Renal Upper Pole IGTA

 Image-Guided Thermal Ablation of Upper Pole Renal Lesions ≤4 cm: Safety and Effectiveness

🔍 **Clinical Question:**  

To compare the safety and effectiveness of image-guided thermal ablation (IGTA) for upper pole versus nonupper pole renal lesions ≤4 cm given the technical challenges of the former.

💡 **Key Insight:**  

Upper pole renal lesions ≤4 cm treated with image-guided thermal ablation showed comparable adverse event rates to nonupper pole lesions (Grade 3 [severe], 2.4% vs 1.3%, P > .99).

Primary effectiveness was 100% for upper pole lesions versus 97.3% for nonupper pole lesions (P = .54), with no difference in 3-year overall survival (92.9% vs 87.0%, P = .22) and local progression-free survival (90.0% vs 100.0%, P = .17).

Polar location (upper vs nonupper) and R.E.N.A.L./m.R.E.N.A.L. nephrometry scores had no association with adverse events or local progression.

👉 **Why it matters:**  

Image-guided thermal ablation for upper pole renal lesions ≤ 4 cm demonstrated safety and oncologic outcomes comparable to non-upper pole lesions despite its increased technical complexity. Polar location alone should not exclude patients from consideration for image-guided thermal ablation.

➡️ **Full Article:** 

https://doi.org/10.1016/j.jvir.2025.10.026

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