European Radiology

, Volume 20, Issue 8, pp 1812–1821

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

  • Christine Hoeffel
  • Maud Pousset
  • Marc-Olivier Timsit
  • Caroline Elie
  • Arnaud Méjean
  • Samuel Merran
  • François Tranquart
  • Ahmed Khairoune
  • Dominique Joly
  • Stéphane Richard
  • Olivier Hélénon
  • Jean-Michel Correas
Urogenital

Abstract

Objective

To evaluate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in the early detection of residual tumour after radiofrequency ablation (RFA) of renal tumours.

Methods

Patients referred to our institution for RFA of renal tumours prospectively underwent CEUS and computed tomography (CT) or magnetic resonance imaging (MRI) before, within 1 day and 6 weeks after treatment. Identification of residual tumour was assessed by three blinded radiologists. Reference standard was CT/MRI performed at least 1 year after RFA.

Results

A total of 66 renal tumours in 43 patients (median age 62 years; range 44–71.5) were studied. Inter-reader agreement (κ value) was 0.84 for CEUS. Prevalence of residual disease was 19%. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), respectively, were as follows: 64% [confidence interval (CI) 39–84], 98% [CI 91–100], 82% [CI 52–95] and 92% [CI 83–97] on 24-h CEUS; 79% [CI 52–92], 100% [CI 94–100], 100% [CI 74–100] and 95% [CI 87–100] on 6-week CEUS; 79% [CI 52–92], 95% [CI 86–98], 79% [CI 52–92] and 95% [CI 86–98] on 24-h CT/MRI; and 100% [CI 72–100], 98% [CI 90–100], 91% [CI 62–98] and 100% [CI 93–100] on 6-week CT/MRI.

Conclusion

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

Keywords

Kidney Tumour Radiofrequency ablation Contrast-enhanced ultrasound CT MRI 

References

  1. 1.
    Boss A, Clasen S, Kuczyk M, Schick F, Pereira PL (2007) Image-guided radiofrequency ablation of renal cell carcinoma. Eur Radiol 17:725–733CrossRefPubMedGoogle Scholar
  2. 2.
    Matin SF, Ahrar K, Cadeddu JA et al (2006) Residual and recurrent disease following renal energy ablative therapy: a multi-institutional study. J Urol 176:1973–1977CrossRefPubMedGoogle Scholar
  3. 3.
    Zagoria RJ, Traver MA, Werle DM, Perini M, Hayasaka S, Clark PE (2007) Oncologic efficacy of CT-guided percutaneous radiofrequency ablation of renal cell carcinomas. AJR Am J Roentgenol 189:429–436CrossRefPubMedGoogle Scholar
  4. 4.
    Pandharipande PV, Gervais DA, Mueller PR, Hur C, Gazelle GS (2008) Radiofrequency ablation versus nephron-sparing surgery for small unilateral renal cell carcinoma: cost-effectiveness analysis. Radiology 248:169–178CrossRefPubMedGoogle Scholar
  5. 5.
    Gervais DA, McGovern FJ, Arellano RS, McDougal WS, Mueller PR (2005) Radiofrequency ablation of renal cell carcinoma: part I, indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR Am J Roentgenol 185:64–71PubMedGoogle Scholar
  6. 6.
    Syvanthong C, Wile GE, Zagoria RJ (2007) Effect of radiofrequency ablation of renal tumors on renal function in patients with a solitary kidney. AJR Am J Roentgenol 188:1619–1621CrossRefPubMedGoogle Scholar
  7. 7.
    Thomsen HS, Morcos SK, Barrett BJ (2008) Contrast-induced nephropathy: the wheel has turned 360 degrees. Acta Radiol 49:646–657CrossRefPubMedGoogle Scholar
  8. 8.
    Bertolotto M, Martegani A, Aiani L, Zappetti R, Cernic S, Cova MA (2008) Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced CT. A feasibility study. Eur Radiol 18:376–383CrossRefPubMedGoogle Scholar
  9. 9.
    Ascenti G, Mazziotti S, Zimbaro G et al (2007) Complex cystic renal masses: characterization with contrast-enhanced US. Radiology 243:158–165CrossRefPubMedGoogle Scholar
  10. 10.
    Claudon M, Cosgrove D, Albrecht T et al (2008) Guidelines and good clinical practice recommendations for contrast-enhanced ultrasound (CEUS)-update. Ultraschall Med 29:28–44CrossRefPubMedGoogle Scholar
  11. 11.
    Vilana R, Bianchi L, Varela M et al (2006) Is microbubble-enhanced ultrasonography sufficient for assessment of response to percutaneous treatment in patients with early hepatocellular carcinoma? Eur Radiol 16:2454–2462CrossRefPubMedGoogle Scholar
  12. 12.
    Kim SK, Lim HK, Kim YH et al (2003) Hepatocellular carcinoma treated with radio-frequency ablation: spectrum of imaging findings. Radiographics 23:107–121CrossRefPubMedGoogle Scholar
  13. 13.
    Meloni MF, Bertolotto M, Alberzoni C et al (2008) Follow-up after percutaneous radiofrequency ablation of renal cell carcinoma: contrast-enhanced sonography versus contrast-enhanced CT or MRI. AJR Am J Roentgenol 191:1233–1238CrossRefPubMedGoogle Scholar
  14. 14.
    Newcombe RG (1998) Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med 17:857–872CrossRefPubMedGoogle Scholar
  15. 15.
    Kunkle DA, Uzzo RG (2008) Cryoablation or radiofrequency ablation of the small renal mass: a meta-analysis. Cancer 113:2671–2680CrossRefPubMedGoogle Scholar
  16. 16.
    Morcos SK, Thomsen HS, Webb JA (1999) Contrast-media-induced nephrotoxicity: a consensus report. Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR). Eur Radiol 9:1602–1613CrossRefPubMedGoogle Scholar
  17. 17.
    Boss A, Martirosian P, Schraml C et al (2006) Morphological, contrast-enhanced and spin labelling perfusion imaging for monitoring of relapse after RF ablation of renal cell carcinomas. Eur Radiol 16:1226–1236CrossRefPubMedGoogle Scholar
  18. 18.
    Merkle EM, Nour SG, Lewin JS (2005) MR imaging follow-up after percutaneous radiofrequency ablation of renal cell carcinoma: findings in 18 patients during first 6 months. Radiology 235:1065–1071CrossRefPubMedGoogle Scholar
  19. 19.
    Juluru K, Vogel-Claussen J, Macura KJ, Kamel IR, Steever A, Bluemke DA (2009) MR imaging in patients at risk for developing nephrogenic systemic fibrosis: protocols, practices, and imaging techniques to maximize patient safety. Radiographics 29:9–22CrossRefPubMedGoogle Scholar
  20. 20.
    Wen YL, Kudo M, Zheng RQ et al (2003) Radiofrequency ablation of hepatocellular carcinoma: therapeutic response using contrast-enhanced coded phase-inversion harmonic sonography. AJR Am J Roentgenol 181:57–63PubMedGoogle Scholar
  21. 21.
    Dill-Macky MJ, Asch M, Burns P, Wilson S (2006) Radiofrequency ablation of hepatocellular carcinoma: predicting success using contrast-enhanced sonography. AJR Am J Roentgenol 186:S287–S295CrossRefPubMedGoogle Scholar
  22. 22.
    Kawamoto S, Permpongkosol S, Bluemke DA, Fishman EK, Solomon SB (2007) Sequential changes after radiofrequency ablation and cryoablation of renal neoplasms: role of CT and MR imaging. Radiographics 27:343–355CrossRefPubMedGoogle Scholar
  23. 23.
    Rhim H, Dodd GD 3rd, Chintapalli KN et al (2004) Radiofrequency thermal ablation of abdominal tumors: lessons learned from complications. Radiographics 24:41–52CrossRefPubMedGoogle Scholar
  24. 24.
    Mayo-Smith WW, Dupuy DE, Parikh PM, Pezzullo JA, Cronan JJ (2003) Imaging-guided percutaneous radiofrequency ablation of solid renal masses: techniques and outcomes of 38 treatment sessions in 32 consecutive patients. AJR Am J Roentgenol 180:1503–1508PubMedGoogle Scholar
  25. 25.
    Zagoria RJ (2004) Imaging-guided radiofrequency ablation of renal masses. Radiographics 24:S59–S71CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Radiology 2010

Authors and Affiliations

  • Christine Hoeffel
    • 1
  • Maud Pousset
    • 2
  • Marc-Olivier Timsit
    • 3
  • Caroline Elie
    • 2
  • Arnaud Méjean
    • 3
  • Samuel Merran
    • 4
  • François Tranquart
    • 5
  • Ahmed Khairoune
    • 6
  • Dominique Joly
    • 10
  • Stéphane Richard
    • 7
    • 8
    • 9
  • Olivier Hélénon
    • 6
  • Jean-Michel Correas
    • 6
  1. 1.CHU de Reims, Hôpital Robert Debré, Pôle d’imagerieService de RadiologieReims CedexFrance
  2. 2.Département de Biostatistiques, Hôpital NeckerUniversité Paris-Descartes, AP-HPParis Cedex 15France
  3. 3.Service d’urologie, Hôpital NeckerUniversité Paris-Descartes, AP-HPParis Cedex 15France
  4. 4.Service d’imagerie médicaleFédération mutualiste parisienneParisFrance
  5. 5.Bracco ResearchPlan les OuatesSwitzerland
  6. 6.Service de radiologie adultes, Hôpital NeckerUniversité Paris-Descartes, AP-HPParis Cedex 15France
  7. 7.Centre Pilote Tumeurs rares INCa, AP-HPService d’urologie, Hôpital de BicêtreLe Kremlin-BicêtreFrance
  8. 8.Service de NéphrologieHôpital NeckerParis Cedex 15France
  9. 9.Génétique oncologique, CNRS FRE 2939, Faculté de médecine Paris-SudLe Kremlin-Bicêtre et Institut de Cancérologie Gustave RoussyVillejuifFrance
  10. 10.Service de Néphrologie, Hôpital NeckerUniversité Paris-Descartes, AP-HPParis Cedex 15France

Personalised recommendations