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Contrast-enhanced CT immediately following percutaneous microwave ablation of cT1a renal cell carcinoma: Optimizing cancer outcomes



To evaluate the effect of intra-procedural contrast-enhanced CT (CECT) and same-session repeat ablation (SSRA) on primary efficacy, the complete eradication of tumor after the first ablation session as confirmed on first imaging follow-up, of clinically localized T1a (cT1a) renal cell carcinoma (RCC).


398 consecutive patients with cT1a RCC were treated with cryoablation between 10/2003 and 12/2017, radiofrequency (RFA) or microwave ablation (MWA) between 1/2010 and 12/2017. SSRA was performed for residual tumor identified on intra-procedural CECT. Kruskal–Wallis and Pearson’s chi-squared tests were performed to assess differences in continuous and categorical variables, respectively. Multivariate linear regression was used to determine predictors for primary efficacy and decline in estimated glomerular filtration rate.


347 consecutive patients (231 M, mean age 67.5 ± 9.1 years) were included. Median tumor diameter was smaller [2.5 vs 2.7 vs 2.6 (p = 0.03)] and RENAL Nephrometry Score (NS) was lower [6 vs 7 vs 7 (p = 0.009] for MWA compared to the RFA and cryoablation cohorts, respectively. Primary efficacy was higher in the MWA cohort [99.4% (170/171)] compared to the RFA [91.4% (85/93)] and cryoablation [92.8% (77/83)] cohorts (p = 0.001). Microwave ablation and SSRA was associated with higher primary efficacy on multivariate linear regression (p = 0.01–0.03).


MWA augmented by SSRA, when residual tumor is identified on intra-procedural CECT, may improve primary efficacy for cT1a RCC.

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Shane A. Wells is the scientific guarantor of this manuscript. Glenn O. Allen MPH kindly provided statistical advice for this manuscript.

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The authors wish to acknowledge the non-author members of the Society of Abdominal Radiology (SAR) Renal Cell Carcinoma Disease-focused Panel (RCC DFP).


The authors state that this work has not received any funding.

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Correspondence to Shane A. Wells.

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The authors of this manuscript declare relationships with the following companies: Shane A. Wells MD—Ethicon Inc., Consultant, Christopher L. Brace PhD—Ethicon Inc, Consultant, Matthew S. Davenport MD—Wolters Kluwer, Royalties.

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Koebe, S.D., Curci, N.E., Caoili, E.M. et al. Contrast-enhanced CT immediately following percutaneous microwave ablation of cT1a renal cell carcinoma: Optimizing cancer outcomes. Abdom Radiol 47, 2674–2680 (2022).

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  • Renal cell carcinoma
  • Ablation
  • Primary efficacy
  • Microwave
  • Cryoablation