Bookmarks
KEY FACTS
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Definitions
- Ablation: Percutaneous direct local tumor destruction
- Energy-based ablation
- Radiofrequency ablation (RFA): Heat based
- Initially most common modality used for renal ablation
- Microwave ablation (MWA): Heat-based cytotoxicity
- Offers faster ablation times; less susceptibility to thermal heat sink effect
- Cryoablation: Freezing/thawing cycle
- Frequently used modality for renal ablation
- Least risk of injury to renal collecting system
- High-intensity focused US: Coagulation necrosis caused by high-intensity US beam focused on small tissue volume
- Respiratory motion/overlying ribs problematic
- Irreversible electroporation: Electrical disruption of integrity of cell membrane
- Promising preliminary animal/human data, still investigational
- Radiofrequency ablation (RFA): Heat based
- Chemical ablation
- Inconsistent cellular necrosis in renal tumors
- Not routinely used for renal ablation
- Inconsistent cellular necrosis in renal tumors
- Energy-based ablation
- Embolization: Transcatheter introduction of intravascular agent for devascularization/occlusion
- Bland embolization: Transcatheter arterial embolization without chemotherapeutic agent
- Transcatheter ethanol injection: Denatures cellular proteins/causes small vessel thrombosis
- Thermal heat sink effect: Thermal energy needed to achieve cytotoxicity is dissipated
- Convective heat transfer to adjacent structures
- Blood flow in vessels abutting tumor prevents adequate heat generation for effective ablation
- Possible with all modalities, but least risk with MWA
- Convective heat transfer to adjacent structures
- Ablation: Percutaneous direct local tumor destruction
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Things to Avoid
Postprocedure Imaging (Ablation)
OUTCOMES
Complications
Expected Outcomes
Selected References
- Abdelsalam ME et al: Ablation of small renal masses. Tech Vasc Interv Radiol. 23(2):100674, 2020
- Mershon JP et al: Thermal ablation of the small renal mass: a critical analysis of current literature. Minerva Urol Nefrol. 72(2):123-34, 2020
- Zhong J et al: Renal ablation: current management strategies and controversies. Chin Clin Oncol. 8(6):63, 2019
- Sanchez A et al: Current management of small renal masses, including patient selection, renal tumor biopsy, active surveillance, and thermal ablation. J Clin Oncol. 36(36):3591-600, 2018
- Omodon M et al: Review of renal artery embolization for treatment of renal angiomyolipoma. Clin Nephrol Urol Sci. 3:1, 2016
- Potretzke AM et al: Re: Thompson RH et al. Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol 2015;67:252-9. Eur Urol. 67(2):e19-20, 2015
- Moreland AJ et al: High-powered microwave ablation of t1a renal cell carcinoma: safety and initial clinical evaluation. J Endourol. 28(9):1046-52, 2014
- Sahni VA et al: Imaging management of incidentally detected small renal masses. Semin Intervent Radiol. 31(1):9-19, 2014
- Gervais DA: Cryoablation versus radiofrequency ablation for renal tumor ablation: time to reassess? J Vasc Interv Radiol. 24(8):1135-8, 2013
- Chan CK et al: The efficacy, safety and durability of selective renal arterial embolization in treating symptomatic and asymptomatic renal angiomyolipoma. Urology. 77(3):642-8, 2011
- Hong K et al. Percutaneous Tumor Ablation, Strategies and Techniques. Thieme, 2011
- Breen DJ et al: Minimally invasive treatment of small renal tumors: trends in renal cancer diagnosis and management. Cardiovasc Intervent Radiol. 33(5):896-908, 2010
- Thumar AB et al: Thermal ablation of renal cell carcinoma: triage, treatment, and follow-up. J Vasc Interv Radiol. 21(8 Suppl):S233-41, 2010
- Arellano RS et al: Percutaneous CT-guided radiofrequency ablation of renal cell carcinoma: efficacy of organ displacement by injection of 5% dextrose in water into the retroperitoneum. AJR Am J Roentgenol. 193(6):1686-90, 2009
- Gervais DA et al: Percutaneous image-guided therapy of intra-abdominal malignancy: imaging evaluation of treatment response. Abdom Imaging. 34(5):593-609, 2009
- Uppot RN et al: Imaging-guided percutaneous ablation of renal cell carcinoma: a primer of how we do it. AJR Am J Roentgenol. 192(6):1558-70, 2009
- Cantwell CP et al: Protecting the ureter during radiofrequency ablation of renal cell cancer: a pilot study of retrograde pyeloperfusion with cooled dextrose 5% in water. J Vasc Interv Radiol. 19(7):1034-40, 2008
- Lokken RP et al: Inflammatory nodules mimic applicator track seeding after percutaneous ablation of renal tumors. AJR Am J Roentgenol. 189(4):845-8, 2007
- Gervais DA et al: 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. AJR Am J Roentgenol. 185(1):64-71, 2005
- Gervais DA et al: Radiofrequency ablation of renal cell carcinoma: part 2, lessons learned with ablation of 100 tumors. AJR Am J Roentgenol. 185(1):72-80, 2005
Related Anatomy
Loading...
