Adrenal metastasis (2025 – CME) – online course
Description
Authors: L. Beyer, R. F. Grasso & M. Pileri
Reviewers: D. Filippiadis, R. T. Hoffmann, M. Mauda-Havakuk, J.Jennings and R. Uberoi.
This course corresponds to chapter 2.2.5.3.1 Malignant chest and abdominal disease in the European Curriculum and Syllabus for Interventional Radiology.
Abstract
This course examines adrenal ablation, emphasizing radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation (CRA) as primary techniques for treating adrenal lesions. The adrenal glands, which are components of the endocrine system, are susceptible to the development of lesions that range in severity from benign adenomas to malignant tumours. RFA induces coagulation necrosis in adrenal tumours using electrical energy. Despite its established safety profile, it presents limitations in terms of ablation volume and temperature increase speed compared to other methods. CRA, which causes cell death by freezing, allows precise ablation zone visualization and reduces the risks to adjacent tissues. MWA, notable for its faster ablation times and larger ablation volumes, is a promising new technique.
This course emphasizes a multidisciplinary approach for patient selection, highlighting the necessity of preprocedural imaging and laboratory tests. Management of hypertensive crises (HC), a common post-ablation complication, particularly post-RFA, is particularly addressed. Postprocedural care focuses on monitoring complications and regular imaging follow-ups, especially for functional tumours such as pheochromocytoma.
The outcomes of these techniques vary and are influenced by tumour size, the treating physician’s expertise, and patient health. This course reviews the efficacy, safety, and long-term outcomes of each method and discusses survival rates and recurrence patterns.
In conclusion, this course presents adrenal ablation as a minimally invasive alternative to surgery, offering healthcare professionals comprehensive knowledge of these techniques, patient selection, procedural complexities, and post-ablation care.
Learning objectives
- Understanding the anatomy of the adrenal glands and their vascularization.
- Understanding the effect of thermal ablation on the adjacent structure and the adverse effects of thermal ablation.
- Learning how to plan optimal procedural access, patient positioning, and relevant image-guidance methods.
- Being able to decide which kind of ablative technology (RFA, MWA, CRA) to use for treatment depending on the size and type of tumour and its imaging, pathology characteristics, and adjacent structures.
- Plan the correct positioning of the probes to achieve optimal adrenal ablation.
- Learn the correct post-operative and clinical management of adrenal ablation
Further information
This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 2.2.5.3.1 Malignant chest and abdominal disease.
The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one hour and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1 European CME credit (ECMEC). The CME accreditation for this course will expire on December 23, 2026. A non-CME accredited version of the course will remain available for two more years.
The acquired CME Certificate will be available in the myCIRSE area under CIRSE Academy.
The enrolment period of this course is linked to the validity of the All-Access Pass.
Release date: January 2025
