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Imaging following renal ablation: what can we learn from recurrent tumors?

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Abstract

Purpose

The purpose of the study was to evaluate the post-contrast appearance of local tumor progression (LTP) following renal ablation to better understand patterns of tumor recurrence and to optimize follow-up imaging protocols.

Methods

From 2002 to 2015, 913 patients underwent 988 renal ablation procedures for treatment of 1064 tumors. LTP was identified in 24 (2.6%) patients during median imaging follow-up of 30 months (range 0–139). One patient with LTP was followed with non-contrast MRI only and was excluded from evaluation. Three body radiologists reviewed the contrast-enhanced CT and/or MRI follow-up imaging in the remaining 23 patients to determine the timing and imaging appearance of the recurrent tumor.

Results

Local tumor progression was identified on contrast-enhanced CT or MRI at median 11 months (range 1 and 68) after renal ablation. Corticomedullary phase imaging was performed in 16/23 (70%) patients. LTP was identified on the corticomedullary phase in all cases, and was most conspicuous on the corticomedullary phase compared to any other phase of imaging in 15/16 (94%) patients. No cases of LTP were best visualized on non-contrast or excretory phase images.

Conclusions

Delayed recurrence following renal ablation is possible; therefore, extended follow-up is indicated in ablation patients. Almost all cases of LTP were best visualized on the corticomedullary phase of imaging, which should be included in any post-ablation imaging protocol. Excretory phase images were not required to diagnose LTP in any case and could be excluded from routine post-ablation follow-up.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA

    Patrick W. Eiken, Thomas D. Atwell, A. Nicholas Kurup & Grant D. Schmit

  2. Department of Urology, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA

    Stephen A. Boorjian & R. Houston Thompson

Authors
  1. Patrick W. Eiken
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  2. Thomas D. Atwell
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  3. A. Nicholas Kurup
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  4. Stephen A. Boorjian
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  5. R. Houston Thompson
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  6. Grant D. Schmit
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Corresponding author

Correspondence to Patrick W. Eiken.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Funding

This study received no extramural funding.

Ethical approval

This study was approved by our institutional review board and was compliant with the Health Insurance Portability and Accountability act. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Eiken, P.W., Atwell, T.D., Kurup, A.N. et al. Imaging following renal ablation: what can we learn from recurrent tumors?. Abdom Radiol 43, 2750–2755 (2018). https://doi.org/10.1007/s00261-018-1541-0

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  • DOI: https://doi.org/10.1007/s00261-018-1541-0

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