• Brian T Welch, Matthew R Callstrom, Paul C Carpenter, C Thomas Wass, Tasha L Welch, Stephen A Boorjian, Douglas A Nichols, Geoffrey B Thompson, Christine M Lohse, Dana Erickson, Bradley C Leibovich, and Thomas D Atwell.
• Departments of Radiology (B.T.W., M.R.C., D.A.N., T.D.A.). Electronic address: welch.brian@mayo.edu.
• J Vasc Interv Radiol. 2014 Apr 1; 25 (4): 593-8.

PurposeTo assess safety, technical success, local control, and survival associated with percutaneous image-guided adrenal ablation.Materials And MethodsAdult 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.ResultsIn 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.ConclusionsImage-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.Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

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