The role of radiologic imaging and biopsy in renal tumor ablation

Purpose: The rate of unintentionally discovered renal masses has been increasing along with a parallel increased incidence of renal cell carcinoma both in men and women. Ablation therapy has emerged as an alternative for the treatment of these small renal tumors. Several techniques have been developed for renal tumor ablation with cryoablation (CA) and radiofrequency ablation (RFA) being among the most widely used and studied. The purpose of this article is to review the role of imaging and renal mass biopsy in renal tumor ablation with focus on CA and RFA. Methods: We performed a PubMed^® database search from January 2000 to January 2010 using the terms: renal tumor ablation, renal biopsy, indications, imaging, computed tomography (CT) guided, magnetic resonance imaging (MRI) guided and ultrasound (US) guided. Conclusion: Nephron-sparing procedures, such as cryoablation and RFA, offer an adequate treatment option for selected patients. Imaging techniques such as ultrasonography, CT and MRI are critical to targeting thermal ablation of renal masses. Intra-operative biopsy prior to treatment is becoming a standard procedure but controversy remains regarding pre-operative biopsy. Additionally, contradictory data exist on the value of post-ablation biopsy.