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Imaging-Guided Radiofrequency Ablation of Solid Renal Tumors

M. A. Farrell1, W. J. Charboneau1, D. S. DiMarco2, G. K. Chow2, H. Zincke2, M. R. Callstrom1, B. D. Lewis1, R. A. Lee1 and C. C. Reading1

1 Department of Radiology, Mayo Clinic, 200 First St., Rochester, MN 55902.
2 Department of Urology, Mayo Clinic, Rochester, MN 55902.



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  		Fig. 1A. —51-year-old man with renal transplant in left lower quadrant. Transverse sonogram of transplant shows 2.4 cm hypoechoic exophytic mass (straight arrows) arising from medial aspect of kidney. Sonographically guided needle biopsy (not shown) confirmed renal cell carcinoma. Tumor was treated with radiofrequency ablation. Bladder (curved arrow) was decompressed with transurethral catheter before ablation.

 


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  		Fig. 1B. —51-year-old man with renal transplant in left lower quadrant. Fat-saturated unenhanced (B) and contrast-enhanced (C) axial T1-weighted gradient-echo MR images obtained 14 months after ablation show no enhancement in tumor (arrows).

 


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  		Fig. 1C. —51-year-old man with renal transplant in left lower quadrant. Fat-saturated unenhanced (B) and contrast-enhanced (C) axial T1-weighted gradient-echo MR images obtained 14 months after ablation show no enhancement in tumor (arrows).

 


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  		Fig. 2A. —66-year-old man with history of right partial nephrectomy for renal cell carcinoma. Axial gadolinium-enhanced MR image shows 2.2-cm enhancing mass in upper pole of left kidney (arrows). This mass was treated with sonographically guided percutaneous radiofrequency ablation.

 


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  		Fig. 2B. —66-year-old man with history of right partial nephrectomy for renal cell carcinoma. Axial contrast-enhanced CT scan obtained 17 months after radiofrequency ablation shows focal encapsulated nonenhancing mass (arrow) at site of previous tumor.

 


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  		Fig. 3A. —72-year-old woman with history of left radical nephrectomy and right partial nephrectomy for renal cell carcinoma. Contrast-enhanced CT scan obtained with patient in decubitus position shows 1.2-cm solid mass (arrow) in medial aspect of right kidney.

 


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  		Fig. 3B. —72-year-old woman with history of left radical nephrectomy and right partial nephrectomy for renal cell carcinoma. CT scan shows CT-guided translumbar approach used to perform radiofrequency ablation of mass with patient under general anesthesia. Note electrode traversing psoas muscle and exposed tine overlaying anterior border of psoas muscle (arrow). After procedure, patient complained of groin pain and paresthesia in distribution of femoral branch of genitofemoral nerve.

 

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