Minimally Invasive Percutaneous Treatment of Small Renal Tumors with Irreversible Electroporation: A Single-Center Experience.

Autor:	Trimmer CK; Departments of Radiology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390. Electronic address: clayton.trimmer@utsouthwestern.edu., Khosla A; Departments of Radiology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390., Morgan M; Urology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390., Stephenson SL; Departments of Radiology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390., Ozayar A; Urology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390., Cadeddu JA; Urology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2015 Oct; Vol. 26 (10), pp. 1465-71. Date of Electronic Publication: 2015 Aug 04.
DOI:	10.1016/j.jvir.2015.06.028
Abstrakt:	Purpose: To evaluate whether irreversible electroporation (IRE) can be used as an ablation technique for small renal tumors (T1a cancers or small benign tumors) and to describe features after ablation on computed tomography (CT) or magnetic resonance (MR) imaging. Materials and Methods: In this retrospective study, 20 patients (mean age, 65 y ± 12.8 y) underwent CT-guided IRE of T1a renal carcinoma (n = 13) or small benign or indeterminate renal masses < 4 cm in size (n = 7). Mean tumor size was 2.2 cm ± 0.7. The ablation area was verified with contrast-enhanced imaging performed immediately after the procedure to determine technical success. Imaging was performed 6 weeks (20 of 20 patients), 6 months (15 of 20), and 12 months (6 of 20) after ablation. Medical records and CT/MR imaging features of all patients were reviewed for recurrence, symptoms, and complications after treatment. Results: Technical success was achieved in all patients (100%); there were no major procedure-related complications. Minor complications occurred in 7 patients, including self-limiting perinephric hematomas, pain difficult to control, and urinary retention. Mean procedure time was 2.0 hours ± 0.7. At 6 weeks, 2 patients required salvage therapy because of incomplete ablation. At 6 months, all 15 patients with imaging studies available had no evidence of recurrence. At 1 year, 1 patient (1 of 6) was noted to have experienced recurrence. CT/MR imaging after IRE ablation demonstrated an area of nonenhancement in the treatment zone that involuted over ~6 months. Conclusions: Renal IRE appears to be a safe treatment for small renal tumors. Tumors treated with IRE demonstrated nonenhancement in the treatment zone with involution on follow-up CT/MR imaging. (Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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