Contrast-enhanced ultrasound-guided percutaneous microwave ablation of renal cell carcinoma that is inconspicuous on conventional ultrasound.
This study was designed to determine the safety, effectiveness and feasibility of contrast-enhanced ultrasound (CEUS)-guided percutaneous microwave ablation (MWA) of renal cell carcinoma (RCC) that is inconspicuous on conventional ultrasound (US).



A total of 32 RCC nodules in 29 patients (23 men and 6 women) were treated with CEUS-guided percutaneous MWA between January 2010 and September 2014. The median maximum diameter of the nodules was 2.4 cm (interquartile range: 1.8-2.9 cm). The US contrast agent was SonoVue, a second-generation contrast agent. CEUS was applied before the needle was inserted into the tumour, and percutaneous MWA was performed under CEUS-guidance.



In total 31 tumours were successfully visualised via CEUS using 1-2 (1.0-2.0 mL) contrast agent injections, and percutaneous MWA was performed under CEUS-guidance. The technical success rate of CEUS-guided percutaneous MWA of RCC was 96.9% (31/32). The mean number of sessions of CEUS-guided percutaneous MWA for each tumour was 1.2 ± 0.4. The mean duration of energy application for each tumour was 7.3 ± 2.7 min. All patients were followed up for 3-71 months (median 17 months) to observe the therapeutic effects and complications. The therapeutic effects were assessed at follow-up with computed tomography (CT) or magnetic resonance imaging (MRI) and CEUS. There was no local tumour progression and the technique effectiveness rate was 100% (31/31). The complications rate was 6.5% and the major complications rate was 3.2%. We observed one case of pleural effusion and one case of renal subcapsular haemorrhage after the percutaneous MWA procedures.



CEUS-guided percutaneous MWA is a safe, efficient and feasible therapy for patients with RCCs inconspicuous on conventional US.
a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China.
Chao-Nan
CN
Chen
a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China.
Ping
P
Liang
a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China.
Jie
J
Yu
a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China.
Xiao-Ling
XL
Yu
a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China.
Zhi-Gang
ZG
Cheng
a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China.
Zhi-Yu
ZY
Han
a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China.
Fang-Yi
FY
Liu
a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China.
Xin
X
Li
D055011:Ablation Techniques; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D003287:Contrast Media / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D010743:Phospholipids / Q000627:therapeutic use*; D013459:Sulfur Hexafluoride / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
Contrast-enhanced ultrasound guidance; percutaneous microwave ablation; renal cell carcinoma