Lousine Boyadzhyan MD, Presenter: Nothing to Disclose

Steven Satish Raman MD, Abstract Co-Author: Nothing to Disclose

Allan Pantuck MD, Abstract Co-Author: Nothing to Disclose

Peter G. Schulam, Abstract Co-Author: Nothing to Disclose

Arie Belldegrun MD, Abstract Co-Author: Nothing to Disclose

David Shin-Kuo Lu MD, Abstract Co-Author: Consultant, Siemens AG Consultant, Vital Images, Inc Consultant, General Electric Company Speaker, General Electric Company Speaker, Boston Scientific Corporation Consultant, Endocare, Inc Research funded, Endocare, Inc Consultant, Covidien AG Speaker, Covidien AG Research funded, Covidien AG

To evaluate the efficacy of CT and Ultrasound (US) guided Radiofrequency (RF) ablation in treatment of cystic Renal Cell Carcinoma (RCC)

After IRB approval, our database was queried to select the cohort of all cystic RCC treated by RF ablation since 2003. A total of 25 lesions were selected, ranging in size from 0.9 - 4.1 cm, which were followed for a mean of 23 months (range 5-38 months). 24 lesions were biopsy proven RCC and 1 lesion was a multilocular cystic nephroma (MLCN). 22 out of 25 lesions were exophytic (cortical) and 3 lesions were central within the renal hilum. RF ablation was performed on an outpatient basis under general anesthesia with the Valleylab CC1 generator using one electrode. The Valleylab electrode was guided into the cystic lesion with US and placed at the interface between the lesion and the kidney. The power was then slowly ramped up from 80 W to a maximum of 130 W for up to 12 minutes. The electrode was only repositioned for a second ablation session for the 4.1 cm MLCN. For all the lesions greater than 1.5 cm, a 22 G Chiba needle was first advanced into the lesion with US guidance and after placement of the RF electode the cystic contents were aspirated for cytology. Following ablation, a baseline CT was performed and the lesion was followed by CT at 3-6 month intervals.

All 25 lesions were treated successfully in a single session resulting in 100 % primary efficacy. During the follow-up period, a single right lower pole lesion demonstrated progressive ill defined perilesional enhancement and thus subsequently underwent a second session of RF ablation without complication, resuling in 96 % secondary efficacy. There were no major complications. In one case, the patient developed a small self limited subcapsular hematoma.

Percutaneous RF ablation is a safe and effective method for treatment of small and medium sized cystic RCC lesions.

To our knowledge, this is the only report of using percutaneous RF ablation to treat cystic RCC, and thus has practical implications for treatment of this subset of RCC lesions.

Boyadzhyan, L, Raman, S, Pantuck, A, Schulam, P, Belldegrun, A, Lu, D, Efficacy of Percutaneous CT- and Ultrasound-guided Radiofrequency Ablation in Treatment of Cystic Renal Cell Carcinoma.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6012052.html