Smits Maarten L J, Wijnen Niek, Bruijnen Rutger C G, Brinkman Willem M, Willemse Peter-Paul M, Ramdhani Khalil, Barendrecht Maurits M, Meijer Richard, Vonken Evert-Jan P A
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Oncological Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
Cardiovasc Intervent Radiol. 2025 Jun;48(6):836-845. doi: 10.1007/s00270-025-04039-1. Epub 2025 Apr 28.
We present a technique that combines Renal arteriography with C-arm CT-Guided Ablation (RenACAGA) to improve tumor visualization, navigation and margin confirmation for percutaneous ablation of renal tumors.
The RenACAGA technique was used for thermal ablation of challenging renal tumors (intraparenchymal or US-occult lesions). All patients treated with RenACAGA between January 1, 2022, and July 1, 2024, were retrospectively evaluated. Procedures were performed in the angiography suite, with catheterization of the renal artery for selective contrast infusion. C-arm CT and guidance software were used for tumor visualization and ablation needle placement. Pre- and post-ablation C-arm CTs were fused to assess ablation margins. Technical success and local tumor recurrence (LTR) rate were evaluated. Complications were graded according to the Common terminology criteria for adverse events (CTCAE) version 5.0.
Seven patients with 10 tumors were treated using the RenACAGA technique. All tumors were successfully identified, punctured and ablated (technical success 100%). During a median follow-up period of 8 months (range 7-25 months), no signs of tumor recurrence at the ablation site were observed (LTR rate 0%). One CTCAE grade 3 periprocedural complication was observed (urinary leakage through the needle tract), along with two CTCAE grade 1 complications (genitofemoral neuralgia (n = 1), and asymptomatic partial splenic infarction (n = 1)).
The RenACAGA technique was successfully used for renal tumor ablation. Further studies are warranted to establish the potential benefits of this technique in terms of superior tumor visualization, targeting, ablation margin assessment, and combination with embolization.
我们介绍一种将肾动脉造影与C形臂CT引导下消融术（RenACAGA）相结合的技术，以改善肾肿瘤经皮消融术中肿瘤的可视化、导航及边缘确认。
RenACAGA技术用于对具有挑战性的肾肿瘤（实质内或超声隐匿性病变）进行热消融。对2022年1月1日至2024年7月1日期间接受RenACAGA治疗的所有患者进行回顾性评估。手术在血管造影室进行，通过肾动脉插管进行选择性造影剂注入。使用C形臂CT和引导软件进行肿瘤可视化及消融针放置。将消融前和消融后的C形臂CT图像融合以评估消融边缘。评估技术成功率和局部肿瘤复发（LTR）率。根据不良事件通用术语标准（CTCAE）第5.0版对并发症进行分级。
7例患者共10个肿瘤接受了RenACAGA技术治疗。所有肿瘤均成功识别、穿刺并消融（技术成功率100%）。在中位随访期8个月（范围7 - 25个月）内，未观察到消融部位有肿瘤复发迹象（LTR率0%）。观察到1例CTCAE 3级围手术期并发症（针道漏尿），以及2例CTCAE 1级并发症（生殖股神经痛（n = 1）和无症状性部分脾梗死（n = 1））。
RenACAGA技术成功用于肾肿瘤消融。有必要进一步研究以确定该技术在改善肿瘤可视化、靶向性、消融边缘评估以及与栓塞术联合应用方面的潜在优势。
