Radiofrequency Ablation Followup

Standard follow-up of patients includes computed tomography or magnetic resonance imaging with and without intravenous contrast at 6 weeks, 6 months, 12 months, and then every 6 months thereafter. With increasing experience, we anticipate that less frequent imaging will be necessary. Ablation is successful if the lesion along with a margin of normal parenchyma no longer enhances on contrast imaging (<10-12 HU). For treatment failures, our protocol is either to retreat or surgical extirpation. This decision is based on the location of the failure, the response to the original treatment and the patient's health and preference. For the radiofrequency-assisted partial nephrectomy group, surveillance is similar to that of conventional partial nephrectomy patients.

During laparoscopic radiofrequency ablation, incisional biopsies which have a higher diagnostic rate than needle core biopsies can also be obtained using a laparoscopic 5-mm cup biopsy instrument.

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