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Percutaneous RF Thermal Ablation of Renal Tumors: Is US Guidance Really Less Favorable Than Other Imaging Guidance Techniques?

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Abstract

The purpose of this study was to compare our experience with ultrasound (US)-guided percutaneous radiofrequency thermal ablation (RFA) of renal tumors with results of CT-guided and MRI-guided series in the current literature. Of 90 consecutive renal tumors treated with RFA in 71 patients, 87 lesions were ablated under US guidance. We performed a retrospective analysis of clinical outcome and safety. Results were then compared to published case series where CT and MRI guidances were used exclusively. In our series we had a major complication rate of 4.6%, whereas in CT- and MRI-based series it was 0–12% (mean, 2.2%) and 0–8.3% (mean, 4.1%), respectively. During follow-up (1–68 months; mean, 24 months) technical effectiveness was 89.7%, while it was between 89.5% and 96% in CT-guided series and between 91.7% and 100% in MRI-guided series. The size of successfully treated lesions (28 mm) was lower than that of partially-ablated lesions (36 mm; p = 0.004) and only central lesion location proved to be a negative prognostic factor (p = 0.009); in CT-guided series, positive prognostic factors were exophytic growth and size ≤3 cm. “Tumor-specific” 2-year survival was 92% in our series, 90–96% in CT-guided series, and not reported in MRI-guided series. In conclusion, despite common beliefs, US guidance in RFA of renal tumors is not less favorable than other guidance techniques. Thus the interventional radiologist can choose his or her preferred technique taking into account personal experience and available equipment.

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Acknowledgments

The work of E. Pagano was supported by the Compagnia di San Paolo, Special Project Oncology. This study was presented at CIRSE 2004.

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Authors and Affiliations

  1. Institute of Radiology, University of Turin, ASO S. Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano, TO, Italy

    Andrea Veltri, Irene Garetto, Paola Sacchetto & Cesare Fava

  2. Unit of Cancer Epidemiology, University of Turin, ASO S. Giovanni Battista, Via Santena 7, 10126, Turin, Italy

    Eva Pagano

  3. Institute of Anesthesiology, Univesity of Turin, ASO S. Giovanni Battista, Corso Dogliotti 14, 10126, Turin, Italy

    Irene Tosetti

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  1. Andrea Veltri
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  2. Irene Garetto
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  3. Eva Pagano
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  4. Irene Tosetti
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  5. Paola Sacchetto
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  6. Cesare Fava
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Correspondence to Andrea Veltri.

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Veltri, A., Garetto, I., Pagano, E. et al. Percutaneous RF Thermal Ablation of Renal Tumors: Is US Guidance Really Less Favorable Than Other Imaging Guidance Techniques?. Cardiovasc Intervent Radiol 32, 76–85 (2009). https://doi.org/10.1007/s00270-008-9414-5

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  • DOI: https://doi.org/10.1007/s00270-008-9414-5

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