title: Renal volumetric analysis: a new paradigm in renal mass treatment assessment.
abstract: Abstract Background and Purpose: Multiple renal volumetric assessment studies have correlated parenchymal volume with the glomerular filtration rate. The objective of this study was to compare renal volumes before and after treatment of renal masses with either partial nephrectomy or radiofrequency ablation (RFA).
  
  
  METHODS
  We reviewed our prospectively collected database of patients with renal masses who were treated between November 2001 and January 2011 with robot-assisted laparoscopic partial nephrectomy (RALPN), laparoscopic RFA (LRFA), or CT-guided percutaneous RFA (CTRFA). Digital Imaging and Communications in Medicine CT imaging data were analyzed in an open-source viewer. Volumetric calculations were used to measure the normal, enhancing bilateral renal parenchyma and tumor volumes. Normal parenchymal volume loss was compared among treatments.
  
  
  RESULTS
  There were 96 patients (68 men) with an average age of 68.0 (36-84) years who met our inclusion criteria. The average tumor diameter, tumor volume, and nephrometry score (NS) was 3.5 cm, 32.0 cm(3), and 7.1 in RALPN (n=26), 2.6 cm, 9.8 cm(3), and 7.1 in CTRFA (n=47), and 2.9 cm, 14.3 cm(3), and 7.2 in LRFA (n=23) groups. The percent change in the operated kidney volume was similar in RALPN (-12%±15), CTRFA (-13%±16), and LRFA (-17%±18) groups. NS was the only variable in a multivariate linear regression model that correlated with the amount of volume lost in the ipsilateral kidney.
  
  
  CONCLUSIONS
  Our retrospective volumetric analysis of renal parenchyma before and after partial nephrectomy or RFA of renal masses revealed that all treatments produce similar volume of collateral damage.
authors.affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, FL 33134, USA. vladmd@gmail.com
authors.forename: Vladislav
authors.initials: V
authors.lastname: Gorbatiy
authors.forename: Viacheslav
authors.initials: V
authors.lastname: Iremashvili
authors.forename: Arturo
authors.initials: A
authors.lastname: Castro
authors.forename: Amanda
authors.initials: A
authors.lastname: Mure
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ortiz
authors.forename: Scott M
authors.initials: SM
authors.lastname: Castle
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Leveillee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D003710:Demography; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011300:Preoperative Care; D011859:Radiography