CT-guided percutaneous lung RF ablation is a promising minimally invasive technique for the treatment of inoperable early-stage NSCLC and pulmonary metastases. Lung ablation can be used as an adjuvant therapy to systemic anticancer treatment, including chemotherapy or radiation therapy, to decrease the tumor cell volume with reasonably low morbidity and mortality in the otherwise severely ill patient. Furthermore, it could be a powerful alternative to surgical treatment or chemotherapy, particularly in selected patients with tumors smaller than 3 cm in diameter who have combined medical illnesses or limited functional lung reserve (Fig. 41.4). Existing evidence indicates good local response and acceptable survival rates. Consequently, its role in the treatment of lung malignancies is promising and the clinical acceptance is evolving.