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Percutaneous Cryoablation of 40 Solid Renal Tumors with US Guidance and CT Monitoring: Initial Experience¹

¹ From the Departments of Radiology (T.D.A., M.A.F., M.R.C., J.W.C.) and Urology (B.C.L., D.E.P., G.K.C., M.L.B.), Mayo Clinic, 200 First St SW, Rochester, MN 55905. Received December 28, 2005; revision requested February 22, 2006; revision received April 5; accepted May 10; final version accepted July 21. Address correspondence to T.D.A. (e-mail: atwell.thomas{at}mayo.edu).

Purpose: To retrospectively determine the safety and effectiveness of percutaneous cryoablation, monitored with computed tomography (CT), for the treatment of solid renal masses.

Materials and Methods: This study was compliant with the Health Insurance Portability and Accountability Act and had institutional review board approval; informed consent was waived. From March 12, 2003, through August 4, 2005, 23 men and 17 women (mean age, 76 years ± 9.7 [standard deviation]; range, 53–92 years), each with a single renal tumor, underwent one percutaneous cryoablation treatment session that combined ultrasonographic (US) guidance and CT monitoring. Technical success was defined as extension of the visible ice ball 5 mm beyond the tumor margin. Local tumor progression was defined as any tumor with intralesional enhancement or a serial increase in tumor size when compared with that on images obtained immediately after ablation. Tumor characteristics, complications, and follow-up were evaluated.

Results: The maximum diameter of the 40 treated lesions ranged from 1.5 to 7.2 cm (mean, 3.4 cm ± 1.3). Twenty (50%) of 40 tumors were 3 cm or larger in diameter. Nineteen tumors (48%) extended into the renal sinus fat. One complication (2%) conformed to a grade 3 event, as determined with the Common Terminology Criteria for Adverse Events (version 3.0) of the National Cancer Institute; the overall complication rate was 8%. Thirty-eight (95%) of 40 cryoablation procedures were technically successful. Twenty-nine patients underwent follow-up (mean, 8.0 months ± 4.3; range, 1.2–18.4 months); no local tumor recurrence was found.

Conclusion: Percutaneous cryoablation with US guidance and CT monitoring is safe and effective for the treatment of solid renal tumors. Longer follow-up should provide further proof of the effectiveness of this technique.

© RSNA, 2007