Combining Transarterial Embolization and Percutaneous Cryoablation for Early-Stage Renal Cell Carcinoma: Embolization Materials and Impacts of Tumor Size.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Tomography Pub Date : 2024-11-07 DOI:10.3390/tomography10110130

Miki Terauchi, Tsuneo Yamashiro, Shungo Sawamura, Shingo Koyama, Noboru Nakaigawa, Keiichi Kondo, Hisashi Hasumi, Kazuhide Makiyama, Daisuke Utsunomiya

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引用次数: 0

Abstract

Background/objectives: Our aim was to compare the complication rates of different embolization materials (absolute ethanol and gelatin sponges) used for combined transarterial embolization (TAE) and to investigate the impact of tumor size on operative time and cryoneedle use during percutaneous cryoablation (PCA).

Methods: We treated 27 patients (9 women and 18 men; mean age, 74 years) with 28 early-stage (T1a) renal cell carcinoma (RCC) lesions using combined TAE and PCA between September 2018 and January 2021. During TAE, 15 lesions in 14 patients were embolized using mixed absolute ethanol and iodized oil. The remaining 13 lesions (in 13 patients) were embolized using a gelatin sponge followed by iodized oil. The PCA was performed within 3 to 21 days of the TAE. We compared complications between the TAE subgroups (i.e., absolute ethanol and gelatin sponge) and assessed potential correlations between tumor size and the operative time of the PCA.

Results: All patients were successfully treated by combined TAE-PCA. Local control was achieved for all patients (monitoring period, 1-48 months; median, 28 months). Although the effect of TAE did not differ between subgroups, a significantly higher number of patients in the absolute ethanol group experienced intraprocedural pain than in the gelatin sponge group (p < 0.05). The operative time of the PCA was significantly correlated with the size of the RCC lesion (p < 0.01). The number of cryoneedles used for the PCA was also correlated with the size of the RCC lesion (p < 0.0001).

Conclusions: For TAE prior to PCA for early-stage RCC, gelatin sponges can replace absolute ethanol to reduce intraprocedural pain. Tumor size correlates with operative time and the number of cryoneedles needed for PCA, which suggests the total medical cost for PCA therefore varies based on the tumor's size.

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联合经动脉栓塞和经皮冷冻消融治疗早期肾细胞癌：栓塞材料和肿瘤大小的影响。

背景/目的：我们的目的是比较用于联合经动脉栓塞术（TAE）的不同栓塞材料（绝对乙醇和明胶海绵）的并发症发生率，并研究肿瘤大小对手术时间和经皮冷冻消融术（PCA）中冷冻针使用的影响：2018年9月至2021年1月期间，我们使用联合TAE和PCA治疗了27名患者（9名女性，18名男性；平均年龄74岁）的28个早期（T1a）肾细胞癌（RCC）病灶。在 TAE 期间，使用混合绝对乙醇和碘化油栓塞了 14 名患者的 15 个病灶。其余13名患者的13个病灶使用明胶海绵栓塞，然后再使用碘化油。PCA 在 TAE 术后 3 到 21 天内进行。我们比较了TAE亚组（即绝对乙醇和明胶海绵）之间的并发症，并评估了肿瘤大小与PCA手术时间之间的潜在相关性：结果：所有患者均成功接受了TAE-PCA联合治疗。结果：所有患者均成功接受了TAE-PCA联合治疗，并实现了局部控制（监测期为1-48个月；中位数为28个月）。虽然TAE的效果在亚组之间没有差异，但绝对乙醇组患者术中出现疼痛的人数明显高于明胶海绵组（P < 0.05）。PCA 的手术时间与 RCC 病灶的大小明显相关（p < 0.01）。PCA 使用的冷冻针数量也与 RCC 病灶的大小相关（p < 0.0001）：结论：对于早期RCC PCA前的TAE，明胶海绵可替代绝对乙醇以减少术中疼痛。肿瘤大小与手术时间和 PCA 所需的冷冻针数量相关，这表明 PCA 的总医疗费用会因肿瘤大小而异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.