Percutaneous Ablation of Non-small Cell Lung Cancer and Metastatic Disease to the Lungs

Publication Date: August 1, 2021
Last Updated: March 14, 2022

In patients with stage IA NSCLC, image-guided thermal ablation is a safe and effective treatment with minimal complications and acceptable long-term oncological and survival outcomes that are comparable to SBRT and sublobar resection.

(C, Moderate)

Image-guided thermal ablation is a safe and effective treatment option for patients with recurrent NSCLC.

(C, Moderate)

Thermal ablation should be considered alongside surgical resection and SBRT in patients who require preservation of lung parenchyma function.

(C, Moderate)

Image-guided thermal ablation of metastatic disease to the lungs may be appropriate in some patients, including those with a limited number of small (≤3 cm) lung metastases.

(C, Weak)

RFA, CA, and MWA are all appropriate modalities for image-guided thermal ablation of primary or secondary lung tumors. The method of ablation should be determined by lesion characteristics and risk mitigation and should be left to the discretion of the operating physician.

(C, Weak)

Biopsy of lung tumors is recommended before or during thermal ablation, when safe and possible.

(D, Weak)

Future research in the form of comparative studies (either randomized controlled trials or well-conducted cohort studies) is required to strengthen the evidence base for image-guided thermal ablation in patients with inoperable stage I NSCLC, recurrent NSCLC, and metastatic lung disease.

(E, Moderate)

Recommendation Grading



Percutaneous Ablation of Non-small Cell Lung Cancer and Metastatic Disease to the Lungs

Authoring Organization

Publication Month/Year

August 1, 2021

Last Updated Month/Year

July 14, 2023

Document Type


External Publication Status


Country of Publication


Inclusion Criteria

Female, Male, Adult, Older adult

Health Care Settings

Ambulatory, Home health, Hospital, Outpatient

Intended Users

Social worker, physician, nurse practitioner, nurse, physician assistant



Diseases/Conditions (MeSH)

D002289 - Carcinoma, Non-Small-Cell Lung


lung cancer, non-small-cell lung carcinoma (NSCLC), biopsy, thermal ablation, cryoablation, microwave ablation, radiofrequency ablation

Source Citation

Genshaft SJ, Suh RD, Abtin F, Baerlocher MO, Chang AJ, Dariushnia SR, Devane AM, Faintuch S, Himes EA, Lisberg A, Padia S, Patel S, Tam AL, Yanagawa J. Society of Interventional Radiology Multidisciplinary Position Statement on Percutaneous Ablation of Non-small Cell Lung Cancer and Metastatic Disease to the Lungs: Endorsed by the Canadian Association for Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, and the Society of Interventional Oncology. J Vasc Interv Radiol. 2021 Aug;32(8):1241.e1-1241.e12. doi: 10.1016/j.jvir.2021.04.024. PMID: 34332724.

Supplemental Methodology Resources

Data Supplement, Data Supplement


Number of Source Documents
Literature Search Start Date
June 1, 1999
Literature Search End Date
June 1, 2019