CT renal arteriography as a novel imaging guidance for the percutaneous ablation of small renal tumors

Abstract

Purpose

To report procedural data and outcomes of a novel image guidance technique, CT renal arteriography (CTRA), performed to target and ablate small intraparenchymal renal tumors.

Materials and methods

We retrospectively analyzed data of 2 patients undergoing CTRA-guided ablation for 3 renal intraparenchymal tumors, from February to March 2023. We previously evaluated tumor visibility with US/CEUS, and in all cases conspicuity was poor, whereas contrast-enhanced CT (CECT) clearly depicted all hypervascular nodules. Our primary endpoint was CTRA-guidance feasibility for renal ablation, defined as the precise probe deployment inside the target tumor. The secondary endpoint was CTRA-guided ablation technical success, intended as the inclusion of the whole tumor inside the necrotic volume, with 5 mm safety margins. RENAL scores, complications, procedural time, dose length product (DLP), serum creatinine variation and hospital stay length were also recorded.

Results

A confident deployment of the probe tip inside the nodule was accomplished in all 3 cases, with a 100% of correct targeting. We observed immediate technical success after all 3 ablations. The 3 nodules had a RENAL score <7 points, and we encountered no complications due to line placement or ablation. The average time from preablative to postablative CTRA was 54 min (50–58min), with a DLP of 3632mGy*cm (2807–4458mGy*cm). Serum creatinine didn’t show a significant variation after the procedures; both patients were hospitalized for 2 days.

Conclusion

Preliminary data showed that CTRA-guidance might provide unique advantages over conventional CECT-guidance to assist the ablation of small renal intraparenchymal tumor not visualized on US/CEUS.

Keywords:

• CT renal arteriography
• imaging guidance
• thermal ablation
• renal cell carcinoma
• kidney tumor

Acknowledgment

We did not receive any funds or other financial help for this publication. This study was not supported by any funding.

Ethical approval

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. Informed consent was obtained from all individual participants included in the study for anonymous data review and publication. Consent for publication was obtained for every individual person’s data included in the study.

Disclosure statement

One of the authors (RM) declares to be reviewer for International Journal of Hyperthermia. No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, RM, upon reasonable request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.