HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gervais, D. A. Articles by Mueller, P. R. Search for Related Content PubMed PubMed Citation Articles by Gervais, D. A. Articles by Mueller, P. R. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Radiofrequency Ablation of Renal Cell Carcinoma: Part 2, Lessons Learned with 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 (171K): [in a new window]   Fig. 1 —70-year-old woman with exophytic renal mass and electrode placed at and parallel to tumor-kidney interface (arrow). Contrast-enhanced CT scan obtained with patient in prone position for radiofrequency ablation shows initial placement of needle electrode at and parallel to tumor-kidney interface.

View larger version (152K): [in a new window]   Fig. 2 —65-year-old man with exophytic renal mass and electrode placed perpendicular to tumor-kidney interface. Unenhanced CT scan obtained with patient in prone position for radiofrequency ablation shows renal mass (arrows) with initial electrode insertion perpendicular to tumor-kidney interface.

View larger version (181K): [in a new window]   Fig. 3A —77-year-old woman with renal mass adjacent to calyx. Contrast-enhanced CT scan obtained in excretory phase before radiofrequency ablation shows small renal cell carcinoma (arrow) adjacent to calyx and infundibulum.

View larger version (177K): [in a new window]   Fig. 3B —77-year-old woman with renal mass adjacent to calyx. Contrast-enhanced CT scan obtained in excretory phase after radiofrequency ablation shows no enhancement in renal mass or adjacent calyx and infundibulum.

View larger version (166K): [in a new window]   Fig. 4 —65-year-old man with asymptomatic leak of contrast material after radiofrequency ablation. Contrast-enhanced CT scan obtained in excretory phase shows nonenhancing renal mass and focal areas of leak of contrast material (arrows) outside collecting system without urinoma accumulation. Patient was asymptomatic, and appearance was stable 12 months after radiofrequency ablation.

View larger version (173K): [in a new window]   Fig. 5A —40-year-old woman with von Hippel-Lindau disease and multiple renal masses who underwent radiofrequency ablation and developed ureteral injury and urine leak requiring urinoma drainage and stenting of ureter. Contrast-enhanced CT scans show upper (A) and lower (B) pole enhancing masses (arrows). Both masses underwent radiofrequency ablation on same day.

View larger version (170K): [in a new window]   Fig. 5B —40-year-old woman with von Hippel-Lindau disease and multiple renal masses who underwent radiofrequency ablation and developed ureteral injury and urine leak requiring urinoma drainage and stenting of ureter. Contrast-enhanced CT scans show upper (A) and lower (B) pole enhancing masses (arrows). Both masses underwent radiofrequency ablation on same day.

View larger version (166K): [in a new window]   Fig. 5C —40-year-old woman with von Hippel-Lindau disease and multiple renal masses who underwent radiofrequency ablation and developed ureteral injury and urine leak requiring urinoma drainage and stenting of ureter. Contrast-enhanced CT scan obtained 1 month after radiofrequency ablation shows leak of contrast material at upper pole needle electrode puncture site (arrow) and accumulation of contrast material into urinoma.

View larger version (156K): [in a new window]   Fig. 5D —40-year-old woman with von Hippel-Lindau disease and multiple renal masses who underwent radiofrequency ablation and developed ureteral injury and urine leak requiring urinoma drainage and stenting of ureter. Contrast-enhanced CT scan obtained at more caudal level than C shows accumulation of urinoma (arrow).

View larger version (133K): [in a new window]   Fig. 5E —40-year-old woman with von Hippel-Lindau disease and multiple renal masses who underwent radiofrequency ablation and developed ureteral injury and urine leak requiring urinoma drainage and stenting of ureter. Spot fluoroscopic image with antegrade injection of contrast material shows leak of contrast material at site of proximal ureteral injury (arrow). This is not same site as upper pole calyceal leak shown in C, but spasm at site of ureteral injury contributed to persistent calyceal leak. Lower catheter was in place to drain urinoma.

View larger version (166K): [in a new window]   Fig. 5F —40-year-old woman with von Hippel-Lindau disease and multiple renal masses who underwent radiofrequency ablation and developed ureteral injury and urine leak requiring urinoma drainage and stenting of ureter. Final spot fluoroscopic image shows nephroureteral catheter (arrow) spanning ureteral injury. Ureteral injury subsequently healed, and restoration of ureteral drainage allowed calyceal leak causing urinoma to close.

View larger version (154K): [in a new window]   Fig. 6 —67-year-old man with renal cell carcinoma. Hydrodissection was used to displace colon, which was within 1 mm of tumor before displacement. Unenhanced CT scan shows needle (arrow) has been placed anterior to kidney and posterior to colon, and 100 mL of sterile water was injected.

View larger version (187K): [in a new window]   Fig. 7A —80-year-old man with renal cell carcinoma and residual crescent of enhancement after radiofrequency ablation. Contrast-enhanced CT scan obtained before radiofrequency ablation shows solid renal mass (arrow) before radiofrequency ablation.

View larger version (160K): [in a new window]   Fig. 7B —80-year-old man with renal cell carcinoma and residual crescent of enhancement after radiofrequency ablation. Contrast-enhanced CT scan obtained after radiofrequency ablation shows peripheral residual enhancement in shape of crescent (arrows).

View larger version (177K): [in a new window]   Fig. 8A —73-year-old woman with renal cell carcinoma and residual nodules of enhancement. Contrast-enhanced CT scan obtained before radiofrequency ablation shows enhancing renal mass (arrows).

View larger version (175K): [in a new window]   Fig. 8B —73-year-old woman with renal cell carcinoma and residual nodules of enhancement. Contrast-enhanced CT scan obtained after radiofrequency ablation shows peripheral nodules (arrows) of residual enhancement. These subsequently underwent complete necrosis after repeat ablation (not shown).

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati