction through application of either hot or cold thermal energy. Radiofrequency (RF) is the most studied technique for therapy of primary and secondary lung tumours [11, 12], but other thermal ablation techniques used to treat pulmonary tumours include microwave (MW) [13–15], cryoablation [16, 17] and laser-induced thermotherapy (LITT) [18, 19]. Microwave ablation (MWA) offers the same benefits of radiofrequency ablation (RFA), but includes some specific advantages: reduced procedural time, reduced heat-sink effect due to the higher temperature achieved ([ 100 C), large areas of cellular necrosis, decreased susceptibility to tissue impedance due to higher energy employed, and simultaneous use of multiple antennae without need of ground pads [20]. Planning, monitoring, targeting and controlling this modality are generally performed with the help of computed tomography (CT). More recently, the implementation of cone-beam CT (CBCT) technology on high-end fluoroscopy suites C-arm has introduced a new imageguidance strategy, sometimes enhanced by 3D navigation systems, which seems to allow faster lung ablations with comparable outcomes [21, 22]. The procedural aspects do Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00270-020-02432-6) contains supplementary material, which is available to authorized users.