Abstract： Background:Treatment of adrenal metastasis from lung carcinoma may prolong survival in the selected patients.However,not all patients can undergo surgery;thus,minimally invasive ablation procedures such as radiofrequency ablation (RFA) and microwave ablation (MWA) have gained acceptance as alternative treatment methods.This study summarized a 5-year single-center experience regarding the evaluation of safety and efficacy of computed tomography (CT)-guided thermal ablation in the management of adrenal metastasis originating from non-small cell lung cancer (NSCLC).Methods:The data of NSCLC patients ablated for adrenal metastasis at the Department of Diagnostic Imaging and Interventional Radiology,General Hospital Sotiria,were retrospectively analyzed.Patients were divided into two groups:RFA group and MWA group according to the therapeutic approaches.Preprocedural blood tests included measurement of international normalized ratio,partial thromboplastin time,and platelet enumeration.A dual-phase contrast-enhanced spiral CT was performed immediately after the procedure to assess the immediate response after ablation and to screen for related complications.Follow-up was performed with CT or magnetic resonance imaging at 1,3,6 months and 1 year after ablation and every 6 months thereafter.Results:A total of 99 ablation sessions in 71 patients with adrenal metastasis originating from NSCLC were included in the final analysis.Self-limited,postablation syndrome occurred in 16/99 (16.1％) of ablation sessions.All procedures were technically successful.Immediate postablation imaging showed no contrast enhancement of the ablated tumor in all patients.Follow-up imaging at 3 months revealed local tumor progression in 8 (22.8％) patients of the RFA group and 7 (19.4％) patients of MWA group,all of them underwent a second session successfully.The 1-year assessment revealed local recurrence of the ablated tumor in six patients (17.1％) of RFA group and seven patients (19.4％) of MWA group.Among these 71 patients,those with tumor size ＞3.5 cm had a higher local recurrence rate (65.2％,15/23) than those with tumors ＜3.5 cm (16.7％,8/48;P =0.012).There was no significant difference in the median survival time between RFA (14.0 months) and MWA (14.6 months) groups (P ＞ 0.05).Conclusions:RFA and MWA showed comparable efficacy and safety in adrenal metastasis treatment.