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McEachen JC, Leng S, Atwell TD, Tollefson MK, Friese JL, Wang Z, Murad MH, Schmit GD. Percutaneous Renal Tumor Ablation: Radiation Exposure During Cryoablation and Radiofrequency Ablation. Cardiovasc Intervent Radiol 2015; 39:233-8. [PMID: 26159355 DOI: 10.1007/s00270-015-1169-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 06/17/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Once reserved solely for non-surgical cases, percutaneous ablation is becoming an increasingly popular treatment option for a wider array of patients with small renal masses and the radiation risk needs to be better defined as this transition continues. MATERIALS AND METHODS Retrospective review of our renal tumor ablation database revealed 425 patients who underwent percutaneous ablation for treatment of 455 renal tumors over a 5-year time period. Imparted radiation dose information was reviewed for each procedure and converted to effective patient dose and skin dose using established techniques. Statistical analysis was performed with each ablative technique. RESULTS For the 331 cryoablation procedures, the mean DLP was 6987 mGycm (SD = 2861) resulting in a mean effective dose of 104.7 mSv (SD = 43.5) and the mean CTDIvol was 558 mGy (SD = 439) resulting in a mean skin dose of 563.2 mGy (SD = 344.1). For the 124 RFA procedures, the mean DLP was 3485 mGycm (SD = 1630) resulting in a mean effective dose of 50.3 mSv (SD = 24.0) and the mean CTDIvol was 232 mGy (SD = 149) resulting in a mean skin dose of 233.2 mGy (SD = 117.4). The difference in patient radiation exposure between the two renal ablation techniques was statistically significant (p < 0.001). CONCLUSION Both cryoablation and RFA imparted an average skin dose that was well below the 2 Gy deterministic threshold for appreciable sequela. Renal tumor cryoablation resulted in a mean skin and effective radiation dose more than twice that for RFA. The radiation exposure for both renal tumor ablation techniques was at the high end of the medical imaging radiation dose spectrum.
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Affiliation(s)
- James C McEachen
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
| | - Shuai Leng
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Thomas D Atwell
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Matthew K Tollefson
- Department of Urology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Jeremy L Friese
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Zhen Wang
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - M Hassan Murad
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Grant D Schmit
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
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