Abstract
The incidence of renal cell carcinoma is rising with the increased number of incidental detection of small tumours. During the past few years, percutaneous imaging-guided radiofrequency ablation has evolved as a minimally invasive treatment of small unresectable renal tumours offering reduced patient morbidity and overall health care costs. In radiofrequency ablation, thermal energy is deposited into a targeted tumour by means of a radiofrequency applicator. In recent studies, radiofrequency ablation was shown to be an effective and safe modality for local destruction of renal cell carcinoma. Radiofrequency applicator navigation can be performed via ultrasound, computed tomography or magnetic resonance guidance; however, ultrasound seems less favourable because of the absence of monitoring capabilities during ablation. On-line monitoring of treatment outcome can only be performed with magnetic resonance imaging giving the possibility of eventual applicator repositioning to ablate visible residual tumour tissue. Long-term follow-up is crucial to assess completeness of tumour ablation. New developments in ablation technology and radiological equipment will further increase the indication field for radiofrequency ablation of renal cell carcinoma. Altogether, radiofrequency ablation seems to be a promising new modality for the minimally invasive treatment of renal cell carcinoma, which was demonstrated to exhibit high short-term effectiveness.
Similar content being viewed by others
References
Godley P, Kim SW (2002) Renal cell carcinoma. Curr Opin Oncol 14:280–285
Konnak JW, Grossman HB (1985) Renal cell carcinoma as an incidental finding. J Urol 134:1094–1096
Chow WH, Devesa SS, Warren JL et al (1999) Rising incidence of renal cell cancer in the United States. JAMA 281:1628–1631
Herring JC, Enquist EG, Chernoff A, Linehan WM, Choyke PL, Walther MM (2001) Parenchymal sparing surgery in patients with hereditary renal cell carcinoma: 10–year experience. J Urol 165:777–781
Novick AC (2002) Nephron-sparing surgery for renal cell carcinoma. Annu Rev Med 53:393–407
Gervais DA, McGovern FJ, Arellano RS, McDougal WS, Mueller PR (2005) 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 185:64–71
Gervais DA, Arellano RS, Mueller PR (2005) Percutaneous radiofrequency ablation of renal cell carcinoma. Eur Radiol 15(5):960–967
Mahnken AH, Gunther RW, Tacke J (2004) Radiofrequency ablation of renal tumors. Eur Radiol 14(8):1449–1455
Mahnken AH, Rohde D, Brkovic D, Gunther RW, Tacke JA (2005) Percutaneous radiofrequency ablation of renal cell carcinoma: preliminary results. Acta Radiol 46(2):208–214
Farrell MA, Charboneau WJ, DiMarco DS, Chow GK, Zincke H, Callstrom MR, Lewis BD, Lee RA, Reading CC (2003) Imaging-guided radiofrequency ablation of solid renal tumors. AJR Am J Roentgenol 18:1509–1513
Mayo-Smith WW, Dupuy DE, Parikh PM, Pezzullo JA, Cronan JJ (2003) Imaging-guided percutaneous radiofrequency ablation of solid renal masses: techniques and outcomes of 38 treatment sessions in 32 consecutive patients. AJR Am J Roentgenol 180(6):1503–1508
Pavlovich CP, Walther MM, Choyke PL, Pautler SE, Chang R, Linehan WM, Wood BJ (2002) Percutaneous radio frequency ablation of small renal tumors: initial results. J Urol 167:10–15
Anderson JK, Matsumoto E, Cadeddu JA (2005) Renal radiofrequency ablation: technique and results. Urol Oncol 23:355–360
Silverman SG, Tuncali K, vanSonnenberg E, Morrison PR, Shankar S, Ramaiya N, Richie JP (2005) Renal tumors: MR imaging-guided percutaneous cryotherapy—initial experience in 23 patients. Radiology 236(2):716–724
HH Pennes (1948) Analysis of tissue and arterial blood temperatures in the resting human forearm. J Appl Physiol 1:93–122
Dewey WC (1994) Arrhenius relationships from the molecule and cell to the clinic. Int J Hyperthermia 10(4):457–483
