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Radiol Med. 2012 Jun;117(4):593-605. doi: 10.1007/s11547-011-0742-1. Epub 2011 Oct 21.

CT-guided percutaneous cryoablation of renal masses in selected patients.

Author information

1
Department of Radiology, National Cancer Institute, Via Venezian 1, 20133, Milan, Italy. carlo.spreafico@istitutotumori.mi.it

Abstract

PURPOSE:

We analysed our experience with computed tomography (CT)-guided percutaneous cryoablation (PCA) in patients who were not surgical candidates or refused surgery for small to medium-sized renal masses.

MATERIALS AND METHODS:

Two freezing cycles were applied and separated by a passive warming cycle using 1.7- and 2.4-mm cryoprobes under either general anaesthesia or sedation based on patient positioning and respiratory status. Postoperative monitoring included haematological and biochemistry evaluation and CT scan 24 h after PCA. Follow-up consisted of a multislice CT scan at 1 month and every 3 months in the first year then every 6 months thereafter.

RESULTS:

Thirty-seven patients (38 lesions) underwent 40 PCA procedures; 5/37 (13.5%) had a solitary kidney. Median mass size was 35 (range 12-70) mm. No complications occurred during the procedure. Clavien grade ≥2 anaemia occurred in two patients (5.4 %): one patient required 1 U of packed red blood cells; the other required an arterial embolisation. Serum creatinine did not increase in any case. Two patients showed persisting or recurrent disease at 1 and 9 months, respectively, and both could be re-treated with PCA. All other patients showed a hypodense mass 3 months after PCA, with no contrast enhancement. Subsequent examinations showed that lesion sizes decreased and CT densitometry remained stable or increased minimally, also with no contrast enhancement.

CONCLUSIONS:

PCA proved relatively easy and safe and could be considered an effective alternative for patients who are not surgical candidates or refuse surgery, as well as in patients with medium-sized lesions.

PMID:
22020435
DOI:
10.1007/s11547-011-0742-1
[Indexed for MEDLINE]

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