Background: This study tested the hypothesis that treatment of symptomatic, partial-thickness rotator cuff tears (sPTRCT) with fresh, uncultured, unmodified, autologous adipose-derived regenerative cells (UA-ADRCs) isolated from lipoaspirate at the point of care is safe and more effective than corticosteroid injection. Methods: Subjects aged between 30 and 75 years with sPTRCT who did not respond to physical therapy treatments for at least 6 weeks were randomly assigned to receive a single injection of an average 11.4 × 10 6 UA-ADRCs (in 5 mL liquid; mean cell viability: 88%) (n = 11; modified intention-to-treat (mITT) population) or a single injection of 80 mg of methylprednisolone (40 mg/mL; 2 mL) plus 3 mL of 0.25% bupivacaine (n = 5; mITT population), respectively. Safety and efficacy were assessed using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), RAND Short Form-36 Health Survey, and pain visual analogue scale (VAS) at baseline (BL) as well as 3 weeks (W3), W6, W9, W12, W24, W32, W40, and W52 post treatment. Fat-saturated T2-weighted magnetic resonance imaging of the shoulder was performed at BL as well as at W24 and W52 post treatment.

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.

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Objective To evaluate the technical and oncological efficacy of an image‐guided cryoablation programme for renal tumours. Patients and Methods A prospective analysis of technical and radiological outcomes was undertaken after treatment of 171 consecutive tumours in 147 patients. Oncological efficacy in a subset of 125 tumours in 104 patients with >6 months' radiological follow‐up and a further subset of 62 patients with solitary, biopsy‐proven renal carcinoma was also analysed. Factors influencing technical success, as determined by imaging follow‐up, and complication rates were statistically analysed using a statistics software package and logistic regression analyses. Results No variables were found to predict subtotal treatment, although gender (P = 0.08), tumour size of >4 cm (P = 0.09) and central location of tumour (P = 0.07) approached significance. Upper pole location was the single variable that was found to predict complications (P = 0.006). Among the 104 patients (125 tumours), radiologically assessed at ≥6 months and with a mean radiological follow‐up of 20.1 months, we found a single case of unexpected late local recurrence. Conclusion Percutaneous image‐guided cryoablation, at a mean of 20.1 months' follow‐up, appears to provide a safe and effective treatment option with a low complication rate. Anteriorly sited tumours should not be considered a contraindication for percutaneous image‐guided cryoablation.