title: A single-institution experience in image-guided thermal ablation of adrenal gland metastases.
abstract: OBJECTIVE
  To assess safety, technical success, local control, and survival associated with percutaneous image-guided adrenal ablation.
  
  
  METHODS
  Adult patients with adrenal metastases who underwent percutaneous image-guided adrenal ablation during the years 2003-2012 were identified. There were 32 patients with 37 adrenal tumors identified. Technical success, safety, local control, and survival were analyzed according to standard criteria.
  
  
  RESULTS
  In 32 patients (25 men and 7 women; mean age, 66 y; age range, 44-88 y) with 37 adrenal tumors, 35 ablation procedures were performed. One patient with an 8.2-cm tumor underwent planned cryoablation debulking fully anticipating untreated margins owing to close proximity of the pancreas (ie, the intent was to diminish tumor burden rather than a curative intervention). Of the 36 patients treated with curative intent, technical success was achieved in 35 (97%) tumors. Follow-up imaging was performed on 34 of 37 tumors (excluding patients with intentional debulking [n = 1], technical failure [n = 1], and absence of follow-up [n = 1]). Local recurrence developed in 3 (8.8%) of 34 tumors. Local tumor control was achieved in 31 lesions at a mean of 22.7 months of follow-up. Recurrence-free survival and overall survival at 36 months were 88% and 52%, respectively, with a median survival of 34.5 months. A Common Terminology Criteria for Adverse Events version 4 grade 3 or 4 complication was observed in three (8.6%) ablation procedures.
  
  
  CONCLUSIONS
  Image-guided ablation is safe and effective for local control of metastatic adrenal tumors and provides a minimally invasive alternative to surgical resection in appropriately selected patients.
authors: Departments of Radiology (B.T.W., M.R.C., D.A.N., T.D.A.). Electronic address: welch.brian@mayo.edu.
authors: Brian T
authors: BT
authors: Welch
authors: Departments of Radiology (B.T.W., M.R.C., D.A.N., T.D.A.).
authors: Matthew R
authors: MR
authors: Callstrom
authors: Endocrinology (P.C.C., D.E.).
authors: Paul C
authors: PC
authors: Carpenter
authors: Anesthesiology (C.T.W., T.L.W.).
authors: C Thomas
authors: CT
authors: Wass
authors: Anesthesiology (C.T.W., T.L.W.).
authors: Tasha L
authors: TL
authors: Welch
authors: Urology (S.A.B., B.C.L.).
authors: Stephen A
authors: SA
authors: Boorjian
authors: Departments of Radiology (B.T.W., M.R.C., D.A.N., T.D.A.).
authors: Douglas A
authors: DA
authors: Nichols
authors: GI and General Surgery (G.B.T.).
authors: Geoffrey B
authors: GB
authors: Thompson
authors: Biostatistics (C.M.L.), Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
authors: Christine M
authors: CM
authors: Lohse
authors: Endocrinology (P.C.C., D.E.).
authors: Dana
authors: D
authors: Erickson
authors: Urology (S.A.B., B.C.L.).
authors: Bradley C
authors: BC
authors: Leibovich
authors: Departments of Radiology (B.T.W., M.R.C., D.A.N., T.D.A.).
authors: Thomas D
authors: TD
authors: Atwell
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D003452:Cryosurgery / Q000009:adverse effects / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012307:Risk Factors; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000401:mortality; D016896:Treatment Outcome