Learning objectives
Describe the role of CT-guided percutaneous ablation in the treatment of functioning adrenal adenomas.
Compare the efficacy and safety between laparoscopic resection and CT-guided percutaneous ablation in treating adrenal adenoma.
Background
The radiofrequency ablation has been applied to functional adrenal tumors,
metastasis,
and primary carcinoma,
with good initial responses and low adverse effects.
The use of radiofrequency ablation to treat adrenal nodules is still an uncommon procedure,
particularly in aldosterone-producing adenomas.
This is a promising and less invasive treatment option for adrenal nodules,
which presents lower complication rates,
being the most common pneumothorax and retroperitoneal hematoma.
Interventional radiology plays an important role beyond diagnosis,
because it can be used as an active part in the treatment.
Findings and procedure details
The effectiveness of ablation treatment is significantly dependent on tumor size.
Lesions up to 3 cm undergo complete ablation,
while a larger lesions may require multiple RFA treatment to prevent recurrence.
The patient are put into the prone position on CT scanner examination table afterdeep sedation with continuous monitoring of blood pressure,
heart rate,
electrocardiography (ECG) tracing,
and oxygen saturation.
During the procedure,
hypertensive peaks can occur and are treated by the anesthesiologists who are following the process.
Afterdeep sedation,
a single Cool-tip radiofrequency needle...
Conclusion
Percutaneous ablation is a promising technique and may be an alternative choice to surgical resection in the treatment of adrenal adenomas.
It has been shown in the literature as a feasible method for treating small adrenal adenomas,
with a high overall success.
This is a safe,
extremely accurate and less invasive treatment option for the adrenal adenomas,
which presents lower complication rates compared to surgical resection.
References
Min‐Hsin Yang,
Yeu‐Sheng Tyan,
Yu‐Hui Huang,
Shao‐Chuan Wang,
Sung‐Lang Chen; Comparison of radiofrequency ablation versus laparoscopic adrenalectomy for benign aldosterone‐producing adenoma; Italian Society of Medical Radiology; June 2016
Shirley Yuk Wah Liu,
Charmant Cheuk Man Chu,
Teresa Kam Chi Tsui,
Simon Kin Hung Wong,
Alice Pik Shan Kong ,
Philip Wai Yan Chiu,
Francis Chun Chung Chow,
Enders Kwok Wai Ng; Aldosterone-producing adenoma in Primary aldosteronism: CT-guided Radiofrequency Ablation - Long-term Results and Recurrence Rate; Radiology: Volume 281: Number 2 - November 2016
Raul N....