Farrah Joyce Wolf MD, Presenter: Nothing to Disclose

Michael David Beland MD, Abstract Co-Author: Speakers Bureau, General Electric Company

Jason Machan, Abstract Co-Author: Nothing to Disclose

Damian E. Dupuy MD, Abstract Co-Author: Nothing to Disclose

William W. Mayo-Smith MD, Abstract Co-Author: Nothing to Disclose

To determine the effectiveness and safety of image-guided radiofrequency ablation of solid renal masses.

This HIPAA-compliant study was approved by the institutional review board. From May 1998 to March 2010, 200 consecutive patients underwent percutaneous CT-guided radiofrequency ablation of 217 renal tumors using conscious sedation. A total of 123 men and 77 women (mean age 73 years; range, 36-91) underwent 228 ablation sessions. A single electrode was used in 28 sessions and a cluster electrode was used in 200 sessions. Hydrodissection was used in 31 ablation sessions to displace adjacent organs. The mean time per treatment was 7.8 minutes (range, 1-15) with an average of 2.3 applications performed per tumor (range, 1-8). Tumors included renal cell carcinomas (n=151), oncocytic neoplasms (n=26), non-fat containing angiomyolipomas (n=7), tumors with non-biopsy proven or indeterminant pathology (n=30) and other malignancies (n=3). Mean tumor size was 2.6cm (range, 1-6), and 22 treated patients had undergone prior nephrectomy. Successful treatment was defined as a lack of enhancement within the treated region on follow-up contrast enhanced CT or MRI.

88% of tumors (191/217) were successfully treated in a single ablation session. Residual disease at the ablation site was detected in 7% of treated tumors (15/217), 11 of which were subsequently re-treated. Median imaging follow-up was 1.6 years (95%CI, 1.2-1.9 years) and median clinical follow-up 1.9 years (95%CI, 1.7-2.2). Procedure related complications occurred in 28 patients: hematomas in 16 (none requiring transfusion); arrhythmias or hypertension in 5; and urinary strictures in 4 patients. Kaplan-Meier survival analysis yielded 3- and 5-year cancer specific mortality rates of 0.9% and 3.7% and an all-cause median time to death of 7.7 years (95%CI, 7-9.4) post-ablation.

Percutaneous CT-guided radiofrequency ablation of solid renal masses is a safe and effective treatment option for non-surgical candidates with renal neoplasms.

Image-guided percutaneous radiofrequency ablation of solid renal masses is a safe and effective, minimally-invasive treatment option as demonstrated by our experience in 200 patients.

Wolf, F, Beland, M, Machan, J, Dupuy, D, Mayo-Smith, W, CT-guided Percutaneous Radiofrequency Ablation of Solid Renal Masses: Effectiveness and Safety in 200 Consecutive Patients.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9010759.html