Percutaneous CT-Guided Radiofrequency Ablation of Renal Neoplasms: Factors Influencing Success

Abstract

No serious complications occurred after 27 CT-guided radiofrequency ablation sessions in 22 patients. In total, no residual tumor was detected on follow-up contrast-enhanced CT or MRI 1-35 months (mean, 7 months) after final tumor ablation in 20 (91%) of 22 patients. Two patients with residual viable tumor deferred further treatment. Complete tumor ablation was achieved after a single treatment session in 83% of patients, and in 8% of patients after subsequent ablation sessions. Size was the major determinant for achieving tumor eradication with a single session of ablation, with all 11 tumors 3 cm or smaller being completely ablated after one session. Tumor location, histology, and the presence of renal disease did not correlate with treatment success. Contrast-enhanced CT performed immediately after ablation is reliable to exclude residual viable tumor. CT-guided radiofrequency ablation of renal tumors is safe and has a high rate of success in the treatment of small renal tumors, with no evidence of recurrence at midterm follow-up of treated patients.

Molecular Genetic Evidence for the Independent Origin of Multifocal Papillary Tumors in Patients with Papillary Renal Cell Carcinomas

“…With advances in radiologic imaging, an increasing proportion of renal cancers are discovered incidentally with a high proportion of these tumors being small (40). As a result, nephron-sparing surgical techniques have become widely employed for renal cancer therapy, even in patients with a normally functioning contralateral kidney, and there is increasing interest in the urologic and radiologic communities in another form of conservative therapy for renal neoplasms-computed tomographyguided radiofrequency ablation of tumors in situ (8,9,11,40). The main objection to conservative surgery for renal cell carcinoma is concern over local recurrence due to the possible presence of small tumors with malignant potential in the portion of kidney left behind.…”

Fine Needle Aspiration Biopsy of Metanephric Adenoma

“…The percutaneous RFA technique utilized in this case has been previously reported. 7 The ablation procedure was completed using the impedance control setting on the device and an ablation probe with a 3-cm active tip. Four separate ablations, each 4 minutes in duration, were completed with the probe tip positioned in different areas of the tumor for each ablation.…”

Trans-Arterial Embolization of Renal Cell Carcinoma prior to Percutaneous Ablation: Technical Aspects, Institutional Experience, and Brief Review of the Literature

“…Its incidence, however, is increasing secondary to the identification of renal tumors in patients who are imaged for other reasons [2,3,4,5]. One unintentional benefit of these incidentally-detected renal masses is that they are typically smaller, of lower grade, and have been associated with longer disease-free survival [6].…”