Percutaneous CT-guided radiofrequency ablation of renal cell carcinoma: efficacy of organ displacement by injection of 5% dextrose in water into the retroperitoneum.
OBJECTIVE
The objective of this study was to evaluate the effectiveness of CT-guided injection of 5% dextrose in water solution (D5W) into the retroperitoneum to displace organs adjacent to renal cell carcinoma.


METHODS
An interventional radiology database was searched to identify the cases of patients who underwent CT-guided percutaneous radiofrequency ablation of biopsy-proven renal cell carcinoma in which D5W was injected into the retroperitoneal space to displace structures away from the targeted renal tumor. The number of organs displaced and the distance between the renal tumor and adjacent organs before and after displacement with D5W were assessed.


RESULTS
The cases of 135 patients with 139 biopsy-proven renal cell carcinomas who underwent 154 percutaneous CT-guided radiofrequency ablation procedures were found in the search. Thirty-one patients with 33 renal cell carcinomas underwent 36 ablation procedures after injection of D5W into the retroperitoneal space. Fifty-five organs were displaced away from renal cell carcinoma with this technique. The average distance between adjacent structures and renal cell carcinomas before displacement was 0.36 cm (range, 0.1-1.0 cm). The average distance between structures and adjacent renal cell carcinomas after displacement was 1.94 cm (range, 1.1-4.3 cm) (p < 0.0001). The average volume of D5W used to achieve organ displacement was 273.5 mL. No complications were associated with this technique.


CONCLUSIONS
CT-guided injection of D5W into the retroperitoneum is an effective method for displacing vital structures away from renal cell carcinoma.
Arellano
Ronald S
RS
Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA. rarellano@partners.org
Garcia
Rodrigo G
RG
Gervais
Debra A
DA
Mueller
Peter R
PR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000601:surgery*; D017115:Catheter Ablation; D003287:Contrast Media; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007267:Injections; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D015641:Radiography, Interventional; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014867:Water / Q000008:administration & dosage
D003287:Contrast Media; D014867:Water; D005947:Glucose