Mircea Cristescu1, E Jason Abel2, Shane Wells3, Timothy J Ziemlewicz4, Sean P Hedican5, Megan G Lubner6, J Louis Hinshaw7, Christopher L Brace8,9,10, Fred T Lee11,12. 1. Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA. mcristescu@uwhealth.org. 2. Department of Urology, University of Wisconsin, Madison, WI, USA. abel@urology.wisc.edu. 3. Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA. swells@uwhealth.org. 4. Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA. tziemlewicz@uwhealth.org. 5. Department of Urology, University of Wisconsin, Madison, WI, USA. hedican@surgery.wisc.edu. 6. Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA. mlubner@uwhealth.org. 7. Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA. jhinshaw@uwhealth.org. 8. Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA. cbrace@uwhealth.org. 9. Department of Medical Physics, University of Wisconsin, Madison, WI, USA. cbrace@uwhealth.org. 10. Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA. cbrace@uwhealth.org. 11. Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA. flee@uwhealth.org. 12. Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA. flee@uwhealth.org.
Abstract
PURPOSE: To evaluate the safety and efficacy of US-guided percutaneous microwave (MW) ablation in the treatment of renal angiomyolipoma (AML). MATERIALS AND METHODS: From January 2011 to April 2014, seven patients (5 females and 2 males; mean age 51.4) with 11 renal AMLs (9 sporadic type and 2 tuberous sclerosis associated) with a mean size of 3.4 ± 0.7 cm (range 2.4-4.9 cm) were treated with high-powered, gas-cooled percutaneous MW ablation under US guidance. Tumoral diameter, volume, and CT/MR enhancement were measured on pre-treatment, immediate post-ablation, and delayed post-ablation imaging. Clinical symptoms and creatinine were assessed on follow-up visits. RESULTS: All ablations were technically successful and no major complications were encountered. Mean ablation parameters were ablation power of 65 W (range 60-70 W), using 456 mL of hydrodissection fluid per patient, over 4.7 min (range 3-8 min). Immediate post-ablation imaging demonstrated mean tumor diameter and volume decreases of 1.8% (3.4-3.3 cm) and 1.7% (27.5-26.3 cm(3)), respectively. Delayed imaging follow-up obtained at a mean interval of 23.1 months (median 17.6; range 9-47) demonstrated mean tumor diameter and volume decreases of 29% (3.4-2.4 cm) and 47% (27.5-12.1 cm(3)), respectively. Tumoral enhancement decreased on immediate post-procedure and delayed imaging by CT/MR parameters, indicating decreased tumor vascularity. No patients required additional intervention and no patients experienced spontaneous bleeding post-ablation. CONCLUSION: Our early experience with high-powered, gas-cooled percutaneous MW ablation demonstrates it to be a safe and effective modality to devascularize and decrease the size of renal AMLs.
PURPOSE: To evaluate the safety and efficacy of US-guided percutaneous microwave (MW) ablation in the treatment of renal angiomyolipoma (AML). MATERIALS AND METHODS: From January 2011 to April 2014, seven patients (5 females and 2 males; mean age 51.4) with 11 renal AMLs (9 sporadic type and 2 tuberous sclerosis associated) with a mean size of 3.4 ± 0.7 cm (range 2.4-4.9 cm) were treated with high-powered, gas-cooled percutaneous MW ablation under US guidance. Tumoral diameter, volume, and CT/MR enhancement were measured on pre-treatment, immediate post-ablation, and delayed post-ablation imaging. Clinical symptoms and creatinine were assessed on follow-up visits. RESULTS: All ablations were technically successful and no major complications were encountered. Mean ablation parameters were ablation power of 65 W (range 60-70 W), using 456 mL of hydrodissection fluid per patient, over 4.7 min (range 3-8 min). Immediate post-ablation imaging demonstrated mean tumor diameter and volume decreases of 1.8% (3.4-3.3 cm) and 1.7% (27.5-26.3 cm(3)), respectively. Delayed imaging follow-up obtained at a mean interval of 23.1 months (median 17.6; range 9-47) demonstrated mean tumor diameter and volume decreases of 29% (3.4-2.4 cm) and 47% (27.5-12.1 cm(3)), respectively. Tumoral enhancement decreased on immediate post-procedure and delayed imaging by CT/MR parameters, indicating decreased tumor vascularity. No patients required additional intervention and no patients experienced spontaneous bleeding post-ablation. CONCLUSION: Our early experience with high-powered, gas-cooled percutaneous MW ablation demonstrates it to be a safe and effective modality to devascularize and decrease the size of renal AMLs.
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