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CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2019; 3(02): 50-57
DOI: 10.4103/AJIR.AJIR_6_19
Review Article

How We Do It: Adrenal Biopsy and Ablation

Ashraf Thabet
Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, Boston, MA, USA
,
Rita Lahoud
Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, Boston, MA, USA
,
Khalid Shaqdan
Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, Boston, MA, USA
,
Ronald S. Arellano
Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, Boston, MA, USA
,
Raul N. Uppot
Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, Boston, MA, USA
› Author Affiliations Financial support and sponsorship Nil.
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Adrenal lesions represent a heterogeneous group of neoplasms that may be benign or malignant. If imaging fails to exclude a lesion as definitely benign or if molecular profiling is required, percutaneous image-guided biopsy may be indicated. When an adrenal lesion requires surgical resection, some patients are found to be too high at surgical risk or some patients may refuse adrenalectomy. Image-guided percutaneous thermal ablation can be an effective alternative – radiofrequency, microwave, and cryoablation have all been described in literature for the successful treatment of adrenal tumors. In this article, technical and clinical factors that reduce the risk of complications, some unique to the adrenal gland, are discussed.

Ablation - adrenal - biopsy - cryoablation - hypertensive crisis - microwave - radiofrequency


Publication History

Article published online:
26 March 2021

© 2019. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Sharma KV, Venkatesan AM, Swerdlow D, DaSilva D, Beck A, Jain N, et al. Image-guided adrenal and renal biopsy. Tech Vasc Interv Radiol 2010;13:100-9.
  • 2 Song JH, Mayo-Smith WW. Current status of imaging for adrenal gland tumors. Surg Oncol Clin N Am 2014;23:847-61.
  • 3 Venkatesan AM, Locklin J, Dupuy DE, Wood BJ. Percutaneous ablation of adrenal tumors. Tech Vasc Interv Radiol 2010;13:89-99.
  • 4 Adler JT, Meyer-Rochow GY, Chen H, Benn DE, Robinson BG, Sippel RS, et al. Pheochromocytoma: Current approaches and future directions. Oncologist 2008;13:779-93.
  • 5 Ethier MD, Beland MD, Mayo-Smith W. Image-guided ablation of adrenal tumors. Tech Vasc Interv Radiol 2013;16:262-8.
  • 6 Wolf FJ, Dupuy DE, Machan JT, Mayo-Smith WW. Adrenal neoplasms: Effectiveness and safety of CT-guided ablation of 23 tumors in 22 patients. Eur J Radiol 2012;81:1717-23.
  • 7 Allolio B, Fassnacht M. Clinical review: Adrenocortical carcinoma: Clinical update. J Clin Endocrinol Metab 2006;91:2027-37.
  • 8 Fintelmann FJ, Tuncali K, Puchner S, Gervais DA, Thabet A, Shyn PB, et al. Catecholamine surge during image-guided ablation of adrenal gland metastases: Predictors, consequences, and recommendations for management. J Vasc Interv Radiol 2016;27:395-402.
  • 9 Gupta S, Wallace MJ, Cardella JF, Kundu S, Miller DL, Rose SC, et al. Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol 2010;21:969-75.
  • 10 Ahmed M, Solbiati L, Brace CL, Breen DJ, Callstrom MR, Charboneau JW, et al. Image-guided tumor ablation: Standardization of terminology and reporting criteria – A 10-year update. Radiology 2014;273:241-60.
  • 11 Dunnick NR, Leight GS Jr., Roubidoux MA, Leder RA, Paulson E, Kurylo L, et al. CT in the diagnosis of primary aldosteronism: Sensitivity in 29 patients. AJR Am J Roentgenol 1993;160:321-4.
  • 12 Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB, et al. Adrenocortical carcinoma: The range of appearances on CT and MRI. AJR Am J Roentgenol 2011;196:W706-14.
  • 13 Krücker J, Xu S, Venkatesan A, Locklin JK, Amalou H, Glossop N, et al. Clinical utility of real-time fusion guidance for biopsy and ablation. J Vasc Interv Radiol 2011;22:515-24.
  • 14 Patel IJ, Davidson JC, Nikolic B, Salazar GM, Schwartzberg MS, Walker TG, et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 2012;23:727-36.
  • 15 Patel IJ, Davidson JC, Nikolic B, Salazar GM, Schwartzberg MS, Walker TG, et al. Addendum of newer anticoagulants to the SIR consensus guideline. J Vasc Interv Radiol 2013;24:641-5.
  • 16 Welch TJ, Sheedy PF 2nd, Stephens DH, Johnson CM, Swensen SJ. Percutaneous adrenal biopsy: Review of a 10-year experience. Radiology 1994;193:341-4.
  • 17 Mayo-Smith WW, Dupuy DE. Adrenal neoplasms: CT-guided radiofrequency ablation – Preliminary results. Radiology 2004;231:225-30.
  • 18 Johnson SP, Bagrosky BM, Mitchell EL, McIntyre RC Jr., Grant NG. CT-guided radiofrequency ablation of an aldosterone-secreting primary adrenal tumor in a surgically unfit patient. J Vasc Interv Radiol 2008;19:1115-7.
  • 19 Venkatesan AM, Locklin J, Lai EW, Adams KT, Fojo AT, Pacak K, et al. Radiofrequency ablation of metastatic pheochromocytoma. J Vasc Interv Radiol 2009;20:1483-90.
  • 20 Abbas A, Idriz S, Railton NJ, McGill N, Nasruddin AB, Sandeman DD, et al. Image-guided ablation of Conn's adenomas in the management of primary hyperaldosteronism. Clin Radiol 2013;68:279-83.
  • 21 Carrafiello G, Laganà D, Recaldini C, Giorgianni A, Ianniello A, Lumia D, et al. Imaging-guided percutaneous radiofrequency ablation of adrenal metastases: Preliminary results at a single institution with a single device. Cardiovasc Intervent Radiol 2008;31:762-7.
  • 22 Yamakado K. Image-guided ablation of adrenal lesions. Semin Intervent Radiol 2014;31:149-56.
  • 23 Chini EN, Brown MJ, Farrell MA, Charboneau JW. Hypertensive crisis in a patient undergoing percutaneous radiofrequency ablation of an adrenal mass under general anesthesia. Anesth Analg 2004;99:1867-9.
  • 24 Efremidis SC, Harsoulis F, Douma S, Zafiriadou E, Zamboulis C, Kouri A, et al. Adrenal insufficiency with enlarged adrenals. Abdom Imaging 1996;21:168-71.
  • 25 Wood BJ, Abraham J, Hvizda JL, Alexander HR, Fojo T. Radiofrequency ablation of adrenal tumors and adrenocortical carcinoma metastases. Cancer 2003;97:554-60.
  • 26 Simon CJ, Dupuy DE, Mayo-Smith WW. Microwave ablation: Principles and applications. Radiographics 2005;25 Suppl 1:S69-83.