Image-guided tumor ablation has become a well-established hallmark of local cancer therapy. The breadth of options available in this growing field increases the need for standardization of terminology and reporting criteria to facilitate effective communication of ideas and appropriate comparison among treatments that use different technologies, such as chemical (eg, ethanol or acetic acid) ablation, thermal therapies (eg, radiofrequency, laser, microwave, focused ultrasound, and cryoablation) and newer ablative modalities such as irreversible electroporation. This updated consensus document provides a framework that will facilitate the clearest communication among investigators regarding ablative technologies. An appropriate vehicle is proposed for reporting the various aspects of image-guided ablation therapy including classification of therapies, procedure terms, descriptors of imaging guidance, and terminology for imaging and pathologic findings. Methods are addressed for standardizing reporting of technique, follow-up, complications, and clinical results. As noted in the original document from 2003, adherence to the recommendations will improve the precision of communications in this field, leading to more accurate comparison of technologies and results, and ultimately to improved patient outcomes.

ablation in comparison with other available treatments (97,98).

These guidelines update previous guidance published in 2005. They have been revised by a group who are members of the UK and Ireland Neuroendocrine Tumour Society with endorsement from the clinical committees of the British Society of Gastroenterology, the Society for Endocrinology, the Association of Surgeons of Great Britain and Ireland (and its Surgical Specialty Associations), the British Society of Gastrointestinal and Abdominal Radiology and others. The authorship represents leaders of the various groups in the UK and Ireland Neuroendocrine Tumour Society, but a large amount of work has been carried out by other specialists, many of whom attended a guidelines conference in May 2009. We have attempted to represent this work in the acknowledgements section. Over the past few years, there have been advances in the management of neuroendocrine tumours, which have included clearer characterisation, more specific and therapeutically relevant diagnosis, and improved treatments. However, there remain few randomised trials in the field and the disease is uncommon, hence all evidence must be considered weak in comparison with other more common cancers.

Objectives Previous attempts at meta-analysis and systematic review have not provided clear recommendations for the clinical application of thermal ablation in metastatic colorectal cancer. Many authors believe that the probability of gathering randomised controlled trial (RCT) data is low. Our aim is to provide a consensus document making recommendations on the appropriate application of thermal ablation in patients with colorectal liver metastases. Methods This consensus paper was discussed by an expert panel at The Interventional Oncology Sans Frontières 2013. A literature review was presented. Tumour characteristics, ablation technique and different clinical applications were considered and the level of consensus was documented.Eur Radiol (2015) Results Specific recommendations are made with regard to metastasis size, number, and location and ablation technique. Mean 31 % 5-year survival post-ablation in selected patients has resulted in acceptance of this therapy for those with technically inoperable but limited liver disease and those with limited liver reserve or co-morbidities that render them inoperable.Conclusions In the absence of RCT data, it is our aim that this consensus document will facilitate judicious selection of the patients most likely to benefit from thermal ablation and provide a unified interventional oncological perspective for the use of this technology. Key Points• Best results require due consideration of tumour size, number, volume and location.• Ablation technology, imaging guidance and intraprocedural imaging assessment must be optimised.• Accepted applications include inoperable disease due to tumour distribution or inadequate liver reserve.• Other current indications include concurrent co-morbidity, patient choice and the test-of-time approach.• Future applications may include resectable disease, e.g. for small solitary tumours.

Chr. Hansen had no input into any aspect of study design or conduct of the trial. Furthermore, Chr. Hansen will have no input into data analysis or subsequent reporting of the trial results. PCC has received consulting fees from Chr. Hansen, but not in relation to this trial.

