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Real-time US/cone-beam CT fusion imaging for percutaneous ablation of small renal tumours: a technical note

  • Interventional
  • Published:
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Abstract

Introduction

Fusion imaging is gaining attention as an imaging technique to assist minimally invasive tumour ablation. Ultrasound (US) and computed tomography (CT) are the most common imaging modalities to guide thermal ablation of renal tumours, yet cone-beam CT (CBCT) has recently been described to successfully assist percutaneous renal interventions. Our goal was to evaluate primary technical success and correct lesion targeting of US/CBCT fusion imaging to guide the ablation of kidney masses < 2 cm in a small group of patients.

Material and methods

Six renal lesions (maximum diameter 11–17 mm) were treated with RFA in 5 different patients using real-time US/CBCT. Fusion imaging was used to identify and monitor tumour ablation. Demographics, tumour characteristics and mean serum creatinine levels were recorded before and after the procedure. Primary technical success and correct lesion targeting represented the main endpoints of the study. Primary technique efficacy was confirmed at 1-month and 3-month contrast-enhanced CT follow-ups.

Results

In all cases, a confident US/CBCT synchronisation was reached and allowed for a correct targeting and a successful percutaneous ablation. Primary technique efficacy was 100%. No recurrence was observed at the follow-up that ranged from 8 to 26 months (mean 16 months).

Conclusions

US/CBCT fusion proved to be a viable method to precisely guide safe and effective percutaneous thermal ablation in patients with small renal tumours, especially when hardly detectable on US.

Key Points

• US/CBCT fusion imaging for renal ablation is safe and feasible.

• US/CBCT fusion imaging allows for an improved targeting and complete ablation of small RCC with poor US-conspicuity.

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Abbreviations

CBCT:

Cone-beam CT

RCC:

Renal cell carcinoma

RFA:

Radiofrequency ablation

US:

Ultrasound

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Funding

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

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Authors and Affiliations

  1. Division of Interventional Radiology, Fondazione Poliambulanza, 25124, Brescia, Italy

    Lorenzo Monfardini

  2. Departament of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, Italy

    Nicolò Gennaro & Luigi Solbiati

  3. Departament of Radiology, Humanitas Clinical and Research Center, 20089, Rozzano, Italy

    Nicolò Gennaro

  4. Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, 20141, Milan, Italy

    Franco Orsi, Paolo Della Vigna, Guido Bonomo, Gianluca Varano & Giovanni Mauri

  5. Department of Radiology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy

    Luigi Solbiati

  6. Department of Oncology and Hematolgy-Oncology, Universita` degli studi di Milano, 20122, Milan, Italy

    Giovanni Mauri

Authors
  1. Lorenzo Monfardini
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  2. Nicolò Gennaro
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  3. Franco Orsi
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  4. Paolo Della Vigna
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  5. Guido Bonomo
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  6. Gianluca Varano
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  7. Luigi Solbiati
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  8. Giovanni Mauri
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Correspondence to Lorenzo Monfardini.

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The scientific guarantor of this publication is Lorenzo Monfardini.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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Monfardini, L., Gennaro, N., Orsi, F. et al. Real-time US/cone-beam CT fusion imaging for percutaneous ablation of small renal tumours: a technical note. Eur Radiol 31, 7523–7528 (2021). https://doi.org/10.1007/s00330-021-07930-w

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  • DOI: https://doi.org/10.1007/s00330-021-07930-w

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