Radiofrequency ablation in kidney tumour management: A method of real-time monitoring

Abstract

Radiofrequency ablation (RFA) is an alternative to surgery in kidney tumour management. The aim was to describe a method of real-time temperature monitoring during ultrasound-guided RFA and establish the related efficacy and safety. Over a 6-year period 110 radiofrequency ablations in patients with kidney tumours and in most cases contraindications to surgery were performed. For the real-time temperature-monitored intervention 42 larger renal lesions exceeding 30 mm (range 31-59 mm) were selected. The monopolar Cool-tip RFA system was applied. The procedure involved the placement of up to three single radiofrequency probes within the tumour before starting the ablation session. Then, while ablating a tumour with one of the probes the remaining non-active electrode(s) served as real-time thermometer(s) to monitor simultaneously the temperature within the ablation zone. The average ablation time was between 10 and 15 min. The absence of contrast enhancement on computed tomography (CT) was considered to be a successful treatment. At a mean follow-up of 24 months (range 6-60 months), 38 tumours (90%) showed no contrast enhancement on CT. Four incompletely ablated tumours (10%) were successfully treated with the second ablation session. Two major and two minor complications occurred. At the time of writing, no local progression has been observed. RFA with the use of non-active probes as thermal probes to monitor the temperature within the tumour results in high efficacy and is associated with low complication rates.