Synchronous biopsy and ablation offer one-session approach to lung nodules
Researchers have successfully demonstrated that both biopsy and cryoablation treatment can be performed during the same procedure for patients with suspicious pulmonary nodules.
A new paper published in the Journal of Vascular and Interventional Radiology details the technical feasibility of the synchronous procedure in patients with highly suspicious small pulmonary nodules. Experts believe these findings suggest that the combined diagnostic and therapeutic approach could benefit both practices and patients by expediting care.
The study included 102 consecutive patients who underwent synchronous biopsy and cryoablation of 1- to 2-cm pulmonary nodules between 2020 and 2025. Treatment decisions were based on clinical and imaging suspicion before final pathology results were available. Researchers placed the cryoprobe before biopsy to provide an intraprocedural landmark to help with targeting the lesion for accurate sampling.
Using between 18 and 39 months of follow-up data on the study cohort, the team measured the synchronous technique’s utility. These measures were based on technical success, diagnostic yield, and adverse events, as well as tumor progression and overall survival.
Cryoablation was technically successful in all 102 patients. Biopsy produced a specific histopathologic diagnosis in 89 patients (87%), identifying 86 malignancies, including 81 cases of non-small cell lung cancer. The average nodule diameter was 1.52 cm.
After a median follow-up of about 35 months, the cumulative incidence of recorded local tumor progression was 9% at both one and three years. Overall survival was 100% at one year and 91% at three years.
In terms of adverse events, pneumothorax requiring chest tube drainage was the most notable reported complication, occurring in 21 patients (21%). There were no procedure-related deaths.
The authors noted that outcomes among patients with confirmed non-small cell lung cancer were within the range reported in comparable cryoablation-only studies; however, the retrospective, single center design and patient population limit its generalizability. Because treatment was performed before final histopathologic confirmation, the approach also reflects a clinical decision based on high suspicion rather than a strategy of routinely treating only biopsy-confirmed malignancies. Further research is needed to compare synchronous treatment with staged biopsy and ablation approaches.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.