Image Evaluation before and after Ablative Therapy for Renal Cell Carcinoma

Abstract

Ablative therapies such as radiofrequency ablation (RFA) or cryoablation are minimally-invasive treatment options for small renal cell carcinomas (RCCs). Usually, RFA is performed under computed tomography (CT) guidance, whereas cryoablation is carried out under CT or magnetic resonance imaging (MRI) guidance. Owing to the recent advancements in imaging modalities and the widespread use of screening tests, the number of cases with small RCCs that are being detected is increasing. Consequently, an increasing number of patients with comorbid disease, or hereditary RCC, are receiving ablative therapy in Japan. However, there are some difficulties associated with this method, and it is important that we critically evaluate the effects of treatment after ablative therapy. Furthermore, during the procedure itself, it remains difficult to determine whether the ablated area is sufficient or not using only CT or MRI guidance. This chapter focuses on the perioperative imaging of ablative therapy for RCCs including the management of complications.