CT and MR imaging after imaging-guided thermal ablation of renal neoplasms

Geoffrey E. Wile, John R. Leyendecker, Kyle A. Krehbiel, Raymond B. Dyer, Ronald J. Zagoria

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

In recent years, thermal tumor ablation techniques such as percutaneous radiofrequency (RF) ablation and cryoablation have assumed an important role in the management of renal tumors, particularly in patients who may be suboptimal candidates for more invasive surgical techniques. Postablation computed tomography (CT) and magnetic resonance (MR) imaging play an important part in evaluation of the ablation zone, surveillance for residual or recurrent tumor, and identification of procedure-related complications. The appearance of the ablation zone may vary depending on the ablation technique used, initial tumor size, and tumor location and composition. Most ablated tumors demonstrate a gradual decrease in size over time once the acute changes have resolved, although tumor involution is more evident after cryoablation than after RF ablation. Exophytic tumor ablation zones typically have a "bull's-eye" appearance on CT scans and MR images obtained after RF ablation, with a visible mass often persisting in the absence of viable tumor. Residual or recurrent tumor often manifests as a focus of nodular or crescentic enhancement on postablation contrast material-enhanced CT scans and MR images, although a thin peripheral rim of enhancement often persists for several months following cryoablation. Complications following renal tumor ablation are usually minor but may include hemorrhage, ureteral stricture, urine leak, colonic perforation and colonephric fistula, and pneumothorax. As more patients undergo renal ablation procedures, it will become increasingly important that radiologists be able to recognize typical postablation CT and MR imaging findings to prevent confusing them with other pathologic processes.

Original languageEnglish (US)
Pages (from-to)325-339
Number of pages15
JournalRadiographics
Volume27
Issue number2
DOIs
StatePublished - Mar 1 2007

Fingerprint

Kidney Neoplasms
Hot Temperature
Tomography
Magnetic Resonance Imaging
Neoplasms
Cryosurgery
Ablation Techniques
Kidney
Magnetic Resonance Spectroscopy
Pneumothorax
Pathologic Processes
Contrast Media
Fistula
Pathologic Constriction
Urine
Hemorrhage

ASJC Scopus subject areas

  • Medicine(all)
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

CT and MR imaging after imaging-guided thermal ablation of renal neoplasms. / Wile, Geoffrey E.; Leyendecker, John R.; Krehbiel, Kyle A.; Dyer, Raymond B.; Zagoria, Ronald J.

In: Radiographics, Vol. 27, No. 2, 01.03.2007, p. 325-339.

Research output: Contribution to journalArticle

Wile, Geoffrey E. ; Leyendecker, John R. ; Krehbiel, Kyle A. ; Dyer, Raymond B. ; Zagoria, Ronald J. / CT and MR imaging after imaging-guided thermal ablation of renal neoplasms. In: Radiographics. 2007 ; Vol. 27, No. 2. pp. 325-339.
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