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Radiofrequency Ablation of Renal Cell Carcinoma: Part 1, Indications, Results, and Role in Patient Management over a 6-Year Period and Ablation of 100 Tumors

¹ Department of Radiology, Massachusetts General Hospital, 55 Fruit St., White 270, Boston, MA 02114.
² Department of Urology, Massachusetts General Hospital, Boston, MA 02114.

View larger version (188K): [in a new window]   Fig. 1A —73-year-old man with small 1.5-cm biopsy-proven renal cell carcinoma. CT images obtained without (A) and with (B) IV contrast material show enhancing renal mass (arrow) before radiofrequency ablation.

View larger version (196K): [in a new window]   Fig. 1B —73-year-old man with small 1.5-cm biopsy-proven renal cell carcinoma. CT images obtained without (A) and with (B) IV contrast material show enhancing renal mass (arrow) before radiofrequency ablation.

View larger version (160K): [in a new window]   Fig. 1C —73-year-old man with small 1.5-cm biopsy-proven renal cell carcinoma. CT image obtained with patient in prone position at radiofrequency ablation shows straight needle electrode (arrow) in tumor.

View larger version (173K): [in a new window]   Fig. 1D —73-year-old man with small 1.5-cm biopsy-proven renal cell carcinoma. CT images obtained without (D) and with (E) IV contrast material show mass (arrow) is no longer enhancing after radiofrequency ablation.

View larger version (189K): [in a new window]   Fig. 1E —73-year-old man with small 1.5-cm biopsy-proven renal cell carcinoma. CT images obtained without (D) and with (E) IV contrast material show mass (arrow) is no longer enhancing after radiofrequency ablation.

View larger version (175K): [in a new window]   Fig. 2A —67-year-old man with large 4.4-cm renal cell carcinoma. CT image obtained with IV contrast material before radiofrequency ablation shows large enhancing renal mass (arrow).

View larger version (176K): [in a new window]   Fig. 2B —67-year-old man with large 4.4-cm renal cell carcinoma. CT image obtained with IV contrast material after radiofrequency ablation shows mass (arrow) is no longer enhancing.

View larger version (158K): [in a new window]   Fig. 3A —67-year-old woman with 4.6-cm renal cell carcinoma and residual viable tumor after radiofrequency ablation. CT image obtained with IV contrast material before radiofrequency ablation shows enhancing renal mass (arrow).

View larger version (161K): [in a new window]   Fig. 3B —67-year-old woman with 4.6-cm renal cell carcinoma and residual viable tumor after radiofrequency ablation. CT image obtained with IV contrast material after first radiofrequency ablation session shows no residual enhancement in mass. Dense areas (arrow) are high in native density but not enhancing.

View larger version (144K): [in a new window]   Fig. 3C —67-year-old woman with 4.6-cm renal cell carcinoma and residual viable tumor after radiofrequency ablation. CT images obtained at more caudal level than than A and B after first radiofrequency ablation session without (C) and with (D) IV contrast material show areas of peripheral residual enhancement (arrows) signifying viable tumor.

View larger version (158K): [in a new window]   Fig. 3D —67-year-old woman with 4.6-cm renal cell carcinoma and residual viable tumor after radiofrequency ablation. CT images obtained at more caudal level than than A and B after first radiofrequency ablation session without (C) and with (D) IV contrast material show areas of peripheral residual enhancement (arrows) signifying viable tumor.

View larger version (190K): [in a new window]   Fig. 3E —67-year-old woman with 4.6-cm renal cell carcinoma and residual viable tumor after radiofrequency ablation. CT image obtained with patient in prone position at radiofrequency ablation shows needle electrode (arrow) targeting areas where residual enhancement was shown on prior CT.

View larger version (132K): [in a new window]   Fig. 3F —67-year-old woman with 4.6-cm renal cell carcinoma and residual viable tumor after radiofrequency ablation. CT images obtained without (F) and with (G) IV contrast material after second radiofrequency ablation session show no residual enhancement in caudal aspect of tumor.

View larger version (147K): [in a new window]   Fig. 3G —67-year-old woman with 4.6-cm renal cell carcinoma and residual viable tumor after radiofrequency ablation. CT images obtained without (F) and with (G) IV contrast material after second radiofrequency ablation session show no residual enhancement in caudal aspect of tumor.

View larger version (8K): [in a new window]   Fig. 4 —Graph of receiver operating characteristic curve fitted from results of radiofrequency ablation of 100 tumors shows renal tumor size is predictor of complete necrosis after radiofrequency ablation.

View larger version (10K): [in a new window]   Fig. 5 —Bar graph shows surviving patients and follow-up periods after radiofrequency ablation.

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