CT-guided percutaneous cryotherapy of renal masses.
Publication/Presentation Date
3-1-2007
Abstract
PURPOSE: To assess the results of initial and current techniques for percutaneous renal cryotherapy, including long-term imaging outcomes.
MATERIALS AND METHODS: Computed tomography (CT)-guided percutaneous cryotherapy was performed on 49 masses in 48 outpatients and procedure comfort noted for each. These 49 masses included 36 primary renal cell carcinomas (RCCs), 3 oncocytomas, 1 angiomyolipoma, 6 renal inflammatory lesions, 2 benign parenchymal changes, and 1 colon cancer metastasis. All complications were graded according to standardized criteria.
RESULTS: Patients received only local anesthesia and moderate sedation during the procedure and were discharged with minimal discomfort within 4-6 hours. All cryotherapy zones were well defined by CT during ablation as hypodense ice with an average diameter of 5.3 cm, covering an average tumor size of 3.3 cm. Average ablation zone diameters showed significant reduction over time (P < .001), becoming significantly less than the original tumor size by 12 months (P < .05). Major and minor complications were seen in 3 (6%) and 11 (22%) procedures, respectively. At a mean follow-up of 1.6 years (range, 1 week to 3.8 years) for primary RCC patients, four failures (11.1%) by imaging criteria were noted, but one proved to be inflammatory tissue at re-biopsy (estimated neoplastic failure rate = 3/36 = 8.3%).
CONCLUSIONS: Percutaneous renal cryotherapy is a well-tolerated outpatient procedure that allows safe, CT monitoring of ice formation beyond visible tumor margins. With appropriate cryoprobe placements, a low failure rate appears less dependent on tumor size or location. Ablation volume involution was >80% after 6 months.
Volume
18
Issue
3
First Page
383
Last Page
392
ISSN
1535-7732
Published In/Presented At
Littrup, P. J., Ahmed, A., Aoun, H. D., Noujaim, D. L., Harb, T., Nakat, S., Abdallah, K., Adam, B. A., Venkatramanamoorthy, R., Sakr, W., Pontes, J. E., & Heilbrun, L. K. (2007). CT-guided percutaneous cryotherapy of renal masses. Journal of vascular and interventional radiology : JVIR, 18(3), 383–392. https://doi.org/10.1016/j.jvir.2006.12.007
Disciplines
Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology
PubMedID
17377184
Department(s)
Department of Radiology and Diagnostic Medical Imaging
Document Type
Article