title: Imaging-guided radiofrequency ablation of cystic renal neoplasms.
abstract: OBJECTIVE
  The purpose of this article is to determine whether percutaneous radiofrequency ablation (RFA) is effective and safe for the treatment of cystic renal neoplasms.
  
  
  METHODS
  This is a retrospective review of imaging-guided RFA of Bosniak III and IV cysts from one institution. Thirty-eight subjects (19 men and 19 women; mean age, 71 years; age range, 46-95 years) underwent RFA of 40 cystic neoplasms (Bosniak III, n = 25; Bosniak IV, n = 15). Percutaneous biopsy was performed in 90% (36/40) of lesions. For patients with imaging follow-up of at least 1 year (n = 21), the mean duration of surveillance was 2.8 years (range, 1-6.5 years). The electronic medical record was reviewed for complications related to the procedure. Estimated glomerular filtration rate (GFR) was measured before RFA and at the last follow-up visit more than 6 months after the RFA session.
  
  
  RESULTS
  According to percutaneous biopsy, 61.1% (22/36) of lesions were malignant, and 38.9% (14/36) of biopsies were inconclusive. There was no local tumor progression, and no subjects developed metastatic disease. One subject developed a new solid renal mass during the course of follow-up. Minor complications occurred in 5.3% (2/38) of ablations and included dysuria and mild hydronephrosis related to a blood clot in the ureter. There was one major complication (2.6%), a case of flash pulmonary edema. On average, estimated GFR decreased by 2.5 mL/min/1.73 m(2).
  
  
  CONCLUSIONS
  Imaging-guided RFA is an effective and safe treatment of Bosniak III and IV cystic renal neoplasms with outcomes comparable to those of surgical therapies.
authors.affiliation: Department of Radiology, Wake Forest Baptist Medical Center, Medical Center Blvd, 3rd Fl MRI, Winston-Salem, NC 27157-1088, USA. bcallen2@wakehealth.edu
authors.forename: Brian C
authors.initials: BC
authors.lastname: Allen
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Chen
authors.forename: David D
authors.initials: DD
authors.lastname: Childs
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Zagoria
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D017115:Catheter Ablation / Q000379:methods*; D015897:Comorbidity; D003287:Contrast Media; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007472:Iohexol; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000601:surgery*; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D007472:Iohexol