Among percutaneous ablation therapies, radiofrequency ablation (RFA) is commonly used for treating lung tumors. Currently, it is expected that use of lung RFA will become increasingly widespread in Japan, as it has been covered by the national health insurance since September 2022. RFA can be used to treat primary and metastatic lung tumors. Preferred candidates for RFA include inoperable patients with stage IA non-small cell lung cancer (NSCLC) and lung oligometastasis. Tumor size and location should be considered in determining the indication for lung RFA. To ensure technical success, the tumor should be ablated with sufficient safety margin using an electrode with an appropriate non-insulated tip length. Multiple overlapping ablation should be performed as needed. Pneumothorax and various other complications can occur after lung RFA. Although serious complications are rare, some complications, such as intractable pneumothorax, interstitial pneumonia, and massive hemorrhage, can be fatal. The literature shows promising local control and survival outcomes after lung RFA in patients with NSCLC and lung metastasis. This review describes basic knowledge that should be known by interventional radiologists who perform lung RFA.
