Contrast-Enhanced Ultrasound-Guided Radiofrequency Ablation of Renal Tumors

Abstract

Although only limited long-term studies evaluating thermal ablation of renal masses have been performed, it appears that thermal ablation has a comparable 5-year success rate to that of partial or total nephrectomy. This technique is often used in patients who are not good candidates for partial or total nephrectomy. Contrast-enhanced ultrasound (CEUS) has been recently approved by the Food and Drug Administration for characterization of focal liver lesions in adults and pediatric patients. CEUS can be used off label for renal applications and has been used for years in Europe and Asia. It has several advantages over contrast-enhanced computed tomography for use as the technique to guide and evaluate efficacy of thermal ablation of renal masses. These include the ability to visualize small amounts of enhancement, repeat dosing to evaluate efficacy of an ablation during a procedure, thin slice thickness, and real-time visualization. Ultrasound contrast is also non-nephrotoxic and non-hepatotoxic, allowing evaluation of patients with renal insufficiency. This article reviews the use of CEUS for the guidance and follow-up of thermal ablative procedures of renal masses.Keywords: contrast-enhanced ultrasound; radiofrequency ablation; renal tumor ablation; small renal masses; ultrasound contrast agents

On the Destruction of Cancer Cells Using Laser-Induced Shock-Waves: A Review on Experiments and Multiscale Computer Simulations

“…9 However, open surgery is always associated with a high risk for the patient, suppression of a patient's immune system and a significant mortality rate. Minimally invasive techniques as an alternative to open surgery, which became available during the 1990's for localized tumor treatment, such as radiofrequency ablation, 10 cryoablation, 11 direct laser ablation, 12 or high-intensity focused ultrasound (HIFU), are methods which use a range of energies for direct in situ tumor destruction through energy absorption and killing by heating or evaporation. Besides direct conversion of mechanical energy into heat, biological material may be damaged by the effects of mechanical stress caused by shock waves.…”

Contrast‐Enhanced Sonographic Features Before and After Interventional Treatment of Ovarian Endometrial Cysts

“…18 Currently, the most frequently used clinical contrast agent is SonoVue, which has already been registered and listed as a pharmaceutical agent in China. 25,26 Contrast-enhanced sonography is generally used clinically to identify and diagnose liver tumors, but recently, its use in studies of kidney, pancreatic, splenic, prostate, breast, and thyroid diseases, as well as abdominal trauma and other conditions, has been gradually increasing. [25][26][27][28] Gynecologic applications and studies have mainly focused on solid tumors in the uterus and ovary, [28][29][30][31] and to our knowledge, an evaluation of the contrast-enhanced sonographic features of ovarian endometrial cysts had not yet been reported.…”

Contrast‐Enhanced Ultrasound Guidance for Interventional Procedures

“…Compared to a standard B‐mode US‐guided procedure, CEUS‐guided ablation therapy of small renal lesions has also shown improved success rates . Compared to CT/MRI, CEUS has high sensitivity, specificity, and accuracy in the detection of postablation residual tumors before the removal of the ablation probe, as mentioned in liver ablation (Figure ) …”