Learning objectives
Depicting CT and MRI features of early post-therapeutic changes and complications,
and the typical aspects of recurrences in the follow-up of kidneys treated with focal radiofrequency ablation (RFA) or cryoablation.
Background
Due to the significantly increased detection rate of incidental renal tumors,
the treatment of small,
asymptomatic renal masses is debated.
The primary treatment for renal malignancies has been radical nephrectomy,
but in recent year,
the method of choice has been nephron-sparing procedures with partial nephrectomy.
(1)
Although no general consensus is met,
percutaneous nephron-sparing minimal invasive ablation treatments are ground gaining on surgery due to their similar oncologic outcomes and low complication rates in treating early-stage renal tumors (T1N0M0).
(1,2) According to the European Association...
Findings and procedure details
We performed an extensive review of imagistic aspects of patients with renal tumors treated by focal therapy,
from the literature and our own case studies,
selecting the most representative cases.
We have classified the radiological changes according to the chosen method for treatment RFA or cryotherapy and furthermore by normal aspects and complications.
Before moving forward we must keep in mind that during the procedure the target lesion is not removed and is left in situ,
therefore the presence of a residual focal mass is...
Conclusion
Imaging features of normal post-therapeutic changes and recurrences after focal therapy of renal tumors have specific and sometimes tricky appearances that may trap untrained radiologists and lead them to describe lesions when there is none or miss small recurrences.
References
1.Wile GE,
Leyendecker JR,
Krehbiel K.A,
Dyer RB,
& Zagoria RJ (2007).
CT and MR Imaging after Imaging-guided Thermal Ablation of Renal Neoplasms.
RadioGraphics,
27(2),
325–339.
doi:10.1148/rg.272065083
2.Kawamoto S,
Permpongkosol S.,
Bluemke D.
A.,
Fishman E.
K.,
& Solomon S.
B.
(2007).
Sequential Changes after Radiofrequency Ablation and Cryoablation of Renal Neoplasms: Role of CT and MR Imaging.
RadioGraphics,
27(2),
343–355.
doi:10.1148/rg.272065119
3.Goldberg SN,
Gazelle GS,
Mueller PR.
Thermal ablation therapy for focal malignancy: a unified approach to underlying principles,
techniques,
and diagnostic imaging guidance....