BackTable Vascular & Interventional Ep. 603 Biopsy and Ablation Decision-Making in Lung Cancer with Dr. Alan Lee, Dr. Scott Oh, Dr. Rob Suh
Jan 2, 2026
Dr. Scott Oh, an interventional pulmonologist, Dr. Rob Suh, a thoracic interventional radiologist, and Dr. Alan Lee, a radiation oncologist, dive into the intricacies of lung cancer treatment. They explore why combining biopsy and ablation may become standard for high-probability cases. The discussions cover sedation strategies, the pros and cons of various biopsy techniques, and groundbreaking advancements like robotic and cryo-biopsy. Their focus on personalized patient care and multidisciplinary collaboration offers valuable insights into improving thoracic oncology outcomes.
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Limits Of Real-Time Ablation Confirmation
- Ablation confirmation tools are desired but imperfect in lung because motion and dosimetry uncertainties limit real-time feedback.
- Operators often rely on experience and imaging surrogates like ground-glass or ice to judge coverage.
Pause And Reformat Before Declaring Success
- Wait several minutes after microwave ablation and inspect reformatted CTs to assess developing ground-glass margins.
- Avoid over-treating an area that already shows treatment effects; use reformats to judge coverage.
Always Check Sagittal And Coronal Reformats
- Always inspect sagittal and coronal CT reformats when assessing lung ablation zones; axial alone can mislead.
- Use multi-planar views during the waiting phase to better estimate margins.