Imaging associated with percutaneous and intraoperative management of renal tumors.
As new minimally invasive treatment options for small renal tumors such as laparoscopic partial nephrectomy (LPN), radiofrequency ablation (RFA), and cryoablation(CA) have been developed, the reliance upon imaging technologies, both intraoperatively and postoperatively, has expanded greatly. CT, MRI, and ultrasonography (US)have proven themselves extremely useful in this regard, but their utility requires a thorough understanding of each modality's limitations, proper intraoperative use, and expected postoperative findings. This article discusses intraoperative use of US for LPN,RFA, and CA. The expected postoperative MRI and CT findings after CA and RFA also are covered, highlighting the different radiographic evolutionary patterns encountered after use of these technologies. Because the success of these new treatments for small re-nal tumors (especially RFA and CA) depends not only on the technology itself but also on the advantages and limitations of the associated radiographic techniques, urologists of the 21st century must be facile at interpreting and manipulating these imaging modalities to appropriately care for their renal tumor patients.
Anderson
J Kyle
JK
Department of Urology, The University of Minnesota, Mayo Memorial Building, 420 Delaware Street Southeast, Room A597, Minneapolis, MN 55455, USA.
Shingleton
W Bruce
WB
Cadeddu
Jeffrey A
JA
D017115:Catheter Ablation; D003452:Cryosurgery; D006801:Humans; D007430:Intraoperative Care; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D009392:Nephrectomy / Q000379:methods; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography