Gianpiero Cardone MD, Presenter: Nothing to Disclose

Maurizio Papa MD, Abstract Co-Author: Nothing to Disclose

Paola Mangili PhD, Abstract Co-Author: Nothing to Disclose

Giorgio Guazzoni MD, Abstract Co-Author: Nothing to Disclose

Giuseppe Balconi, Abstract Co-Author: Nothing to Disclose

This study aims to determine the safety and efficacy of CA in the management of small renal carcinomas and to assess its medium term outcome.

We report the mid-term CT/MR imaging follow-up in 115 pts who gained at least 5 years follow-up after CA of 96 renal carcinomas. Treatment was administered under laparoscopic US guidance in 101 pts and using percutaneous CT guidance in 14 pts. Pts were followed up clinically, biochemically and by imaging 24 hours after surgery, and subsequently every 6 months. Imaging follow-up was obtained using a 1,5T MR system in 104 cases and using CT in 11 pts with contraindications to MR. 

24 hours after treatment all cryolesions were more than 1 cm larger than the original masses; cryolesions decreased in size by an average of 38% at 1 month, 64% at 6 months, 80% at 12 months and 93% at 84 months following LC. Early postprocedural MR and CT ce- images showed complete ischemia of cryolesions. Follow-up revealed no evidence of local recurrence in 111/115 pts (96%). 4 pts showed local recurrence at 12, 24 and 96 months. 12/115 pts (9%) demonstrated metachronous nodules in the same or in the contralateral kidney at 12, 24 and 48 months. 2 pts showed a pancreatic metastatic nodule at 12 and 24 months. 11/115 pts died for metastasis of a previous malignancy. 1 pt showed ureteral fistula and 1 pt showed proximal ureteral stenosis. No significant rise in creatinine level was noted postprocedurally. After surgery 11% of the cases showed small perilesional haematomas.

Our experience suggests that CA is a safe, well tolerated and minimally invasive therapy for small renal carcinomas. MR is an effective tool in the imaging follow-up of renal lesions treated with CA, and the high contrast resolution of MR allows a better evaluation of vascularization of treated areas on subtracted ce images compared to CT. CT can be used as an alternative choice to MR, but lower contrast resolution of CT to MR makes it difficult to differentiate the cryolesion from the surrounding perilesional collections. A limit of CA is the difficulty to perform repeated treatments in the same kidney.

CA is a safe, well tolerated and minimally invasive therapy for small renal carcinomas. MR and CT are effective imaging techniques in the follow-up of renal lesions treated with CA. 

Cardone, G, Papa, M, Mangili, P, Guazzoni, G, Balconi, G, Percutaneous and Laparoscopic Cryoablation (CA) of Renal Carcinomas: Mid-term CT and MR Imaging Follow-up.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045693.html