MP100-05 LONG-TERM OUTCOME DATA FROM 47 TREATED RENAL MALIGNANCIES WITH MRI-GUIDED AND MONITORED LASER ABLATION: A SINGLE CENTER STUDY

Abstract

You have accessJournal of UrologyKidney Cancer: Ablative Therapy1 Apr 2017MP100-05 LONG-TERM OUTCOME DATA FROM 47 TREATED RENAL MALIGNANCIES WITH MRI-GUIDED AND MONITORED LASER ABLATION: A SINGLE CENTER STUDY Sherif Nour, Kareem Elfatairy, Debra Weber, Melinda Lewis, and Viraj Master Sherif NourSherif Nour More articles by this author , Kareem ElfatairyKareem Elfatairy More articles by this author , Debra WeberDebra Weber More articles by this author , Melinda LewisMelinda Lewis More articles by this author , and Viraj MasterViraj Master More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3112AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous ablation has become a viable treatment option for localized renal malignancy. MRI guidance has shown an added value for intraprocedural confirmation of complete ablation, potentially reducing the incidence of recurrence. The aim of this study is to report the long term local control data associated with in-bore MRI-guided laser ablation of renal malignancies. METHODS 34 patients (18M, 16F, age=29-88y) with 47 renal masses underwent biopsies followed by MRI-guided laser ablations. A laser fiber with 15mm diffusing tip encased in 5.5 F cooling catheter (Visualase, Texas, USA) was introduced into the target lesion. A test dose of diode laser energy (980nm, 30sec, 9W) was applied to verify location of ablation nidus. Subsequently, ablative energy dose was delivered (27W cycles of 90-240 sec) with treatment endpoint based realtime thermal monitoring of ablation. Fiber repositioning for additional ablation was conducted as needed. RESULTS Biopsies showed 1 renal metastasis from lung cancer and 46 RCCs (23 clear, 11 papillary, 2 chromophobe, 7 oncocytic, 1 poorly differentiated, 2 not specified). Tumor sizes were 0.7-4.5 cm (17 upper, 10 lower, 19 midpole). 11 patients (30%) had a single kidney, 6 patients (18%) had prior partial nephrectomy, and 2 lesions were recurrent after cryoablation. Access to desired part of kidney was feasible in all cases. The flexible nature of laser fibers eliminated the complexity of handling bulky ablation probes. Short ablation cycles facilitated accurate temperature mapping. 9 small-moderate self-limited perinephric hematomas and 1 delayed abscess occurred. Otherwise, no complications were encountered. Median follow-up was 24 months (max = 56 months). No residual or recurrent neoplasms were identified. CONCLUSIONS Interactively guided renal ablations performed within an interventional MRI suite are safe and well-tolerated. Data indicate reliable local tumor control with 0% recurrence rate over extended follow-up durations. Efficacy is likely related to improved visualization of tumor margins and temperature sensitivity of MRI allowing refined ablation procedures tailored to tumor response rather than following standard pre-determined ablation parameters. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1331 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Sherif Nour More articles by this author Kareem Elfatairy More articles by this author Debra Weber More articles by this author Melinda Lewis More articles by this author Viraj Master More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...