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Improved outcome of percutaneous radiofrequency ablation in renal cell carcinoma: a retrospective study of intraoperative contrast-enhanced ultrasonography in 73 patients

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Abstract

Objectives

To evaluate the impact of contrast-enhanced ultrasonography (CEUS) during percutaneous radiofrequency ablation (PRFA) procedure in renal cell carcinoma (RCC).

Methods

From January 2008 to July 2010, 73 patients with sporadic unilateral RCC were enrolled to our study (57 men and 16 women, age range: 37–78 years, mean age 57.9 years). The diameter of the tumor was 1.7–5.8, 3.4 cm on average. The patients were divided into two groups depending on the intraoperative ultrasonography type: CEUS group and conventional ultrasound group. Patients in CEUS group received CEUS before insertion of the electrode, and the second CEUS was performed right after the initial ablation to dynamically evaluate the images. If there was highly suspicious residue, additional ablation and repeated CEUS were applied. Patients in the conventional ultrasound group received PRFA guided by gray-scale ultrasound. All of these patients received contrast-enhanced computed tomography (CT) examination 7 days after the procedure (patients in CEUS group received CEUS conducted with each CT scan), with subsequent CT and CEUS assessment at 3, 6, and every 6 months thereafter.

Results

The mean follow-up period was 22 months (range: 12–42 months). All tumors were biopsied before RFA. The local tumor control rate was 94.6% (35/37) in the CEUS group and 86.1% (31/36) in the conventional ultrasound group (P < 0.05); the cancer-specific survival rate and the overall survival rate were 100%. The post-RFA (12 months) mean GFR levels were 84.7 ± 27.5 mL/min/1.73 m2 (P > 0.05, compared with pre-GFR: 86.4 ± 26.2 mL/min/1.73 m2) in the CEUS group and 81.9 ± 22.8 mL/min/1.73 m2 (P > 0.05, compared with pre-GFR: 83.5 ± 23.7 mL/min/1.73 m2) in the conventional ultrasound group.

Conclusion

Intraoperative CEUS can “real-time” monitor the ablated area during PRFA procedure. This technique can help to achieve a higher success rate compared with conventional ultrasound. No impact of intraoperative CEUS has been found on GFR level.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Urology Department, The Affiliated Nanjing Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China

    Xiaozhi Zhao, Wei Wang, Shiwei Zhang, Jun Liu, Fan Zhang, Changwei Ji, Xiaogong Li, Weidong Gan, Gutian Zhang & Hongqian Guo

Authors
  1. Xiaozhi Zhao
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  2. Wei Wang
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  3. Shiwei Zhang
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  4. Jun Liu
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  5. Fan Zhang
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  6. Changwei Ji
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  7. Xiaogong Li
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  8. Weidong Gan
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  9. Gutian Zhang
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  10. Hongqian Guo
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Corresponding author

Correspondence to Hongqian Guo.

Additional information

Xiaozhi Zhao and Wei Wang contribute equally to this work as co-first authors.

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Zhao, X., Wang, W., Zhang, S. et al. Improved outcome of percutaneous radiofrequency ablation in renal cell carcinoma: a retrospective study of intraoperative contrast-enhanced ultrasonography in 73 patients. Abdom Radiol 37, 885–891 (2012). https://doi.org/10.1007/s00261-011-9828-4

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  • DOI: https://doi.org/10.1007/s00261-011-9828-4

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