Imaging-Guided Percutaneous Radiofrequency Ablation of Solid Renal Masses: Techniques and Outcomes of 38 Treatment Sessions in 32 Consecutive Patients

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Abstract
OBJECTIVE. The purpose of this study was to describe the treatment techniques and results of 38 consecutive imaging-guided percutaneous radiofrequency ablations of solid renal masses performed in 32 patients. MATERIALS AND METHODS. Solid renal masses in 32 patients underwent 38 treatment sessions using imaging-guided percutaneous radiofrequency ablation. During 36 sessions, radiofrequency ablation was performed using CT guidance, and two, using sonographic guidance. The average patient age was 76 years (range, 52–87 years), and the average renal mass size was 2.6 cm (range, 1–5 cm). The average number of radiofrequency treatments per solid mass at each session was 2.4 (range, 1–6 treatments), and the average time per treatment was 9.2 min (range, 3–14 min). A single electrode was used in 12 sessions, and a cluster electrode was used in 26 sessions. The average follow-up time was 9 months (range, 1–36 months). RESULTS. Twenty-six of 32 patients had successful treatment of the solid renal mass using percutaneous imaging-guided radiofrequency ablation after one treatment session. Successful treatment was defined as lack of enhancement of the treated region on follow-up CT. Six of 32 patients had residual enhancing tissue after the first treatment session and returned for a second session. Five of these six retreatments were successful. Masses requiring a second treatment session were significantly larger than masses treated in a single session (3.5 vs 2.4 cm, respectively; p = 0.0013). Two patients had perinephric hematomas (which did not require transfusion), and one patient developed a 5-mm skin metastasis at the electrode insertion site, which was resected without recurrence. CONCLUSION. Percutaneous imaging-guided radiofrequency ablation shows promise in the treatment of solid renal malignancies.