Related Differential Diagnoses
Loading...
References
Tables
Tables
KEY FACTS
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Definitions
- Ablation: Percutaneous direct local tumor destruction
- Energy-based ablation
- Radiofrequency ablation (RFA): Heat based
- Initially most common modality used for renal ablation
- Microwave ablation (MWA): Heat-based cytotoxicity
- Offers faster ablation times; less susceptibility to thermal heat sink effect
- Cryoablation: Freezing/thawing cycle
- Frequently used modality for renal ablation
- Least risk of injury to renal collecting system
- High-intensity focused US: Coagulation necrosis caused by high-intensity US beam focused on small tissue volume
- Respiratory motion/overlying ribs problematic
- Irreversible electroporation: Electrical disruption of integrity of cell membrane
- Promising preliminary animal/human data, still investigational
- Radiofrequency ablation (RFA): Heat based
- Chemical ablation
- Inconsistent cellular necrosis in renal tumors
- Not routinely used for renal ablation
- Inconsistent cellular necrosis in renal tumors
- Energy-based ablation
- Embolization: Transcatheter introduction of intravascular agent for devascularization/occlusion
- Bland embolization: Transcatheter arterial embolization without chemotherapeutic agent
- Transcatheter ethanol injection: Denatures cellular proteins/causes small vessel thrombosis
- Thermal heat sink effect: Thermal energy needed to achieve cytotoxicity is dissipated
- Convective heat transfer to adjacent structures
- Blood flow in vessels abutting tumor prevents adequate heat generation for effective ablation
- Possible with all modalities, but least risk with MWA
- Convective heat transfer to adjacent structures
- Ablation: Percutaneous direct local tumor destruction
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Things to Avoid
Postprocedure Imaging (Ablation)
OUTCOMES
Complications
Expected Outcomes
Selected References
- Abdelsalam ME et al: Ablation of small renal masses. Tech Vasc Interv Radiol. 23(2):100674, 2020
- Mershon JP et al: Thermal ablation of the small renal mass: a critical analysis of current literature. Minerva Urol Nefrol. 72(2):123-34, 2020
- Zhong J et al: Renal ablation: current management strategies and controversies. Chin Clin Oncol. 8(6):63, 2019
- Sanchez A et al: Current management of small renal masses, including patient selection, renal tumor biopsy, active surveillance, and thermal ablation. J Clin Oncol. 36(36):3591-600, 2018
- Omodon M et al: Review of renal artery embolization for treatment of renal angiomyolipoma. Clin Nephrol Urol Sci. 3:1, 2016
- Potretzke AM et al: Re: Thompson RH et al. Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol 2015;67:252-9. Eur Urol. 67(2):e19-20, 2015
- Moreland AJ et al: High-powered microwave ablation of t1a renal cell carcinoma: safety and initial clinical evaluation. J Endourol. 28(9):1046-52, 2014
- Sahni VA et al: Imaging management of incidentally detected small renal masses. Semin Intervent Radiol. 31(1):9-19, 2014
- Gervais DA: Cryoablation versus radiofrequency ablation for renal tumor ablation: time to reassess? J Vasc Interv Radiol. 24(8):1135-8, 2013
- Chan CK et al: The efficacy, safety and durability of selective renal arterial embolization in treating symptomatic and asymptomatic renal angiomyolipoma. Urology. 77(3):642-8, 2011
- Hong K et al. Percutaneous Tumor Ablation, Strategies and Techniques. Thieme, 2011
- Breen DJ et al: Minimally invasive treatment of small renal tumors: trends in renal cancer diagnosis and management. Cardiovasc Intervent Radiol. 33(5):896-908, 2010
- Thumar AB et al: Thermal ablation of renal cell carcinoma: triage, treatment, and follow-up. J Vasc Interv Radiol. 21(8 Suppl):S233-41, 2010
- Arellano RS et al: Percutaneous CT-guided radiofrequency ablation of renal cell carcinoma: efficacy of organ displacement by injection of 5% dextrose in water into the retroperitoneum. AJR Am J Roentgenol. 193(6):1686-90, 2009
- Gervais DA et al: Percutaneous image-guided therapy of intra-abdominal malignancy: imaging evaluation of treatment response. Abdom Imaging. 34(5):593-609, 2009
- Uppot RN et al: Imaging-guided percutaneous ablation of renal cell carcinoma: a primer of how we do it. AJR Am J Roentgenol. 192(6):1558-70, 2009
- Cantwell CP et al: Protecting the ureter during radiofrequency ablation of renal cell cancer: a pilot study of retrograde pyeloperfusion with cooled dextrose 5% in water. J Vasc Interv Radiol. 19(7):1034-40, 2008
- Lokken RP et al: Inflammatory nodules mimic applicator track seeding after percutaneous ablation of renal tumors. AJR Am J Roentgenol. 189(4):845-8, 2007
- Gervais DA et al: 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. AJR Am J Roentgenol. 185(1):64-71, 2005
- Gervais DA et al: Radiofrequency ablation of renal cell carcinoma: part 2, lessons learned with ablation of 100 tumors. AJR Am J Roentgenol. 185(1):72-80, 2005
