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-  2019 

Percutaneous cryoablation for renal cell carcinoma using ultrasound

DOI: 10.1177/0284185118798175

Keywords: Cryoablation,cryotherapy,renal cell carcinoma,radiation,kidney

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Abstract:

Usefulness of ultrasound (US)-guided mass targeting and computed tomography (CT)-guided ice-ball monitoring in percutaneous cryoablation (PCA) for renal cell carcinoma (RCC) is still uncertain. To assess radiation dose and short-term outcomes of PCA for RCC using US-guided targeting and CT-guided ice-ball monitoring. Thirty-nine consecutive patients who underwent PCA for biopsy-proven RCC were included. Mass targeting was performed with US and ice-ball was monitored with CT guidance. Effective radiation dose of CT during PCA was recorded. Follow-up was conducted with contrast-enhanced CT or magnetic resonance imaging (MRI) (mean follow-up time?=?10.1?±?7.0 months). Local tumor progression was defined by the presence of focal enhancing areas at the ablation zone (CT, ≥ 20 HU; MRI, presence of focal enhancement on subtraction contrast-enhanced image). Technical success, major complication rate (e.g. Clavien–Dindo classification ≥ 3), and one-year local tumor progression-free survival (PFS) rate were analyzed. Mean effective radiation dose in association with PCA was 12.1?±?4.5 mSv (range?=?7.0–25.2 mSv). Technical success was achieved in 100%. Local tumor progression occurred in a single patient (2.6%, 1/39), and one-year local tumor PFS rate was 95.7%. No major complication was found. PCA using US-guided targeting and CT-guided ice-ball monitoring may allow acceptable local tumor control for RCC, as a radiation-reducing strategy

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