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Figure 4b.  Biopsy-proved metachronous primary tumor of the left lung in a 75-year-old man who had undergone right pneumonectomy for bronchogenic carcinoma several years earlier. Owing to the size of the lesion, RF ablation and brachytherapy implantation were performed during one session. (a) CT scan obtained with the patient prone shows the RF electrode inserted into the lesion. Four overlapping ablations were performed. (b) CT scan obtained after RF ablation shows a brachytherapy catheter being used to place radioactive iodine seeds around the periphery of the mass. (c) Chest radiograph obtained 2 hours after RF ablation shows the lesion with the brachytherapy seeds in place. (d) Follow-up CT scan obtained 11 months later shows retraction of the soft tissue in the area of treatment with brachytherapy and RF ablation.