Ultrasound-Guided Percutaneous Thermal Ablation of Renal Cancers—In Search for the Ideal Tumour

Abstract

Over the recent years, the progress in imaging techniques has led to an increased detection of kidney tumours, including small renal masses. While surgery is still the standard of care, there is a growing interest in minimally invasive methods. Ultrasound (US)-guided percutaneous ablation is particularly attractive because it is a safe and relatively simple procedure. In this study, we investigated the success of percutaneous radiofrequency ablation (RFA) in relation to kidney tumour diameter and location. Between August 2016 and September 2021, 253 patients with 259 renal tumours underwent US-guided RFA as a primary treatment in our institution. A total of 67 patients were excluded from this study. Abdominal computed tomography (CT) and tumour biopsy were performed before the procedure. Patients were followed with contrast-enhanced CT, the average follow-up time was 28 months. The studied group was composed of 186 patients with 191 renal tumours—only biopsy-confirmed renal cancers were included. During the follow-up, 46 cases of residual disease and 4 cases of local progression were found. There was a significant correlation between tumour size and the ablation success rate. The success rate was 73.5% and 87.6% for lesions ≤25 mm, 94.6% for lesions ≤25 mm and exophytic, 79.1% for lesions 26–30 mm and 84.4% for lesions 26–30 mm and exophytic, respectively. Four Clavien-Dindo grade ≥2 complications were observed. US-guided percutaneous RFA of T1a renal cancers is safe and well-tolerated. Its effectiveness depends on tumour size, with best results for exophytic lesions smaller than 3 cm. Most of the recurrent or residual tumours can be successfully re-treated with US-guided percutaneous RFA.

Real-Time Contrast-Enhanced Ultrasound Combined with Ultrasound Monitoring Radiofrequency Ablation Versus Laparoscopic Partial Nephrectomy for cT1a Renal Cell Carcinoma: A Comparative Study with Mid-Term Follow-Up

“…Notably, the technical e ciency of US-induced RFA for T1a RCC treatment was only 75.4%, as reported by Jasinski et al 27 . In the RFA group, the high technical success and technique e cacy may be attributable to four reasons.…”

“…In 1997, Zlotta et al 26 rst used RFA to treat small RCC. The RFA is widely used as an alternative treatment for small RCC due to its advantages of minimal trauma, good e cacy, fast recovery, fewer complications, strong repeatability, low requirements for patient primary conditions, and the ability to be performed under local anesthesia 4,7,27 . However, multiple studies have reported that insu cient intraoperative ablation and the inability to evaluate the ablation effect in real-time by conventional US, CT, or MRI leads to tumor residue and local recurrence after RFA [28][29][30] .…”

“…Anterior renal tumors were once considered a relative contraindication for percutaneous ablation, as they pose a risk of damage to adjacent organs, including the small intestine, pancreas, and colon 34 . The di culty of puncture for upper polar tumors is greater and more likely to damage organs such as the pleura, spleen, and liver 27,35 . Additionally, RFA exhibits a higher likelihood of identifying and managing central RCC than LPN 28 .…”

Ultrasound image segmentation of renal tumors based on UNet++ with fusion of multiscale residuals and dual attention

“…Malignant renal tumors, also known as kidney cancer, have become one of the ten most common cancers in the world in recent years (Jasinski et al 2023). According to statistics, the incidence of kidney cancer has increased from 3% to more than 7% in the past decade.…”

Measurement of Thermal Conductivity and Thermal Diffusivity of Porcine and Bovine Kidney Tissues at Supraphysiological Temperatures up to 93 °C

“…Among the different thermo-electro-mechanical characteristics of tissues, tissue thermal properties underlie the mechanisms of heat transfer within biological media [ 5 ]. Hence, their accurate estimation is also favorable in view of the increased effectiveness and safety of thermal-energy-based therapies for the treatment of various diseases [ 6 , 7 , 8 , 9 , 10 ]. The thermal properties regulate the processes of conduction, storage, and release of thermal energy within the tissue [ 5 ].…”