BACKGROUND AND PURPOSE: Renal cryoablation has gained popularity as a treatment option for localized renal masses. Treatment success is typically defined by the absence of contrast enhancement on follow-up imaging. We investigate the evolution of lesions that demonstrate contrast enhancement on CT after renal cryoablation. PATIENTS AND METHODS: Retrospective review of records of laparoscopic and percutaneous cryoablation (LCA and PCA) was performed, identifying records with postoperative radiographic enhancement. Imaging studies were reviewed and radiographic (pre- and post-contrast Hounsfield units, pattern and location of enhancement) and clinical data including follow up were collected. RESULTS: One hundred and seventy-two cryoablation procedures were analyzed. Of these, 30 (17.4%) showed enhancement on follow-up CT. In 28 cases, contrast enhancement was demonstrated on the first postoperative study. Seven patients underwent salvage treatments. Spontaneous resolution of enhancement was noted in 17 (56.7%) cases. No association was found between enhancement pattern (diffuse/nodular/rim) and resolution. Of lesions enhancing >35 HU, only 14.3% resolved spontaneously. Delayed enhancement (after negative imaging studies) occurred in two patients; both underwent salvage treatments. CONCLUSIONS: Most of the time, contrast-enhancements after cryoablation are evident on the first follow-up imaging study. More than 50% of these resolve spontaneously, and only one of four patients need salvage treatment. Delayed appearance of enhancement after previously negative imaging and highly enhancing lesions (>35 HU) are unlikely to resolve and should be considered suspicious for local recurrence or incomplete ablation. Further investigation is warranted to reach a consensus on a radiographic definition of local recurrence after renal cryoablation.
BACKGROUND AND PURPOSE: Renal cryoablation has gained popularity as a treatment option for localized renal masses. Treatment success is typically defined by the absence of contrast enhancement on follow-up imaging. We investigate the evolution of lesions that demonstrate contrast enhancement on CT after renal cryoablation. PATIENTS AND METHODS: Retrospective review of records of laparoscopic and percutaneous cryoablation (LCA and PCA) was performed, identifying records with postoperative radiographic enhancement. Imaging studies were reviewed and radiographic (pre- and post-contrast Hounsfield units, pattern and location of enhancement) and clinical data including follow up were collected. RESULTS: One hundred and seventy-two cryoablation procedures were analyzed. Of these, 30 (17.4%) showed enhancement on follow-up CT. In 28 cases, contrast enhancement was demonstrated on the first postoperative study. Seven patients underwent salvage treatments. Spontaneous resolution of enhancement was noted in 17 (56.7%) cases. No association was found between enhancement pattern (diffuse/nodular/rim) and resolution. Of lesions enhancing >35 HU, only 14.3% resolved spontaneously. Delayed enhancement (after negative imaging studies) occurred in two patients; both underwent salvage treatments. CONCLUSIONS: Most of the time, contrast-enhancements after cryoablation are evident on the first follow-up imaging study. More than 50% of these resolve spontaneously, and only one of four patients need salvage treatment. Delayed appearance of enhancement after previously negative imaging and highly enhancing lesions (>35 HU) are unlikely to resolve and should be considered suspicious for local recurrence or incomplete ablation. Further investigation is warranted to reach a consensus on a radiographic definition of local recurrence after renal cryoablation.
Authors: Tommy Kjærgaard Nielsen; Øyvind Østraat; Ole Graumann; Bodil Ginnerup Pedersen; Gratien Andersen; Søren Høyer; Michael Borre Journal: Technol Cancer Res Treat Date: 2016-07-11
Authors: Enrique Sanz; Vital Hevia; Fernando Arias; José Javier Fabuel; Sara Álvarez; Rafael Rodríguez-Patrón; Victoria Gómez; Víctor Díez-Nicolás; Cristina González-Gordaliza; Francisco Javier Burgos Journal: Curr Urol Rep Date: 2015-01 Impact factor: 3.092
Authors: Muneeb Ahmed; Luigi Solbiati; Christopher L Brace; David J Breen; Matthew R Callstrom; J William Charboneau; Min-Hua Chen; Byung Ihn Choi; Thierry de Baère; Gerald D Dodd; Damian E Dupuy; Debra A Gervais; David Gianfelice; Alice R Gillams; Fred T Lee; Edward Leen; Riccardo Lencioni; Peter J Littrup; Tito Livraghi; David S Lu; John P McGahan; Maria Franca Meloni; Boris Nikolic; Philippe L Pereira; Ping Liang; Hyunchul Rhim; Steven C Rose; Riad Salem; Constantinos T Sofocleous; Stephen B Solomon; Michael C Soulen; Masatoshi Tanaka; Thomas J Vogl; Bradford J Wood; S Nahum Goldberg Journal: Radiology Date: 2014-06-13 Impact factor: 11.105
Authors: Muneeb Ahmed; Luigi Solbiati; Christopher L Brace; David J Breen; Matthew R Callstrom; J William Charboneau; Min-Hua Chen; Byung Ihn Choi; Thierry de Baère; Gerald D Dodd; Damian E Dupuy; Debra A Gervais; David Gianfelice; Alice R Gillams; Fred T Lee; Edward Leen; Riccardo Lencioni; Peter J Littrup; Tito Livraghi; David S Lu; John P McGahan; Maria Franca Meloni; Boris Nikolic; Philippe L Pereira; Ping Liang; Hyunchul Rhim; Steven C Rose; Riad Salem; Constantinos T Sofocleous; Stephen B Solomon; Michael C Soulen; Masatoshi Tanaka; Thomas J Vogl; Bradford J Wood; S Nahum Goldberg Journal: J Vasc Interv Radiol Date: 2014-10-23 Impact factor: 3.464