External Validation of the Percutaneous Renal Ablation Complexity Scoring System in Patients Undergoing Percutaneous Cryoablation or Microwave Ablation of Renal Tumors

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.

Automated summary

The P-RAC scoring system has limited ability in predicting procedural complexity in percutaneous thermal renal tumor ablation, especially in patients treated with microwave ablation (MWA). However, the scoring system may be useful in identifying patients at risk of major adverse events (AEs).