Radiofrequency ablation of renal tumours: diagnostic accuracy of contrast-enhanced ultrasound for early detection of residual tumour

Abstract

CEUS has high specificity for the early diagnosis of residual tumour after renal RFA.

Contrast enhanced ultrasound of renal masses. A reappraisal of EFSUMB recommendations and possible emerging applications.

“…CEUS also increased the conspicuity of less defined / invisible lesions, issue demonstrated for hepatic tumours [51,52]. It has been also demonstrated that CEUS accurately depicts the vascularized, active parts in partially ablated renal tumours [16].…”

“…CEUS has proved to be a useful tool for the assessment of the treatment ( fig 5) [15]. In a series of patients with renal tumours treated by RFA in whom a prevalence of residual disease of 19% was documented, the sensitivity and specificity of CEUS in early detection of residual tumours was 64% and 98 %, respectively [16].…”

Contrast-Enhanced Ultrasound-Guided Radiofrequency Ablation of Renal Tumors

“…However, CEUS had lower sensitivity than that of CT/ MRI, and had worse image quality at the upper renal poles and at the periphery of the treated areas. Hoeffel et al also noted that CEUS performed better in the assessment of hypervascular tumors, a concept that has been noted in several other studies and could be related to the ability of UCAs to image the microvasculature (6,9,12). Other limitations of CEUS may include lesion location as well as the specific properties of UCAs when used in the kidneys.…”

“…However, unlike MRI, CEUS can be used in patients with arthroprosthesis or pacemakers, and faces less of a problem of movement artifacts from patients who cannot stay still (9). Furthermore, there has been mounting concern about the use of gadolinium MRI contrast agents in patients with chronic renal failure and how it may be associated with nephrogenic systemic sclerosis (6,9).…”

“…One of its biggest benefits is that the procedure is renal sparing, and RFA is currently used for small tumors, usually less than 5 cm, in patients who are not candidates for surgical removal (7). Besides being used as an attempted cure of RCC, it may also be used to treat RCC-associated intractable hematuria, local recurrences, isolated metastases, and palliation of symptoms (6). RFA is considered a minimally invasive procedure in which a probe is inserted into the target tissue and alternating electrical currents are used to generate heat to destroy tumor cells and associated neovascularity.…”