Transarterial ethiodised oil marking before CT-guided renal cryoablation: evaluation of tumour visibility in various renal cell carcinoma subtypes

• Published in: Clinical radiology 2023-04, Vol.78 (4), p.279-285
• Main Authors: Tsuji, Y., Miura, H., Hirota, T., Ota, Y., Yamashita, M., Asai, S., Fujihara, A., Hongo, F., Ukimura, O., Yamada, K.
• Format: Article
• Language: English
• Subjects: Carcinoma, Renal Cell - diagnostic imaging; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - surgery; Cryosurgery; Diagnosis, Differential; Ethiodized Oil; Humans; Kidney Neoplasms - diagnostic imaging; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Retrospective Studies; Tomography, X-Ray Computed
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2022.12.010

To evaluate ethiodised oil retention of transarterial embolisation using ethiodised oil (ethiodised oil marking) before computed tomography (CT)-guided percutaneous cryoablation (PCA) according to renal cell carcinoma (RCC) subtype. Ethiodised oil marking was performed 1–3 days before PCA in 99 patients with 99 RCCs from 2016 to 2020. Ethiodised oil retention on CT images was evaluated retrospectively and CT attenuation values in the tumour were measured. Regions of interest (ROI) were placed on the tumours to calculate: average (ROI-average), maximal (ROI-max), minimum (ROI-min), and standard deviation (ROI-SD). Qualitative scores comprising a five-point scale (5, excellent; 1, poor) were evaluated for the retention scores (RS) of ethiodised oil in the tumour (ethiodised oil-RS) and the visualisation scores (VS) of the boundary between the tumour and renal parenchyma (boundary-VS). The histological subtypes comprised clear cell (ccRCC; n=85), papillary (pRCC; n=6), and chromophobe/oncocytoma renal cell carcinoma (chrRCC; n=8). The mean ROI-average, ROI-max, and ROI-SD were significantly higher in ccRCCs than in chrRCCs and pRCCs (p4 in all subtypes. Even with poor intratumour ethiodised oil retention (n=6), sufficient boundary-VS was obtained due to “inverted marking.” All PCA procedures were completed without additional intravenous contrast material injection at the time of PCA. Regardless of the tumour subtypes, ethiodised oil marking aids in visualising the boundary between the tumour and parenchyma on non-contrast CT in PCA. •Ethiodized oil marking is useful in cryoablation for renal cell carcinomas.•The ethiodized oil retention patterns depend on subtypes of the tumor.•Ethiodized oil marking aids in good visibility regardless of tumor subtype.