Evaluation of feasibility and safety of percutaneous radiofrequency ablation using bipolar radiofrequency devices in a prospective multicenter cohort of patients with benign aldosterone-producing adenoma. A total of five institutions participated. CT-guided percutaneous RFA was performed for patients diagnosed as APA. The safety of the procedure was evaluated using the Common Terminology Criteria for Adverse Events. During the 84-day follow-up period, serial changes in plasma aldosterone concentration and plasma renin activity were measured. The percentage of patients with normalized hormonal activity after the procedure, was calculated with 95% confidence intervals. Forty patients were enrolled, and two patients were excluded for cerebral hemorrhage and no safe puncture root. In another patients, RFA was tried, but an intraprocedural intercostal arterial injury occurred. Consequently, RFA was completed in thirty-seven patients (20 men, 17 women; mean age, 50.4 ± 10.0 year). The tumor size was 14.8 ± 3.8 mm. The treatment success rate of the ablation was 94.6% (35/37), and a 2nd session was performed in 2.7% (1/37) patients. Grade 4 adverse events were observed in 4 out of 38 sessions (10.5%). The normalization of plasma aldosterone concentration or aldosterone-renin ratio was 86.5% (72.0–94.1: 95% confidence interval) on day 84. Percutaneous CT-guided RFA for APA using a bipolar radiofrequency system was safe and feasible with clinical success rate of 86.5% on day 84.

HighlightsWe tried to establish the epigenetics of malignant transformation in PCC/PGLs.Benign and malignant PCC/PGLs were examined using whole genomic methylation analysis.Selected candidate CpGs were narrowed down by analysis of individual genomic regions.Two were left as the final candidates, related to ACSBG1 and MAST1 respectively.Epigenetics in these genes might be involved in malignant transformation of PCC/PGLs.

Purpose: Evaluation of feasibility and safety of percutaneous radiofrequency ablation (RFA) using bipolar radiofrequency (RF) devices in a prospective multicenter cohort of patients with benign aldosterone-producing adenoma (APA).Methods: A total of five institutions participated. CT-guided percutaneous RFA was performed for patients diagnosed as APA. The safety of the procedure was evaluated using the Common Terminology Criteria for Adverse Events. During the 84-day follow-up period, serial changes in plasma aldosterone concentration and plasma renin activity were measured. The percentage of patients with normalized hormonal activity after the procedure, was calculated with 95% confidence intervals.Results: Thirty-eight patients (20 men, 18 women; mean age, 50.4 ± 10.0 year) were enrolled, and one patient was excluded for intraprocedural intercostal arterial injury. The tumor size was 14.8 ± 3.8 mm. The technical success rate of the RFA procedure was 94.6% (35/37), and a 2nd session was performed in 2.7% (1/37) patients. Grade 4 adverse events were observed in 4 out of 38 sessions (10.5%). The normalization of plasma aldosterone concentration or aldosterone-renin ratio was 86.5% （72.0–94.1: 95% confidence interval） on day 84.Conclusions: Percutaneous CT-guided RFA for APA using a bipolar RF system was safe and feasible.