MRI-guided percutaneous laser ablation of small renal cell carcinoma: Initial clinical experience.
BACKGROUND
The number of detected small renal cell carcinomas (RCCs) has been rising, largely due to advances in imaging. Open surgical resection is the standard management of small RCCs; however, imaging-guided percutaneous ablative therapies have emerged as a minimally invasive treatment alternative, especially for patients who are poor candidates for surgery.


OBJECTIVE
To evaluate the initial clinical experience of magnetic resonance imaging (MRI)-guided percutaneous laser ablation of small RCCs.


METHODS
Eight patients with 10 tumors were treated with percutaneous MRI-guided laser ablation. All tumors (diameter range 1.5-3.8 cm, mean 2.7 cm) were biopsy-proven RCCs. By using a 0.23 T open MRI system and general anesthesia in patients, one to four (mean 2.6) laser fibers were placed and the tumors were ablated under near real-time MRI control by observing the signal void caused by the temperature change in the heated tissue. The treatment was considered successful if the tumor showed no contrast enhancement at follow-up imaging.


RESULTS
All except one tumor were successfully ablated in one session. The first patient treated showed enhancing residual tumor in post-procedural MRI; she has thus far declined retreatment. One complication, a myocardial infarction, occurred; all other patients tolerated the procedure well. No local recurrence was discovered during the follow-up (range 12-30 months, mean 20 months).


CONCLUSIONS
In this small group of patients with relatively short follow-up period, MRI-guided percutaneous laser ablation proved to be a promising treatment option for small RCCs.
Kariniemi
Juho
J
Department of Radiology, Department of Surgery, Oulu University Hospital, Oulu, Finland. juho.kariniemi@oulu.fi
Ojala
Risto
R
Hellström
Pekka
P
Sequeiros
Roberto Blanco
RB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome