Computerized tomography guided percutaneous renal cryoablation with the patient under conscious sedation: initial clinical experience.
OBJECTIVE
We report on our initial clinical experience with CT guided percutaneous renal cryoablation.


METHODS
CT guided percutaneous renal cryoablation was performed on 27 tumors using conscious sedation in 20 patients. Eligible patients had tumors of 5 cm or less and were poor surgical candidates or otherwise warranted nephron sparing treatment. Tumors were classified as central or noncentral depending on their relationship to the renal sinus fat. During cryoablation intraoperative active ice ball formation was monitored with real-time CT imaging to ensure adequate tumor coverage. Postoperative followup imaging was obtained at regular intervals.


RESULTS
Our method appears technically feasible as of the 27 cryoablations performed, only 1 complication occurred requiring blood transfusion in a patient with a large, centrally located tumor. To date we have 16 tumors in 12 patients with imaging followup of 1 month or more (mean followup 5.9 months). Mean baseline tumor size in this group was 2.5 cm with 11 small (3 cm or less) and 5 large (more than 3 cm) tumors. Of the tumors 5 were centrally located and 11 were noncentrally located. Preliminary data suggest that of the 16 cryoablated tumors 15 showed no signs of enhancement on followup.


CONCLUSIONS
CT guided percutaneous renal cryoablation appears to be a feasible treatment option for small, noncentrally located renal tumors. While early results appear promising, longer followup is needed to more clearly define the role of this treatment method.
Gupta
Ajay
A
Russell H. Morgan Department of Radiology, Division of Cardiovascular and Interventional Radiology, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
Allaf
Mohamad E
ME
Kavoussi
Louis R
LR
Jarrett
Thomas W
TW
Chan
David Y S
DY
Su
Li-Ming
LM
Solomon
Stephen B
SB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016292:Procedural Sedation; D003452:Cryosurgery / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed