Minimally invasive alternatives to surgery for the treatment of malignancy are 
becoming more attractive owing to improvements in technology, reduced morbidity 
and mortality, and the ability to provide treatment in an outpatient setting. 
Radio-frequency (RF) ablation has become the imaging-guided ablative method of 
choice because of its relatively low cost, its capability of creating large 
regions of coagulative necrosis in a controlled fashion, and its relatively low 
toxicity. RF ablation in the thorax involves the use of computed tomography (CT) 
to localize the tumor and determine the optimal approach. The size of the tumor 
determines whether a cluster of electrodes or a single electrode of a particular 
length will be used to perform the ablation. CT fluoroscopy aids in guiding 
placement of the electrode. In patients with non-small cell lung malignancy who 
are not candidates for surgery owing to poor cardiorespiratory reserve, RF 
ablation alone or followed by conventional radiation therapy with or without 
chemotherapy may prove to be a treatment option. In patients with metastatic 
disease, RF ablation may be suitable for treatment of a small tumor burden or 
for palliation of larger tumors that cause symptoms such as cough, hemoptysis, 
or pain. Patients with chest wall or osseous metastatic tumors in whom other 
therapies have failed may benefit from RF ablation as an alternative to 
radiation therapy.