New technologies in tumor ablation.

PURPOSE OF REVIEW

The application of ablative modalities for small renal masses continues to increase. In addition, multiple technologies continue to be studied for the treatment of these renal masses. This review focuses on new and emerging technologies so that the clinician can become more familiar with these modalities as they become available in clinical practice.

RECENT FINDINGS

Radiofrequency ablation (RFA) and cryoablation (cryo) continue to be the most often used ablative modalities for the treatment of small renal masses. In addition, they are the most thoroughly studied modalities leading to a set of well defined variables predicting successful ablation. Microwave ablation (MWA) and irreversible electroporation are newer modalities that offer theoretical advantages to RFA and cryo, although each differs in the specific advantage provided. Multiple animal studies have been performed with each modality; however, in both cases, the optimal device settings are not well defined. For MWA in particular, there are a significant number of systems available and within each system, there are an array of variables that can be modified, which influences the ablation zone size and shape. Other emerging technologies include stereotactic body radiation and high-intensity focused ultrasound, although each has limited data supporting their efficacy to date.

SUMMARY

Ablation technology continues to multiply and evolve. Newer technologies such as MWA and irreversible electroporation are promising as they offer theoretical advantages to RFA and cryo. However, both require further studies to identify the optimal tumor characteristics and device settings leading to successful ablation.