title: Percutaneous Renal Tumor Ablation: Radiation Exposure During Cryoablation and Radiofrequency Ablation.
abstract: BACKGROUND
  Once reserved solely for non-surgical cases, percutaneous ablation is becoming an increasingly popular treatment option for a wider array of patients with small renal masses and the radiation risk needs to be better defined as this transition continues.
  
  
  METHODS
  Retrospective review of our renal tumor ablation database revealed 425 patients who underwent percutaneous ablation for treatment of 455 renal tumors over a 5-year time period. Imparted radiation dose information was reviewed for each procedure and converted to effective patient dose and skin dose using established techniques. Statistical analysis was performed with each ablative technique.
  
  
  RESULTS
  For the 331 cryoablation procedures, the mean DLP was 6987 mGycm (SD = 2861) resulting in a mean effective dose of 104.7 mSv (SD = 43.5) and the mean CTDIvol was 558 mGy (SD = 439) resulting in a mean skin dose of 563.2 mGy (SD = 344.1). For the 124 RFA procedures, the mean DLP was 3485 mGycm (SD = 1630) resulting in a mean effective dose of 50.3 mSv (SD = 24.0) and the mean CTDIvol was 232 mGy (SD = 149) resulting in a mean skin dose of 233.2 mGy (SD = 117.4). The difference in patient radiation exposure between the two renal ablation techniques was statistically significant (p < 0.001).
  
  
  CONCLUSIONS
  Both cryoablation and RFA imparted an average skin dose that was well below the 2 Gy deterministic threshold for appreciable sequela. Renal tumor cryoablation resulted in a mean skin and effective radiation dose more than twice that for RFA. The radiation exposure for both renal tumor ablation techniques was at the high end of the medical imaging radiation dose spectrum.
authors.affiliation: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA. james.mceachen2@gmail.com.
authors.forename: James C
authors.initials: JC
authors.lastname: McEachen
authors.affiliation: Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
authors.forename: Shuai
authors.initials: S
authors.lastname: Leng
authors.affiliation: Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Atwell
authors.affiliation: Department of Urology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Tollefson
authors.affiliation: Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Friese
authors.affiliation: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
authors.affiliation: Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
authors.forename: Grant D
authors.initials: GD
authors.lastname: Schmit
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D000069079:Radiation Exposure; D011846:Radio Waves; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Ablation; CT/CTA; Clinical practice; Interventional oncology; Kidney/renal; Radiation; Radiofrequency ablation