CTICasesEvolution of Microwave Ablation Zone
Imaging findings
Serial chest CT scans in a patient post microwave ablation of a biopsy-proven lung adenocarcinoma show typical temporal evolution: initially, a large, well-defined zone of consolidation (representing thermal necrosis and hemorrhage) surrounds the nodule with a patent air bronchogram. Subsequent CTs show cavity formation (excavation), fluid filling, and eventual contraction into a small scar, without metabolic activity on PET/CT.
Key takeaways
Microwave ablation is a minimally invasive thermal ablation technique used to treat early-stage lung cancers in non-surgical candidates. The post-ablation CT findings follow a predictable evolution, starting with a large zone of consolidation that is larger than the original tumor due to the ablation margin. Subsequent excavation, fluid-filling, and scarring are normal signs of treatment response and should not be mistaken for recurrence.
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