REGULAR CONTENT
Final ID
612
Type
Educational Exhibit-Poster Only
Authors
V Daruwalla1, M Le2, K Patel3, A Mohandas4, M Gunduru1, J Collins5
Institutions
1Dmc/Wayne State University, Detroit, MI, 2Detroit Medical Center/Wayne State University, Detroit, MI, 3Wayne State University, Detroit, MI, 4Detroit Medical Center/ Wayne State University, Detroit, MI, 5Northwestern University, Chicago, IL
Purpose
Minimally invasive CT guided percutaneous ablation of renal tumors with radioablation or cryoablation is a recognized alternative treatment option in patients who are not a candidate for surgery. However, thermal injury to vital organs is a risk that may be mitigated with hydrodissection. The goal of this systematic review is to evaluate the feasibility, safety, efficacy, and complication of RFA and cryoablation with hydrodissection. In doing so, we also re-evaluate the injected fluid and actual displaced distance achieved for ablation.
Materials & Methods
We performed a systematic review using MEDLINE and EMBASE databases to evaluate the feasibility, safety, efficacy, complications, and the anticipated and actual displaced distance using hydrodissection during radioablation and cryoablation for ablation of renal tumors. The initial literature search and review of reference lists of relevant articles yielded a total of 95 articles. Further screening of the titles and abstracts and application of the inclusion criteria eliminated 81 irrelevant articles. After reviewing the full texts of the remaining 14 articles, 5 relevant articles were included in our study.
Results
Five articles were analyzed, resulting in a total of 122 patients who underwent percutaneous ablation of renal tumors with hydrodissection. The overall technical success rate was 96.0%; overall complication rate of 2.0%; and overall actual displaced distance was 2.11 cm. However, iodinated contrast mixed with D5W achieves higher technical success rate (100% vs 95%), larger displaced distance (2.7 vs 1.7 cm, p<0.05), and lower complication rate (0.0% vs 2.5%) than without iodinated contrast.
Conclusions
Hydrodissection is a safe and effective technique to prevent non targeted thermal injury with an excellent technical success and low complication. The threshold displaced distance of 2 cm is feasible and can be safely recommended to provide multiple benefits, eliminating the operator dependant threshold inconsistencies. Iodinated contrast mixed with D5W achieves higher displaced distance and allows for better differentiation of vital structure from the renal tumor.
Final ID
612
Type
Educational Exhibit-Poster Only
Authors
V Daruwalla1, M Le2, K Patel3, A Mohandas4, M Gunduru1, J Collins5
Institutions
1Dmc/Wayne State University, Detroit, MI, 2Detroit Medical Center/Wayne State University, Detroit, MI, 3Wayne State University, Detroit, MI, 4Detroit Medical Center/ Wayne State University, Detroit, MI, 5Northwestern University, Chicago, IL
Purpose
Minimally invasive CT guided percutaneous ablation of renal tumors with radioablation or cryoablation is a recognized alternative treatment option in patients who are not a candidate for surgery. However, thermal injury to vital organs is a risk that may be mitigated with hydrodissection. The goal of this systematic review is to evaluate the feasibility, safety, efficacy, and complication of RFA and cryoablation with hydrodissection. In doing so, we also re-evaluate the injected fluid and actual displaced distance achieved for ablation.
Materials & Methods
We performed a systematic review using MEDLINE and EMBASE databases to evaluate the feasibility, safety, efficacy, complications, and the anticipated and actual displaced distance using hydrodissection during radioablation and cryoablation for ablation of renal tumors. The initial literature search and review of reference lists of relevant articles yielded a total of 95 articles. Further screening of the titles and abstracts and application of the inclusion criteria eliminated 81 irrelevant articles. After reviewing the full texts of the remaining 14 articles, 5 relevant articles were included in our study.
Results
Five articles were analyzed, resulting in a total of 122 patients who underwent percutaneous ablation of renal tumors with hydrodissection. The overall technical success rate was 96.0%; overall complication rate of 2.0%; and overall actual displaced distance was 2.11 cm. However, iodinated contrast mixed with D5W achieves higher technical success rate (100% vs 95%), larger displaced distance (2.7 vs 1.7 cm, p<0.05), and lower complication rate (0.0% vs 2.5%) than without iodinated contrast.
Conclusions
Hydrodissection is a safe and effective technique to prevent non targeted thermal injury with an excellent technical success and low complication. The threshold displaced distance of 2 cm is feasible and can be safely recommended to provide multiple benefits, eliminating the operator dependant threshold inconsistencies. Iodinated contrast mixed with D5W achieves higher displaced distance and allows for better differentiation of vital structure from the renal tumor.