Kenkichi Michimoto1, Kanichiro Shimizu2, Yoshihiko Kameoka2, Shunichi Sadaoka2, Jun Miki3, Koichi Kishimoto3. 1. Department of Radiology, Kashiwa Hospital, The Jikei University Scholl of Medicine, 163-1, Kashiwa-shita, Kashiwa-shi, Chiba, 277-0004, Japan. michikoo@jikei.ac.jp. 2. Department of Radiology, Kashiwa Hospital, The Jikei University Scholl of Medicine, 163-1, Kashiwa-shita, Kashiwa-shi, Chiba, 277-0004, Japan. 3. Department of Urology, Kashiwa Hospital, The Jikei University School of Medicine, 163-1, Kashiwa-shita, Kashiwa-shi, Chiba, 277-0004, Japan.
Abstract
PURPOSE: To retrospectively evaluate the feasibility of transcatheter arterial embolization (TAE) using a mixture of absolute ethanol and iodized oil to improve localization of endophytic renal masses on unenhanced computed tomography (CT) prior to CT-guided percutaneous cryoablation (PCA). MATERIALS AND METHODS: Our institutional review board approved this retrospective study. From September 2011 to June 2015, 17 patients (mean age, 66.8 years) with stage T1a endophytic renal masses (mean diameter, 26.5 mm) underwent TAE using a mixture of absolute ethanol and iodized oil to improve visualization of small and endophytic renal masses on unenhanced CT prior to CT-guided PCA. TAE was considered successful that accumulated iodized oil depicted whole of the tumor edge on CT. PCA was considered successful when the iceball covered the entire tumor with over a 5 mm margin. Oncological and renal functional outcomes and complications were also evaluated. RESULTS: TAE was successfully performed in 16 of 17 endophytic tumors. The 16 tumors were performed under CT-guided PCA with their distinct visualization of localization and safe ablated margin. During the mean follow-up period of 15.4 ± 5.1 months, one patient developed local recurrence. Estimated glomerular filtration rate declined by 8 % with statistical significance (P = 0.01). There was no procedure-related significant complication. CONCLUSION: TAE using a mixture of absolute ethanol and iodized oil to improve visualization of endophytic renal masses facilitated tumor localization on unenhanced CT, permitting depiction of the tumor edge as well as a safe margin for ablation during CT-guided PCA, with an acceptable decline in renal function.
PURPOSE: To retrospectively evaluate the feasibility of transcatheter arterial embolization (TAE) using a mixture of absolute ethanol and iodized oil to improve localization of endophytic renal masses on unenhanced computed tomography (CT) prior to CT-guided percutaneous cryoablation (PCA). MATERIALS AND METHODS: Our institutional review board approved this retrospective study. From September 2011 to June 2015, 17 patients (mean age, 66.8 years) with stage T1a endophytic renal masses (mean diameter, 26.5 mm) underwent TAE using a mixture of absolute ethanol and iodized oil to improve visualization of small and endophytic renal masses on unenhanced CT prior to CT-guided PCA. TAE was considered successful that accumulated iodized oil depicted whole of the tumor edge on CT. PCA was considered successful when the iceball covered the entire tumor with over a 5 mm margin. Oncological and renal functional outcomes and complications were also evaluated. RESULTS:TAE was successfully performed in 16 of 17 endophytic tumors. The 16 tumors were performed under CT-guided PCA with their distinct visualization of localization and safe ablated margin. During the mean follow-up period of 15.4 ± 5.1 months, one patient developed local recurrence. Estimated glomerular filtration rate declined by 8 % with statistical significance (P = 0.01). There was no procedure-related significant complication. CONCLUSION:TAE using a mixture of absolute ethanol and iodized oil to improve visualization of endophytic renal masses facilitated tumor localization on unenhanced CT, permitting depiction of the tumor edge as well as a safe margin for ablation during CT-guided PCA, with an acceptable decline in renal function.
Authors: Andrew J Gunn; Benjamin J Mullenbach; May M Poundstone; Jennifer B Gordetsky; Edgar S Underwood; Soroush Rais-Bahrami Journal: Diagn Interv Radiol Date: 2018-11 Impact factor: 2.630