Purpose

To assess the ability of the Percutaneous Renal Ablation Complexity (P-RAC) scoring system to predict procedural complexity or adverse events (AEs) in adult patients undergoing percutaneous thermal ablation of renal tumors.

Materials and Methods

A retrospective review of 240 consecutive adult patients who underwent percutaneous thermal renal ablation from 2004 to 2018 was conducted. The P-RAC score was calculated for each renal tumor and procedural complexity recorded. A correlation coefficient was calculated for the P-RAC score and both the number of probes used and procedural duration. Receiver operating characteristic curves assessed the score’s ability to predict the use of adjunctive techniques and/or major AEs, classified according to the Society of Interventional Radiology guidelines.

Results

For the entire cohort, there was a weak correlation between P-RAC scores and both the number of probes used (r = 0.31; P < .001) and procedural duration (r = 0.18; P = .03). When evaluating only patients treated with microwave ablation (MWA), no correlation between P-RAC scores and either the number of probes (P = .7) used or procedural duration (P = .4) was found. The area under the curve (AUC) for the P-RAC score to predict the use of adjunctive techniques was 0.55 and 0.53 for the entire cohort and MWA group, respectively. The AUC for the P-RAC score to predict major AEs was 0.70, 0.71, and 0.73 for the entire cohort, MWA group, and cryoablation group, respectively.

Conclusions

The P-RAC scoring system is limited in its ability to predict percutaneous thermal renal tumor ablation procedural complexity, especially in patients treated with MWA. The scoring system may have a role in identifying patients at risk of major AEs.

中文翻译：

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接受经皮冷冻消融或微波消融肾肿瘤患者经皮肾消融复杂性评分系统的外部验证

目的

评估经皮肾消融复杂性 (P-RAC) 评分系统预测接受肾肿瘤经皮热消融的成年患者手术复杂性或不良事件 (AE) 的能力。

材料和方法

对 2004 年至 2018 年接受经皮热肾消融术的 240 名连续成年患者进行了回顾性研究。计算每个肾肿瘤的 P-RAC 评分并记录程序的复杂性。计算 P-RAC 评分与使用的探针数量和程序持续时间的相关系数。接受者操作特征曲线评估了分数预测辅助技术和/或主要 AE 的使用的能力，根据介入放射学会指南进行分类。

结果

对于整个队列，P-RAC 评分与使用的探针数量 ( r  = 0.31；P < .001) 和手术持续时间 ( r  = 0.18；P  = .03) 之间存在弱相关性。 当仅评估接受微波消融 (MWA) 治疗的患者时，未发现P-RAC 评分与使用的探头数量 ( P  = .7) 或手术持续时间 ( P = .4) 之间存在相关性。对于整个队列和 MWA 组，P-RAC 评分预测辅助技术使用的曲线下面积 (AUC) 分别为 0.55 和 0.53。对于整个队列、MWA 组和冷冻消融组，P-RAC 评分预测主要 AE 的 AUC 分别为 0.70、0.71 和 0.73。

结论

P-RAC 评分系统在预测经皮热肾肿瘤消融程序复杂性方面的能力有限，尤其是在接受 MWA 治疗的患者中。评分系统可能在识别处于主要 AE 风险中的患者方面发挥作用。