In the investigators' initial experience at the University of Pittsburgh Medical Center, they treated 18 patients with RFA and included primary and metastatic lung tumors. Selected patients were not candidates for complete surgical resection based on surgical risk, multiple lesions, poor pulmonary reserve or refusal of further surgery. Twenty-eight lung nodules were treated with RFA in 18 patients (12 male, 6 female). Tumors included metastatic carcinoma (9), sarcoma (6) or lung cancer (3). Mean age was 52 years (range, 27-95). Thoracic surgeons performed RFA by mini-thoracotomy (5) or CT-guided percutaneously (13) under general anesthesia in the operating room. In both approaches, the patient was positioned in the lateral decubitus position. In the CT-guided procedures we employ the services of a CT technician and the thoracic surgeon places a small finder needle into the center of the lung nodule. The surgeon confirms successful central placement of the finder needle during CT imaging, and the LeVeen™ needle electrode size is chosen according to the diameter of the target lesion. The needle electrode has a diameter of 14 gauge with a 15 cm shaft length and is introduced in the center of the lesion under CT guidance. Several applications in different locations within the lesion may be required for larger masses, with the therapy beginning at the most distal area and progressing proximally. Chest tubes were required in 46% (n=13) of percutaneous procedures. Mean length of stay was 3 days (range, 1-7 days). Complications included recurrent pneumothorax (1/18), pneumonitis (6/18), small pleural effusion (7/18) and transient renal failure (1/18). One death occurred from hemoptysis 19 days post-RFA of a central nodule. This patient had also received recent brachytherapy. After a mean follow-up of 4 months (range, 1-11 months), computed tomography revealed resolution with decreased density of treated sites less than 4 cm. Six patients (33%) died of progressive metastatic disease during the follow-up period.