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Published online before print February 28, 2007, 10.1148/radiol.2431052133
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Percutaneous Cryoablation of 40 Solid Renal Tumors with US Guidance and CT Monitoring: Initial Experience1

Thomas D. Atwell, MD, Michael A. Farrell, MD, Matthew R. Callstrom, MD, J. William Charboneau, MD, Bradley C. Leibovich, MD, David E. Patterson, MD, George K. Chow, MD and Michael L. Blute, MD

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).


Figure 1A
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  		Figure 1a: Transverse CT scans used to monitor cryoablation after hydrodisplacement of the adjacent colon. The patient was a 74-year-old man with multiple comorbidities and an incidentally discovered 4.3-cm mass in the left kidney that enhanced with contrast material. (a) CT scan shows that the mass (arrows), which enhances with contrast material, extends into renal sinus fat. (b) Scan obtained immediately before cryoablation. Sterile water was injected through a 5-F catheter (arrow) to displace the descending colon (arrowhead). (c) Scan obtained in the early stages of cryoablation shows a hypoattenuating ice ball (arrows) extending from two cryoprobes. (d) Scan obtained in the later stages of cryoablation shows the enlarging ice ball (arrows) encompassing the renal mass.

 

Figure 1B
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  		Figure 1b: Transverse CT scans used to monitor cryoablation after hydrodisplacement of the adjacent colon. The patient was a 74-year-old man with multiple comorbidities and an incidentally discovered 4.3-cm mass in the left kidney that enhanced with contrast material. (a) CT scan shows that the mass (arrows), which enhances with contrast material, extends into renal sinus fat. (b) Scan obtained immediately before cryoablation. Sterile water was injected through a 5-F catheter (arrow) to displace the descending colon (arrowhead). (c) Scan obtained in the early stages of cryoablation shows a hypoattenuating ice ball (arrows) extending from two cryoprobes. (d) Scan obtained in the later stages of cryoablation shows the enlarging ice ball (arrows) encompassing the renal mass.

 

Figure 1C
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  		Figure 1c: Transverse CT scans used to monitor cryoablation after hydrodisplacement of the adjacent colon. The patient was a 74-year-old man with multiple comorbidities and an incidentally discovered 4.3-cm mass in the left kidney that enhanced with contrast material. (a) CT scan shows that the mass (arrows), which enhances with contrast material, extends into renal sinus fat. (b) Scan obtained immediately before cryoablation. Sterile water was injected through a 5-F catheter (arrow) to displace the descending colon (arrowhead). (c) Scan obtained in the early stages of cryoablation shows a hypoattenuating ice ball (arrows) extending from two cryoprobes. (d) Scan obtained in the later stages of cryoablation shows the enlarging ice ball (arrows) encompassing the renal mass.

 

Figure 1D
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  		Figure 1d: Transverse CT scans used to monitor cryoablation after hydrodisplacement of the adjacent colon. The patient was a 74-year-old man with multiple comorbidities and an incidentally discovered 4.3-cm mass in the left kidney that enhanced with contrast material. (a) CT scan shows that the mass (arrows), which enhances with contrast material, extends into renal sinus fat. (b) Scan obtained immediately before cryoablation. Sterile water was injected through a 5-F catheter (arrow) to displace the descending colon (arrowhead). (c) Scan obtained in the early stages of cryoablation shows a hypoattenuating ice ball (arrows) extending from two cryoprobes. (d) Scan obtained in the later stages of cryoablation shows the enlarging ice ball (arrows) encompassing the renal mass.

 

Figure 2A
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  		Figure 2a: Transverse CT scans of technically successful cryoablation of an anterior renal mass. The patient was an 83-year-old woman with an incidentally discovered 2.3-cm anterior mass in the left kidney. (a) Scan shows a mass that enhances with contrast material (arrow) abutting the renal pelvic fat. (b) Scan shows an ice ball (arrowheads) developing during cryoablation. (c) Arterial phase scan obtained 10 months after ablation shows retraction of the ablation defect and no recurrent tumor.

 

Figure 2B
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  		Figure 2b: Transverse CT scans of technically successful cryoablation of an anterior renal mass. The patient was an 83-year-old woman with an incidentally discovered 2.3-cm anterior mass in the left kidney. (a) Scan shows a mass that enhances with contrast material (arrow) abutting the renal pelvic fat. (b) Scan shows an ice ball (arrowheads) developing during cryoablation. (c) Arterial phase scan obtained 10 months after ablation shows retraction of the ablation defect and no recurrent tumor.

 

Figure 2C
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  		Figure 2c: Transverse CT scans of technically successful cryoablation of an anterior renal mass. The patient was an 83-year-old woman with an incidentally discovered 2.3-cm anterior mass in the left kidney. (a) Scan shows a mass that enhances with contrast material (arrow) abutting the renal pelvic fat. (b) Scan shows an ice ball (arrowheads) developing during cryoablation. (c) Arterial phase scan obtained 10 months after ablation shows retraction of the ablation defect and no recurrent tumor.

 




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