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Original Research |
1 All authors: Department of Radiology, University of Michigan Medical Center and University of Michigan Health Systems, 1500 E Medical Center Dr., SPC 5030, UH B1 D530C, Ann Arbor, MI 48109-5030.
OBJECTIVE. The objective of our study was to evaluate the evolution of the appearances of successfully ablated renal masses on CT and MRI.
MATERIALS AND METHODS. We conducted a retrospective review of 28 solid renal masses in 25 patients who underwent percutaneous radiofrequency ablation (RFA) between July 2003 and July 2006 in whom there was no evidence of residual tumor during at least 1 year of imaging follow-up and there was postablation biopsy proof of nonviable tissue within the ablation cavity. Three radiologists assessed the size, morphology, and CT or MRI characteristics of the initial tumor and of the ablated tumor or ablation cavity at imaging follow-up 1–2, 3–5, 6–11, and 12–24 months after RFA.
RESULTS. The mean initial tumor volume was 5.5 cm3
(range, 0.3–22.3 cm3). Within 1–2 months, the
postablation beds of small masses (
3 cm3) were larger than the
volume of the initial tumor. Large masses (> 3 cm3) did not show
this increase in volume. At 12 months after RFA, the postablation beds had
decreased in size but had not disappeared. On CT, the postablation beds did
not show enhancement at any time. On MRI, the postablation beds often showed a
thin rim of peripheral enhancement. Imaging follow-up often revealed local
stranding in the perinephric fat adjacent to the ablation site. Exophytic
tumors were more likely to separate from the renal parenchyma as they
contracted toward their epicenter and were more likely to reveal a complete
halo of soft-tissue attenuation in the adjacent perinephric fat, which became
more apparent on the longer-term follow-up imaging studies.
CONCLUSION. Successfully ablated tumors show predictable imaging features that can be used to guide interpretation of CT and MRI surveillance examinations.
Keywords: kidney disease MRI oncologic imaging radiofrequency ablation renal cell carcinoma renal masses
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