Sapareto SA, Dewey WC (1984) Thermal dose determination in cancer therapy. Int J Radiat Oncol Biol Phys 10:787–800
Goldberg SN, Gazelle GS (2001) Radiofrequency tissue ablation: physical principles and techniques for increasing coagulation necrosis. Hepatogastroenterology 48:359–367
Mulier S, Miao Y, Mulier P, Dupas B, Pereira P, de Baere T, Lencioni R, Leveillee R, Marchal G, Michel L, Ni Y (2005) Electrodes and multiple electrode systems for radiofrequency ablation: a proposal for updated terminology. Eur Radiol 15:798–808
Pereira PL, Trubenbach J, Schenk M, Subke J, Kroeber S, Schaefer I, Remy CT, Schmidt D, Brieger J, Claussen CD (2004) Radiofrequency ablation: in vivo comparison of four commercially available devices in pig livers. Radiology 232:482–490
Frich L, Hol PK, Roy S, Mala T, Edwin B, Clausen OP, Gladhaug IP (2006) Experimental hepatic radiofrequency ablation using wet electrodes: electrode-to-vessel distance is a significant predictor for delayed portal vein thrombosis. Eur Radiol 16:1990–1999. 16 Mar DOI 10.1007/s00330-006-0177-6
Burdio F, Navarro A, Sousa R, Burdio JM, Guemes A, Gonzalez A, Cruz I, Castiella T, Lozano R, Berjano E, Figueras J, de Gregorio MA (2006) Evolving technology in bipolar perfused radiofrequency ablation: assessment of efficacy, predictability and safety in a pig liver model. Eur Radiol 16:1826–1824. 16 Mar DOI 10.1007/s00330-005-0131-z
Clasen S, Schmidt D, Boss A, Dietz K, Krober SM, Claussen CD, Pereira PL (2006) Multipolar radiofrequency ablation with internally cooled electrodes: experimental study in ex vivo bovine liver with mathematic modeling. Radiology 238(3):881–890
Miao Y, Ni Y, Bosmans H et al (2001) Radiofrequency ablation for eradication of renal tumor in a rabbit model by using a cooled-tip electrode technique. Ann Surg Oncol 8:651–657
Hsu TH, Fidler ME, Gill IS (2000) Radiofrequency ablation of the kidney: acute and chronic histology in porcine model. Urology 56:872–875
Crowley JD, Shelton J, Iverson AJ, Burton MP, Dalrymple NC, Bishoff JT (2001) Laparoscopic and computed tomography-guided percutaneous radiofrequency ablation of renal tissue: acute and chronic effects in an animal model. Urology 57:976–980
Lee JM, Kim SW, Chung GH, Lee SY, Han YM, Kim CS (2003) Open radio-frequency thermal ablation of renal VX2 tumors in a rabbit model using a cooled-tip electrode: feasibility, safety, and effectiveness. Eur Radiol 13:1324–1332
Aschoff AJ, Sulman A, Martinez M, Duerk JL, Resnick MI, MacLennan GT, Lewin JS (2001) Perfusion-modulated MR imaging-guided radiofrequency ablation of the kidney in a porcine model. AJR Am J Roentgenol 177:151–158
Eichel L, Kim IY, Uribe C, Khonsari S, Basillote J, Steward E, Coad J, Bischof J, Rudie E, Kluge S, McDougall EM, Clayman RV (2005) Third Prize: Comparison of radical nephrectomy, laparoscopic microwave thermotherapy, cryotherapy, and radiofrequency ablation for destruction of experimental VX-2 renal tumors in rabbits. J Endourol 19:1082–1087
Novick AC (2002) Nephron-sparing surgery for renal cell carcinoma. Annu Rev Med 53:393–407
Uzzo RG, Novick AC (2001) Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol 166:6–18
Sowery RD, Siemens DR (2004) Growth characteristics of renal cortical tumors in patients managed by watchful waiting. Can J Urol 11:2407–2410
Wehle MJ, Thiel DD, Petrou SP, Young PR, Frank I, Karsteadt N (2004) Conservative management of incidental contrast-enhancing renal masses as safe alternative to invasive therapy. Urology 64:49–52
Zagoria RJ, Hawkins AD, Clark PE, Hall MC, Matlaga BR, Dyer RB, Chen MY (2004) Percutaneous CT-guided radiofrequency ablation of renal neoplasms: factors influencing success. AJR Am J Roentgenol 183:201–207
Ryo E, Takeshita S, Shiba M, Ayabe T (2006) Radiofrequency ablation for cystic adenomyosis: a case report. J Reprod Med 51:427–430
