Percutaneous radiofrequency ablation of renal tumors: Technique, limitations, and morbidity

Objectives. To evaluate our evolving experience with percutaneous radiofrequency (RF) renal tumor ablation and focus on our technique to ensure maximal treatment efficacy and reduce the possibility of complications. Methods. Fifteen patients with small (less than 4 cm) posterior or lateral contrast-enhancing (more than 10 Hounsfield units) renal tumors were candidates for RF treatment. Of these patients, 12 (13 tumors) received computed tomography-guided percutaneous RF ablation. General anesthesia was administered in all but our first 2 patients, who received intravenous sedation. After treatment, patients were closely followed up with computed tomography scans at 6 weeks and 3, 6, and 12 months, and every 6 months thereafter. Successful ablation was defined as a lesion along with a margin of normal parenchyma that no longer enhanced (less than 10 Hounsfield units) on follow-up contrast imaging. Results. The mean tumor size was 2.4 ± 0.6 cm. The average procedure time was 95 minutes (range 60 to 150) and length of stay 0.9 days. All patients underwent the procedure without any major complications. At a mean follow-up of 4.9 months, 12 (93%) of 13 tumors were successfully ablated. In 3 patients, the procedure was not performed because of intervening bowel or lung parenchyma when positioned in the prone position before the procedure. Conclusions. Computed tomography-guided percutaneous RF ablation of small renal tumors is a viable minimally invasive treatment option with a high short-term success rate and low morbidity. This new technology must be uniformly applied to assess its long-term efficacy.