• Dong Kyu Kim, Jong Yun Won, and Sung Yoon Park.
• 1 Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
• Acta Radiol. 2019 Jun 1; 60 (6): 798-804.

BackgroundUsefulness of ultrasound (US)-guided mass targeting and computed tomography (CT)-guided ice-ball monitoring in percutaneous cryoablation (PCA) for renal cell carcinoma (RCC) is still uncertain.PurposeTo assess radiation dose and short-term outcomes of PCA for RCC using US-guided targeting and CT-guided ice-ball monitoring.Material And MethodsThirty-nine consecutive patients who underwent PCA for biopsy-proven RCC were included. Mass targeting was performed with US and ice-ball was monitored with CT guidance. Effective radiation dose of CT during PCA was recorded. Follow-up was conducted with contrast-enhanced CT or magnetic resonance imaging (MRI) (mean follow-up time = 10.1 ± 7.0 months). Local tumor progression was defined by the presence of focal enhancing areas at the ablation zone (CT, ≥ 20 HU; MRI, presence of focal enhancement on subtraction contrast-enhanced image). Technical success, major complication rate (e.g. Clavien-Dindo classification ≥ 3), and one-year local tumor progression-free survival (PFS) rate were analyzed.ResultsMean effective radiation dose in association with PCA was 12.1 ± 4.5 mSv (range = 7.0-25.2 mSv). Technical success was achieved in 100%. Local tumor progression occurred in a single patient (2.6%, 1/39), and one-year local tumor PFS rate was 95.7%. No major complication was found.ConclusionPCA using US-guided targeting and CT-guided ice-ball monitoring may allow acceptable local tumor control for RCC, as a radiation-reducing strategy.

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