Sahin M, Kartal A, Haykir R, Cakir M (2006) RF-assisted cystectomy and pericystectomy: a new technique in the treatment of liver hydatid disease. Eur Surg Res 38:90–93
Mickisch GH, Mattes RH (2005) Combination of surgery and immunotherapy in metastatic renal cell carcinoma. World J Urol 23:191–195
Lewin JS, Nour SG, Connell CF, Sulman A, Duerk JL, Resnick MI, Haaga JR (2004) Phase II clinical trial of interactive MR imaging-guided interstitial radiofrequency thermal ablation of primary kidney tumors: initial experience. Radiology 232:835–845
Boss A, Clasen S, Kuczyk M, Anastasiadis A, Schmidt D, Claussen CD, Schick F, Pereira PL (2005) Radiofrequency ablation of renal cell carcinomas using MR imaging: initial results. Rofo 177:1139–1145
Boss A, Clasen S, Kuczyk M, Anastasiadis A, Schmidt D, Graf H, Schick F, Claussen CD, Pereira PL (2005) Magnetic resonance-guided percutaneous radiofrequency ablation of renal cell carcinomas: a pilot clinical study. Invest Radiol 40(9):583–590
Beisland C, Medby PC, Sander S, Beisland HO (2000) Nephrectomy—indications, complications and postoperative mortality in 646 consecutive patients. Eur Urol 37:58–64
Butler BP, Novick AC, Miller DP, Campbell SA, Licht MR (1995) Management of small unilateral renal cell carcinomas: radical versus nephron-sparing surgery. Urology 45:34–40
Kam AW, Littrup PJ, Walther MM, Hvizda J, Wood BJ (2004) Thermal protection during percutaneous thermal ablation of renal cell carcinoma. J Vasc Interv Radiol 15:753–758
Farrell MA, Charboneau JW, Callstrom MR, Reading CC, Engen DE, Blute ML (2003) Paranephric water instillation: a technique to prevent bowel injury during percutaneous renal radiofrequency ablation. AJR Am J Roentgenol 181:1315–1317
Boss A, Clasen S, Kuczyk M, Anastasiadis A, Schmidt D, Claussen CD, Schick F, Pereira PL (2005) Thermal damage of the genitofemoral nerve due to radiofrequency ablation of renal cell carcinoma: a potentially avoidable complication. AJR Am J Roentgenol 185:1627–1631
Morcos SK, Thomsen HS, Webb JA (1999) Contrast-media-induced nephrotoxicity: a consensus report. Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR). Eur Radiol 9:1602–1613
Merkle EM, Nour SG, Lewin JS (2005) MR imaging follow-up after percutaneous radiofrequency ablation of renal cell carcinoma: findings in 18 patients during first 6 months. Radiology 235:1065–1071
Boss A, Martirosian P, Schraml C, Clasen S, Fenchel M, Anastasiadis A, Claussen CD, Pereira PL, Schick F (2006) Morphological, contrast-enhanced and spin labeling perfusion imaging for monitoring of relapse after RF ablation of renal cell carcinomas. Eur Radiol 16:1-11. DOI 10.1007/s00330-005-0098-9
Thomsen HS (2004) Gadolinium-based contrast media may be nephrotoxic even at approved doses. Eur Radiol 14:1654–1656
Zlotta AR, Wildschutz T, Wood BJ et al (1997) Radiofrequency interstitial tumor ablation (RITA) is a possible new modality for treatment of renal cancer: ex vivo and in vivo experience. J Endourol 11:251–258
McGovern FJ, Wood BJ, Goldberg SN et al (1999) Radiofrequency ablation of renal cell carcinoma via image guided needle electrodes. J Urol 161:599–600
Hall WH, McGahan JP, Link DP, deVere White RW (2000) Combined embolization and percutaneous radiofrequency ablation of a solid renal tumor. AJR Am J Roentgenol 174:1592–1594
Ogan K, Jacomides L, Dolmatch BL et al (2002) Percutaneous radiofrequency ablation of renal tumors: technique, limitations, and morbidity. Urology 60:954–958
Sabharwal R, Vladica P (2006) Renal tumors: technical success and early clinical experience with radiofrequency ablation of 18 tumors. Cardiovasc Intervent Radiol 29:202–209
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Boss, A., Clasen, S., Kuczyk, M. et al. Image-guided radiofrequency ablation of renal cell carcinoma. Eur Radiol 17, 725–733 (2007). https://doi.org/10.1007/s00330-006-0415-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-006-0415-y