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Percutaneous Microwave Ablation of Renal Angiomyolipomas

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Abstract

Purpose

To evaluate the safety and efficacy of US-guided percutaneous microwave (MW) ablation in the treatment of renal angiomyolipoma (AML).

Materials and Methods

From January 2011 to April 2014, seven patients (5 females and 2 males; mean age 51.4) with 11 renal AMLs (9 sporadic type and 2 tuberous sclerosis associated) with a mean size of 3.4 ± 0.7 cm (range 2.4–4.9 cm) were treated with high-powered, gas-cooled percutaneous MW ablation under US guidance. Tumoral diameter, volume, and CT/MR enhancement were measured on pre-treatment, immediate post-ablation, and delayed post-ablation imaging. Clinical symptoms and creatinine were assessed on follow-up visits.

Results

All ablations were technically successful and no major complications were encountered. Mean ablation parameters were ablation power of 65 W (range 60–70 W), using 456 mL of hydrodissection fluid per patient, over 4.7 min (range 3–8 min). Immediate post-ablation imaging demonstrated mean tumor diameter and volume decreases of 1.8 % (3.4–3.3 cm) and 1.7 % (27.5–26.3 cm3), respectively. Delayed imaging follow-up obtained at a mean interval of 23.1 months (median 17.6; range 9–47) demonstrated mean tumor diameter and volume decreases of 29 % (3.4–2.4 cm) and 47 % (27.5–12.1 cm3), respectively. Tumoral enhancement decreased on immediate post-procedure and delayed imaging by CT/MR parameters, indicating decreased tumor vascularity. No patients required additional intervention and no patients experienced spontaneous bleeding post-ablation.

Conclusion

Our early experience with high-powered, gas-cooled percutaneous MW ablation demonstrates it to be a safe and effective modality to devascularize and decrease the size of renal AMLs.

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Authors and Affiliations

  1. Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA

    Mircea Cristescu, Shane Wells, Timothy J. Ziemlewicz, Megan G. Lubner, J. Louis Hinshaw, Christopher L. Brace & Fred T. Lee Jr.

  2. Department of Urology, University of Wisconsin, Madison, WI, USA

    E. Jason Abel & Sean P. Hedican

  3. Department of Medical Physics, University of Wisconsin, Madison, WI, USA

    Christopher L. Brace

  4. Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA

    Christopher L. Brace & Fred T. Lee Jr.

Authors
  1. Mircea Cristescu
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  2. E. Jason Abel
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  3. Shane Wells
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  4. Timothy J. Ziemlewicz
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  5. Sean P. Hedican
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  6. Megan G. Lubner
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  7. J. Louis Hinshaw
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  8. Christopher L. Brace
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  9. Fred T. Lee Jr.
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Corresponding author

Correspondence to Fred T. Lee Jr..

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Conflict of Interest

Megan G. Lubner MD is a GE AUR Radiology Research Fellowship 2011–2013 grant recipient. J. Louis Hinshaw MD is a shareholder of Cellectar Biosciences, as well as a stockholder and former Board of Medical Advisors member for Neuwave Medical. Christopher L. Brace Ph.D. is a National Institutes of Health grant recipient for work with microwave ablation technology. He is a shareholder of, and receives personal fees from, NeuWave Medical, and has multiple patents related to thermal ablation, pending and issued. Fred T. Lee Jr. MD is a shareholder and serves on the board of directors of NeuWave Medical. He has multiple patents related to thermal ablation and receives inventor royalties from Covidien AG. Mircea Cristescu, E. Jason Abel MD, Shane Wells MD, Timothy J. Ziemlewicz MD, Sean P. Hedican MD have nothing to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Cristescu, M., Abel, E.J., Wells, S. et al. Percutaneous Microwave Ablation of Renal Angiomyolipomas. Cardiovasc Intervent Radiol 39, 433–440 (2016). https://doi.org/10.1007/s00270-015-1201-5

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  • DOI: https://doi.org/10.1007/s00270-015-1201-5

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