CT-Guided Microwave Ablation of 45 Renal Tumors: Analysis of Procedure Complexity Utilizing a Percutaneous Renal Ablation Complexity Scoring System

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• 作者：Alberto V. Mansilla ; MD^a ; ^{alberto.mansilla.md@flhosp.org} ; Eugene E. Bivins Jr ; BS ; MS II^c ; Francisco Contreras ; MD^a ; Manuel A. Hernandez ; MD^a ; Nathan Kohler ; MD ; PhD^b ; Julie W. Pepe ; PhD^d
• 关键词：GFR ; glomerular filtration rate ; MW ; microwave ; P-RAC ; percutaneous renal ablation complexity ; RCC ; renal cell carcinoma
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：28
• 期：2
• 页码：222-229
• 全文大小：1010 K
• 卷排序：28

文摘

To develop a scoring system that stratifies complexity of percutaneous ablation of renal tumors.Materials and MethodsAnalysis was performed of 36 consecutive patients (mean age, 64 y; range, 30–89 y) who underwent CT-guided microwave (MW) ablation of 45 renal tumors (mean tumor diameter, 2.4 cm; range, 1.2–4.0 cm). Technical success and effectiveness were determined based on intraprocedural and follow-up imaging studies. The RENAL score and the proposed percutaneous renal ablation complexity (P-RAC) score were calculated for each tumor.ResultsTechnical success was 93.3% (n = 42). Biopsy of 38 of 45 renal tumors revealed 23 renal cell carcinomas. Median follow-up period was 9.7 months (range, 2.9–46.8 months). There were no tumor recurrences. One major complication, ureteropelvic junction stricture, occurred (2.6%). The P-RAC score was found to differ statistically from the RENAL score (t = 3.754, df = 44, P = .001). A positive correlation was found between the P-RAC score and number of antenna insertions (r = .378, n = 45, P = .011) and procedure duration (r = .328, n = 45, P = .028). No correlation was found between the RENAL score and number of MW antenna insertions (r = .110, n = 45, P = .472) or procedure duration (r = .263, n = 45, P = .081). Hydrodissection was significantly more common in the P-RAC high-complexity category than in low-complexity category (χ2 = 12.073, df = 2, P = .002).ConclusionsThe P-RAC score may be useful in stratifying percutaneous renal ablation complexity. Further studies with larger sample sizes are necessary to validate the P-RAC score and to determine if it can predict risk of complications.