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Aims In this article we present our experience with radiofrequency ablation (RFA) in the treatment of 105 renal tumors. Materials and Methods RFA was performed on 105 renal tumors in 97 patients, with a mean tumor size of 32 mm (11-68 mm). The mean patient age was 71.7 years (range, 36-89 years). The ablations were carried out under ultrasound (n = 43) or CT (n = 62) guidance. Imaging followup was by contrast-enhanced CT within 10 days and then at 6-monthly intervals. Multivariate analysis was performed to determine variables associated with procedural outcome. Results Eighty-three tumors were completely treated at a single sitting (79%). Twelve of the remaining tumors were successfully re-treated and a clinical decision was made not to re-treat seven patients. A patient with a small residual crescent of tumor is under follow-up and may require further treatment. In another patient, re-treatment was abandoned due to complicating pneumothorax and difficult access. One patient is awaiting further re-treatment. The overall technical success rate was 90.5%. Multivariate analysis revealed tumor size to be the only significant variable affecting procedural outcome. (p = 0.007, Pearson v 2 ) Five patients had complications. There have been no local recurrences. Conclusion Our experience to date suggests that RFA is a safe and effective, minimally invasive treatment for small renal tumors.Keywords Kidney Á Computed tomography Á Kidney neoplasms Á Therapeutic radiology Á Radiofrequency ablation In recent years radiofrequency ablation (RFA) has continued to evolve into an effective image-guided tool for the minimally invasive destruction of small-volume, discrete tumors. While the vast majority of experience has been gained in the treatment of hepatocellular carcinoma (HCC) and colorectal metastases in the liver, recent attention has turned to renal tumors [1][2][3][4]. Renal tumors represent 3% of all human tumors [5] and the 5-year survival rate for RCC has increased from 34% in 1954 to 62% in 1996 [6]. There has also been a 126% increase in the incidence of renal cell carcinoma in the United States since 1950 [6]. Both the increased incidence and the improved survival are largely attributable to the radiologic detection of early-stage disease [7]. In addition, despite other strategies, this detection is largely serendipitous at cross-sectional imaging studies for other symptomatology. Some series have suggested that up to 85% of all renal tumors are in fact detected incidentally [8]. The improved outcome from smaller-volume tumors has been reflected by the TNM classification

Purpose To evaluate the long-term efficacy of image-guided cryoablation of sporadic clinical T1 (cT1) biopsy-proven renal cell carcinoma (RCC) and the technical success and safety of all cryoablation treatments. Materials and Methods For this retrospective single-institution study, 433 patients (median age, 68 years; range, 19-90 years), of whom 293 were men (median age, 69 years; range, 19-90 years) and 140 were women (median age, 68 years; range, 30-89 years), who had 484 cT1 renal masses (mean size, 33 mm) and who were treated between 2007 and 2016 were identified from a prospectively maintained tumor registry. Treatment efficacy for all treated lesions and complication rates of all procedures were computed. Oncologic outcomes for a subset of 220 patients with sporadic biopsy-proven RCC were analyzed. The Kaplan-Meier method was used to estimate local recurrence-free survival (LRFS), metastasis-free survival (MFS), and overall survival (OS) rates. Results Of the 484 treated cT1 renal masses, 474 were imaged subsequently, with a primary treatment efficacy of 96% (453 of 474), increasing to 98% (465 of 474) after secondary ablation, and a major complication rate (Clavien-Dindo grade ≥ III) of 4.9% (23 of 473 procedures). The estimated LRFS and MFS rates, respectively, for the 220 patients with biopsy-proven RCC were 97.2% (95% confidence interval [CI]: 92.6%, 99.0%) and 97.7% (95% CI: 93.3%, 99.1%) at 3 years and 93.9% (95% CI: 85.8%, 97.4%) and 94.4% (95% CI: 86.7%, 97.7%) at 5 years. The estimated OS of all 433 patients was 91.7% (95% CI: 87.5%, 94.5%) and 78.8% (95% CI: 71.1%, 84.6%) at 3 and 5 years, respectively. Conclusion Five-year oncologic outcomes after image-guided cryoablation for clinical T1 renal cell carcinoma are competitive with those of resection at a lower complication rate. © RSNA, 2018.