Adrenal neoplasms: CT-guided radiofrequency ablation--preliminary results

Abstract

Purpose: To evaluate initial experience with radiofrequency (RF) ablation of adrenal neoplasms.

Materials and methods: Thirteen adrenal masses in 12 patients (bilateral metastases in one patient) were treated with computed tomography (CT)-guided percutaneous RF ablation. Eleven adrenal lesions were metastases (five from lung cancer, four from renal cell carcinoma, and two from melanoma); one lesion was a pheochromocytoma and one was an aldosteronoma. There were 10 men and two women (average age, 58 years; range, 40-77 years) in the study; average adrenal mass diameter was 3.9 cm (range, 1-8 cm). Average number of RF applications per adrenal mass was 2.7 (range, 1-5 applications); average time per application was 7.8 minutes (range, 4-13 minutes). An internally cooled single electrode was used in five sessions; an internally cooled cluster electrode was used in eight sessions.

Results: Average follow-up was 11.2 months (range, 1-46 months). Eleven of 13 lesions were treated successfully with RF ablation after one session. Successful treatment was defined as lack of enhancement of the treated region on follow-up CT images and resolution of the biochemical abnormality in two patients. In two patients with large adrenal lesions (4 and 8 cm in diameter), enhancement of residual tissue was observed after one treatment session; this finding was indicative of residual tumor. One patient with thrombocytopenia that resulted from chemotherapy had a small hematoma, but no transfusion was required. No patient developed hypertension during the RF application. No patient with metastases had recurrent tumor at the treated site, and this lack of recurrence indicated effective local control; 11 patients had progression of metastatic disease at extraadrenal sites.

Conclusion: Preliminary data suggest that CT-guided RF ablation is an effective technique for local control of adrenal neoplasms.