Learning objectives
Aim of this poster is to describe post radiofrequency ablation (RFA) appearances of renal tumours and also to point out signs of renal tumour recurrence after the procedure.
Background
The incidence of renal cell carcinoma (RCC) has been gradually increasing.
However,
there have been improvements in treatment options also [1].
Most renal cancers are now detected at early-stage being suitable for nephron-sparing ablative procedures,
such as radiofrequency ablation (RFA),
cryoablation,
micro-wave ablation (MWA).
Compared to minimally invasive surgery for RCC,
percutaneous ablation is less invasive with fewer complications and faster convalescence [2].
Percutaneous ablation procedures may be repeated when not completely successful in single session or performed repeatedly in patients with syndromic renal cancers...
Findings and procedure details
After RFA of renal tumours,
follow up CT scan at our institution is performed at 1,4,7 and 11 months and then yearly for 5 years.
Appearances post RFA can be variable.
Disease surveillance must be undertaken using a dedicated CT renal mass protocol with unenhanced and contrast-enhanced CT scan as the bare minimum [6],
because abnormal enhancement is key indicator of residual or recurrent local disease.
After successful effective ablation,
tumor is seen as area of hyper-density (> 40 HU) [7] on unenhanced CT scan...
Conclusion
Image-guided percutaneous thermal ablation is a promising treatment option for renal tumors.
Better tumour detection has led to increase in patients undergoing radiological follow up for image guided percutaneous renal tumour ablation.
Radiologists need to be aware of post radiofrequency ablation (RFA) appearances in order to detect recurrent/residual renal tumour.
Personal information
Dr Muhammad Fahad Shahzad Shaukat
International Training Fellow Radiology
Heartlands Hospital
Birmingham,
UK
Dr Sadia Sultana
Radiology Registrar
Heartlands Hospital
Birmingham,
UK
Dr Madava Djearaman
Consultant Radiologist
Clinical Lead Thermal Ablation
HeartlandsHospital
Birmingham,
UK
Dr Shahid Hussain
ConsultantRadiologist
CT Clinical Lead Radiology Directorate
Simulation Lead Birmingham RadiologyScheme
Heartlands Hospital
Birmingham,
UK
References
1.American Cancer Society Website.
www.
cancer.org/Cancer/KidneyCancer/DetailedGuide/ kidney-cancer-adult-key-statistics.
Published 2011.
Accessed December 18,
2018
2.Hui GC,
Tuncali K,
Tatli S,
Morrison PR,
Silverman SG.
Comparison of percutaneous and surgical approaches to renal tumor ablation: meta-analysis of effectiveness and complication rates.
J Vasc Interv Radiol 2008; 19:1311–132
3.Kowalczyk KJ,
Choueiri TK,
Hevelone ND,
et al.
Comparative effectiveness,
costs and trends in treatment of small renal masses from 2005 to 2007.
BJU Int 2013; 112:E273–E280
4.Castle SM,
Gorbatiy V,
Avallone MA,
Eldefrawy A,
Caulton DE,
Leveillee RJ.
Cost...