METHODS: From January 2008 to July 2010, 73 patients with sporadic unilateral RCC were enrolled to our study (57 men and 16 women, age range: 37-78 years, mean age 57.9 years). The diameter of the tumor was 1.7-5.8, 3.4 cm on average. The patients were divided into two groups depending on the intraoperative ultrasonography type: CEUS group and conventional ultrasound group. Patients in CEUS group received CEUS before insertion of the electrode, and the second CEUS was performed right after the initial ablation to dynamically evaluate the images. If there was highly suspicious residue, additional ablation and repeated CEUS were applied. Patients in the conventional ultrasound group received PRFA guided by gray-scale ultrasound. All of these patients received contrast-enhanced computed tomography (CT) examination 7 days after the procedure (patients in CEUS group received CEUS conducted with each CT scan), with subsequent CT and CEUS assessment at 3, 6, and every 6 months thereafter.
RESULTS: The mean follow-up period was 22 months (range: 12-42 months). All tumors were biopsied before RFA. The local tumor control rate was 94.6% (35/37) in the CEUS group and 86.1% (31/36) in the conventional ultrasound group (P < 0.05); the cancer-specific survival rate and the overall survival rate were 100%. The post-RFA (12 months) mean GFR levels were 84.7 ± 27.5 mL/min/1.73 m2 (P > 0.05, compared with pre-GFR: 86.4 ± 26.2 mL/min/1.73 m2) in the CEUS group and 81.9 ± 22.8 mL/min/1.73 m2 (P > 0.05, compared with pre-GFR: 83.5 ± 23.7 mL/min/1.73 m2) in the conventional ultrasound group.
CONCLUSION: Intraoperative CEUS can "real-time" monitor the ablated area during PRFA procedure. This technique can help to achieve a higher success rate compared with conventional ultrasound. No impact of intraoperative CEUS has been found on GFR level.
Written by:
Zhao X, Wang W, Zhang S, Liu J, Zhang F, Ji C, Li X, Gan W, Zhang G, Guo H. Are you the author?
Urology Department, The Affiliated Nanjing Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
Reference: Abdom Imaging. 2011 Dec 1. Epub ahead of print.
doi: 10.1007/s00261-011-9828-4
PubMed Abstract
PMID: 22131041
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