Percutaneous computed tomography (CT) -guided cryoablation is an effective curative treatment for renal cell carcinoma. Improvements in treatment efficacy reflect not only the learning curve but also the integration of multiple adjunctive techniques that can be implemented at different stages of the procedure. Tumour targeting can be enhanced by intravenous contrast administration, or by intra-arterial delivery of contrast medium or iodized oil. Fusion imaging is another option to improve tumour delineation by registering intraprocedural CT with prior cross-sectional imaging. Probe placement for difficult-to-access lesions may be facilitated by alternative access routes, while electromagnetic navigation and robotic systems are being developed as alternatives to manual advancement. To mitigate the cold-sink effect and reduce bleeding risk, transarterial techniques such as embolization or temporary arterial occlusion can be added. Finally, thermoprotective manoeuvres are increasingly used to displace adjacent organs, thereby improving the feasibility, safety, and efficacy of renal cryoablation.
Cancers. 2026 Mar 13*** epublish ***
Julien Garnon, Pierre-Alexis Autrusseau, Theo Mayer, Gregory Bertucci, Thomas Fournaise, Julia Weiss
Service de Radiologie, Centre de Lutte Contre le Cancer, Institut Strauss, 67200 Strasbourg, France., Service de Radiologie, Centre Hospitalier de Polynésie Française, Pirae, 98716 Papeete, France., Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 67200 Strasbourg, France.