C-arm CT-guided renal arterial embolisation followed by radiofrequency ablation for treatment of patients with unresectable renal cell carcinoma

• Published in: Clinical radiology Vol. 71; no. 1; pp. 79 - 85
• Main Authors: Duan, X.-H, Li, Y.-S, Han, X.-W, Wang, Y.-L, Jiao, D.-C, Li, T.-F, Chen, P.-F, Fang, Y
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-01-2016
• Subjects: Biopsy; Carcinoma, Renal Cell - diagnostic imaging; Carcinoma, Renal Cell - therapy; Catheter Ablation - instrumentation; Catheter Ablation - methods; Combined Modality Therapy; Contrast Media; Embolization, Therapeutic - methods; Female; Humans; Kidney Neoplasms - diagnostic imaging; Kidney Neoplasms - therapy; Male; Middle Aged; Radiography, Interventional - instrumentation; Radiography, Interventional - methods; Radiology; Retrospective Studies; Tomography, X-Ray Computed - instrumentation; Tomography, X-Ray Computed - methods; Treatment Outcome; Triiodobenzoic Acids
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2015.10.012

Aim To explore the value of using flat detector (FD) equipped angiographic C-arm CT (CACT) systems in treating unresectable renal cell carcinoma (RCC) by selective renal arterial embolisation (RAE) followed by radiofrequency ablation (RFA) (RAE-RFA). Materials and methods A total of 28 patients who were not candidates for surgery were enrolled. The average size of tumours was 6.7±2.2 cm (range 4.1–9.6 cm). Twenty-eight tumours were treated with CACT-guided RFA, 5–7 days after CACT-guided RAE. Results CACT-guided RAE-RFA was technically successful in all patients. Tumour enhancement disappeared after a single RAE-RFA session in 20 patients, after two RAE-RFA sessions in four patients and after three RAE-RFA sessions in the other four patients. One patient died of lung metastasis and haematuria 13 months after RAE-RFA, and another patient died of pulmonary heart disease 23 months after repeat RAE-RFA. In the 26 living patients, tumours remained controlled during a mean follow-up period of 27 months and showed significant reduction in tumour size (6.7±2.2 cm to 3.9±1.7 cm, p <0.01). There were no significant changes in creatinine levels or urea nitrogen concentrations before and after the last RAE-RFA ( p >0.05). There were no serious complications during and after the procedure. Conclusion CACT-guided RAE followed by RFA appears to be a safe and effective technique for treating patients with inoperable RCC.