Comparison of expandable electrodes in percutaneous radiofrequency ablation of renal cell carcinoma |
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| Authors: | Gulesserian Talin Mahnken Andreas H Schernthaner Ruediger Memarsadeghi Mazda Weber Michael Tacke A Kettenbach Joachim |
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| Institution: | 1. Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, IMAGINE, 30029 Nîmes, France;2. Department of Interventional Radiology, Hôpital Européen Georges Pompidou, AP-HP, INSERM U970, Université Paris Cité, Faculté de Médecine, 75006 Paris, France;3. Department of Urology, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, 75006 Paris, France;4. Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology (BESPIM), CHU Nîmes, 30029 Nîmes France;5. Department of Urology, Nîmes University Hospital, University of Montpellier, 30029 Nîmes, France;6. Department of Diagnostic and Interventional Imaging, Groupe Hospitalier Pellegrin, 33000 Bordeaux, France;7. Department of Radiology, CHU de Montpellier, Arnaud de Villeneuve Hospital, University of Montpellier, 34090 Montpellier, France;8. Department of Urology, CHU de Montpellier, Lapeyronie Hospital, University of Montpellier, 34295 Montpellier, France;9. Department of Diagnostic and Interventional Imaging, AP-HM, Hôpital de La Timone; Université Aix-Marseille, CERIMED, Faculté de Médecine, EA 4264, Laboratoire d''Imagerie Interventionnelle Expérimentale, 13005 Marseille, France;10. Department of Diagnostic and Interventional Imaging, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm U 1209, 38700 La Tronche, France;11. Service d''Imagerie Urinaire et Vasculaire, Hospices Civils de Lyon; Faculté de Médecine Lyon Est, 69002 Lyon, France;12. Service d''Urologie et Chirurgie de la Transplantation, Hospices Civils de Lyon; Faculté de Médecine Lyon Est, 69002 Lyon, France |
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| Abstract: | OBJECTIVE: To compare two different expandable electrodes in radiofrequency ablation of renal cell carcinoma. METHODS: Percutaneous ablation was performed at two centers using either an expandable 7F umbrella-shaped LeVeen probe (diameter 2-4 cm) and a 200-W generator (group A), or an expandable Starburst XL electrode with a 150-W generator (group B). From each center, eight patients with one tumor each were matched retrospectively with regard to tumor volume, which was 9.71+/-6.43 cm3 for group A and 8.74+/-4.35 cm3 for group B (mean tumor diameter: 2.47+/-0.9 cm versus 2.50+/-0.4 cm, respectively). An unpaired t-test showed no significant difference in tumor volume between the two groups (p=0.820). RESULTS: Sixteen patients with 16 tumors were treated. The primary technical success of radiofrequency ablation was 94% (15 of 16 patients). After retreatment of residual tumor in one patient from group B, secondary technical success was 100%. No major complications were observed. The resulting mean volume of the almost spherical necroses was 21.1+/-9.1 cm3 versus 14.6+/-6.7 cm3 for groups A and B (diameter of necrosis: 3.5+/-0.7 cm versus 3.1+/-0.6 cm, respectively). A Mann-Whitney U-test showed no significant difference in necrosis volume between the two groups (CI -0.215; 0.471]; p=0.2892). The calculated shape value of S (ratio of length to height of the coagulation necrosis) was 0.9+/-0.1 and 1.0+/-0.1 for groups A and B, respectively. No local recurrence was observed during a mean follow-up of 14.8+/-11.6 months, while extrarenal tumor progression occurred in three patients. CONCLUSIONS: No significant differences in coagulation volume and shape were found after RF ablation of renal cell carcinoma using two different expandable electrodes. To avoid local recurrence, however, accurate placement of probes and appropriate expansion of the electrode is necessary. |
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