Bertolotti Lorenzo, Bazzocchi Maria Vittoria, Iemma Enrico, Pagnini Francesco, Ziglioli Francesco, Maestroni Umberto, Patera Annalisa, Natale Matteo Pio, Martini Chiara, De Filippo Massimo
Department of Medicine and Surgery, Section of Radiology, University of Parma, Maggiore Hospital, Via Gramsci 14, 43126 Parma, Italy.
Department of Urology, Parma University Hospital, Via Gramsci 14, 43126 Parma, Italy.
Diagnostics (Basel). 2023 Jan 20;13(3):388. doi: 10.3390/diagnostics13030388.
Over the last two decades the detection rate of small renal masses has increased, due to improving diagnostic accuracy, and nephron-sparing treatments have become the first-choice curative option for small renal masses. As a minimally invasive alternative, thermal ablation has increased in popularity, offering a good clinical outcome and low recurrence rate. Radiofrequency ablation, Cryoablation, and Microwave ablation are the main ablative techniques. All of them are mostly overlapping in term of cancer specific free survival and outcomes. These techniques require imaging study to assess lesions features and to plan the procedure: US, CT, and both of them together are the leading guidance alternatives. Imaging findings guide the interventional radiologist in assessing the risk of complication and possible residual disease after procedure. The purpose of this review is to compare different ablative modalities and different imaging guides, underlining the effectiveness, outcomes, and complications related to each of them, in order to assist the interventional radiologist in choosing the best option for the patient.
在过去二十年中，由于诊断准确性的提高，小肾肿块的检出率有所增加，保留肾单位的治疗已成为小肾肿块的首选治愈性选择。作为一种微创替代方法，热消融越来越受欢迎，具有良好的临床效果和低复发率。射频消融、冷冻消融和微波消融是主要的消融技术。它们在癌症特异性无瘤生存率和治疗效果方面大多重叠。这些技术需要影像学检查来评估病变特征并规划手术：超声、CT以及两者结合是主要的引导选择。影像学检查结果可指导介入放射科医生评估术后并发症风险和可能的残留疾病。本综述的目的是比较不同的消融方式和不同的影像学引导，强调与每种方式相关的有效性、治疗效果和并发症，以帮助介入放射科医生为患者选择最佳方案。
