The Radiographic Evolution of Radio Frequency Ablated Renal Tumors

Matsumoto, Edward D.; Watumull, Lori M; Johnson, D. Brooke; Ogan, Kenneth; Taylor, Grant D.; Josephs, Shellie C.; Cadeddu, Jeffrey A.

doi:10.1097/01.ju.0000132124.01060.0c

Cited by 108 publications

(42 citation statements)

References 22 publications

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“…6). These lesions usually exhibit an enhancement difference of more than 10 HU between unenhanced and contrastenhanced CT images [22,25,26] or an increase in signal intensity by greater than 20% between unenhanced and contrast-enhanced MR images [26,27].…”

Section: Residual or Recurrent Rccmentioning

confidence: 99%

Complications of image-guided radiofrequency ablation of renal cell carcinoma: causes, imaging features and prevention methods

Park

Kim

2009

Eur Radiol

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Radiofrequency (RF) ablation is an alternative treatment for renal cell carcinoma (RCC) in patients unable to undergo surgery. Although RF ablation has a low complication rate because of its minimally invasive nature, unintended heat may be conducted by several critical organs during ablation procedures, leading to a variety of complications. Major complications that usually require treatment include bowel injury, ureteral injury, massive bleeding and residual or recurrent tumour. Minor complications that may require only observation include pain, haematoma, haematuria, neuromuscular injury, pneumothorax, infarction and inflammatory tract mass. The most common cause of complications is the tumour's proximity to neighbouring organs. In addition, careless electrode manipulation and the patient's comorbidities may also lead to complications. To avoid many of these complications, the distance between the tumour and neighbouring organs should be widened using methods such as changing the patient's position, using the RF electrode as a lever and hydrodissection. Furthermore, carefully manipulating the RF electrode and assessing the patient's general condition help to prevent complications. In this review, we discuss the complications resulting from RF ablation of RCC with an emphasis on causes, imaging features and prevention methods.

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Section: Residual or Recurrent Rccmentioning

confidence: 99%

Complications of image-guided radiofrequency ablation of renal cell carcinoma: causes, imaging features and prevention methods

Park

Kim

2009

Eur Radiol

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“…In fact, cryoablation-treated lesions should ''shrink'' as the traumatic cellular lysis of the melting ice results in acute neutrophil and macrophage infiltration with resultant tumor resorption. Conversely, for RF-treated lesions, the associated protein denaturation causes stabilization or ''fixation'' of tumor architecture resulting in slow, if any, resorption of residual tissue [46]. As such, radiographic markers of successful RFA include absence of contrast enhancement and growth, as opposed to lesion involution.…”

Section: Definition Of Treatment Successmentioning

confidence: 94%

Renal ablative therapy: Radiofrequency ablation and cryoablation

Raman

Hall

Cadeddu

2009

Journal of Surgical Oncology

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Widespread use of cross-sectional imaging has contributed to an increase in diagnosis of small renal masses. While extirpation has historically been the "gold standard" for managing such tumors, thermal ablation is increasingly utilized as primary surgical therapy. Contemporary series suggest that ablative procedures maintain oncologic outcomes similar to extirpation while minimizing patient morbidity. As more renal masses are diagnosed in elderly or comorbid patients, ablation will likely assume a central role in management strategies.

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“…In the percutaneous approach, sonographic and CT guidance are typically used for probe placement, whereas in the laparoscopic approach, ultrasound guidance is used for probe placement into the tumor. Patients are followed using serial contrast-enhanced CT or MRI, with nonenhancement and slight shrinkage of the lesion being the expected findings of a successful ablation [16,17]. Table 2 summarizes the literature on renal tumor RFA.…”

Section: Cryoablationmentioning

confidence: 99%

Oncologic outcomes for ablative therapy of kidney cancer

Park

Cadeddu²,

Shingleton

2007

Curr Urol Rep

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Needle ablative therapies for small incidental renal masses are emerging as alternatives to traditional extirpative surgery. Reasons include their associated decreased morbidity, shorter convalescence, and the ability to avert the higher risk of extirpative surgery in an aging patient population. Cryoablation (CA) and radiofrequency ablation are the two most thoroughly studied needle ablative methods used for renal cancer. High-intensity focused ultrasound has also been studied but with limited published human experience at this time. For both radiofrequency ablation and CA, in vitro experiments, animal studies, and (increasingly) human experience have been published, allowing us to define appropriate candidates for such therapies, their oncologic outcomes, and the potential pitfalls. While long-term data is being collected, the current literature suggests that CA and radiofrequency ablation can be safely performed and can effectively eradicate small renal cancers with cancer-specific survival rates similar to those of traditional surgical options.

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The Radiographic Evolution of Radio Frequency Ablated Renal Tumors

Abstract: The radiographic features and evolution of radio frequency ablated renal tumors are unique. Successfully treated tumors demonstrated no contrast enhancement, minimal shrinkage and occasional retraction from normal parenchyma by fat infiltration.

Cited by 108 publications

References 22 publications

Complications of image-guided radiofrequency ablation of renal cell carcinoma: causes, imaging features and prevention methods

Complications of image-guided radiofrequency ablation of renal cell carcinoma: causes, imaging features and prevention methods

Renal ablative therapy: Radiofrequency ablation and cryoablation

Oncologic outcomes for ablative therapy of kidney cancer

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