Image-guided Percutaneous Ablation of Renal Tumors: Outcomes,Technique, and Application in Urologic Practice

The recent increase in detection of small (≤4 cm) renal cortical neoplasms has engendered changes in the management of these incidental renal tumors. There is increased interest in new forms of minimally invasive therapies, including focal renal mass ablation with cryotherapy and radiofrequency ablation (RFA). Percutaneous cryoablation (PCA) and percutaneous RFA are among the newest approaches to minimally invasive renal surgery offering excellent patient recovery, lower rates of procedure-related complications, and promising oncologic outcomes. Ablative techniques were once considered a treatment option only in highly selected cases. However, with excellent efficacy of ablative technologies having been demonstrated with intermediate-term follow-up, renal ablation has expanded to a larger patient population. Percutaneous renal ablative procedures are optimized when performed in a combined fashion, with urologists and interventional radiologists collaborating to optimize the chance of success of the ablation. This article reviews the recent advances in PCA and percutaneous RFA and offers suggestions for patient selection in contemporary urologic practice.