title: Minimally Invasive Percutaneous Treatment of Small Renal Tumors with Irreversible Electroporation: A Single-Center Experience.
abstract: OBJECTIVE
  To evaluate whether irreversible electroporation (IRE) can be used as an ablation technique for small renal tumors (T1a cancers or small benign tumors) and to describe features after ablation on computed tomography (CT) or magnetic resonance (MR) imaging.
  
  
  METHODS
  In this retrospective study, 20 patients (mean age, 65 y ± 12.8 y) underwent CT-guided IRE of T1a renal carcinoma (n = 13) or small benign or indeterminate renal masses < 4 cm in size (n = 7). Mean tumor size was 2.2 cm ± 0.7. The ablation area was verified with contrast-enhanced imaging performed immediately after the procedure to determine technical success. Imaging was performed 6 weeks (20 of 20 patients), 6 months (15 of 20), and 12 months (6 of 20) after ablation. Medical records and CT/MR imaging features of all patients were reviewed for recurrence, symptoms, and complications after treatment.
  
  
  RESULTS
  Technical success was achieved in all patients (100%); there were no major procedure-related complications. Minor complications occurred in 7 patients, including self-limiting perinephric hematomas, pain difficult to control, and urinary retention. Mean procedure time was 2.0 hours ± 0.7. At 6 weeks, 2 patients required salvage therapy because of incomplete ablation. At 6 months, all 15 patients with imaging studies available had no evidence of recurrence. At 1 year, 1 patient (1 of 6) was noted to have experienced recurrence. CT/MR imaging after IRE ablation demonstrated an area of nonenhancement in the treatment zone that involuted over ~6 months.
  
  
  CONCLUSIONS
  Renal IRE appears to be a safe treatment for small renal tumors. Tumors treated with IRE demonstrated nonenhancement in the treatment zone with involution on follow-up CT/MR imaging.
authors.affiliation: Departments of Radiology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390. Electronic address: clayton.trimmer@utsouthwestern.edu.
authors.forename: Clayton K
authors.initials: CK
authors.lastname: Trimmer
authors.affiliation: Departments of Radiology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390.
authors.forename: Ankaj
authors.initials: A
authors.lastname: Khosla
authors.affiliation: Urology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390.
authors.forename: Monica
authors.initials: M
authors.lastname: Morgan
authors.affiliation: Departments of Radiology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390.
authors.forename: Summer L
authors.initials: SL
authors.lastname: Stephenson
authors.affiliation: Urology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390.
authors.forename: Asim
authors.initials: A
authors.lastname: Ozayar
authors.affiliation: Urology, University of Texas Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX 75390.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cadeddu
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D053672:Electrochemotherapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome