Image-guided radiofrequency ablation of renal cell carcinoma

Abstract

The incidence of renal cell carcinoma is rising with the increased number of incidental detection of small tumours. During the past few years, percutaneous imaging-guided radiofrequency ablation has evolved as a minimally invasive treatment of small unresectable renal tumours offering reduced patient morbidity and overall health care costs. In radiofrequency ablation, thermal energy is deposited into a targeted tumour by means of a radiofrequency applicator. In recent studies, radiofrequency ablation was shown to be an effective and safe modality for local destruction of renal cell carcinoma. Radiofrequency applicator navigation can be performed via ultrasound, computed tomography or magnetic resonance guidance; however, ultrasound seems less favourable because of the absence of monitoring capabilities during ablation. On-line monitoring of treatment outcome can only be performed with magnetic resonance imaging giving the possibility of eventual applicator repositioning to ablate visible residual tumour tissue. Long-term follow-up is crucial to assess completeness of tumour ablation. New developments in ablation technology and radiological equipment will further increase the indication field for radiofrequency ablation of renal cell carcinoma. Altogether, radiofrequency ablation seems to be a promising new modality for the minimally invasive treatment of renal cell carcinoma, which was demonstrated to exhibit high short-term effectiveness.

Navigator respiratory‐triggered diffusion‐weighted imaging in the follow‐up after hepatic radiofrequency ablation—initial results

“…Especially, the correlation between perfusion and diffusion changes that are present immediately after thermal ablation might be particularly helpful in the accurate assessment of the extent of the induced coagulative at the end of the RF procedure. Furthermore, the diagnostic information of DWI could be useful in postablational imaging of other organs, for example, after RF ablation of the kidneys (25) or the prostate. However, it needs to be considered that the diagnostic findings in DWI may vary in different tumor entities and 2 ) and ADC map are shown together with the T1 and contrast-enhanced images.…”

Successful management of renal leiomyosarcoma using radiofrequency ablation: Case report and brief review of literature

“…Most series concluded that RFA provides reasonable long-term oncological control. Some data suggested that RFA had outcomes similar to surgery [27][28][29][30][31][32][33][34][35] .…”

Contrast-Enhanced Ultrasound-Guided Radiofrequency Ablation of Renal Tumors

“…RFA has found an increasing role in the treatment of small renal tumors in patients who are not candidates for surgical resection, as previously outlined in the Introduction (19). It is an outpatient procedure in which a probe is inserted into the tumor and delivers thermal energy within the tissue that is created via a high-frequency alternating current released from the active electrode at the tip (1,7,20). According to Boss et al (7), the subsequent thermal damage will lead to coagulative necrosis and cellular death once the target temperature exceeds 48-50°C.…”

“…These include significant comorbidities, a life expectancy between 1 and 10 years, chronic renal failure, patient only having one or a transplant kidney, advanced age, bilateral RCC, Von Hippel-Lindau (VHL) disease, or refusal of conventional therapy (4-6). Many of these contraindications can be commonly found in the elderly, which is problematic since the average age of diagnosis of RCC is 64 (1,7). Chronic renal failure is especially important because those requiring dialysis also have an increased risk of developing RCC (1).…”