Focal renal therapy for small renal masses (T1a or T 1b) has been used as primary treatment for patients with comorbidities who are considered poor candidates for surgical resection. With a continuing effort toward optimization of minimally invasive nephron-sparing modalities, the effort to expand the patient pool will continue. As long-term results of renal ablative therapies become available and the safety, precision, and efficacy become well established, renal ablation may be used with increasing frequency for a wider group of patients. When this happens, high-quality imaging for localization and targeting of these renal lesions will become the central core of the treatment, with emphasis on superior results, accurate positioning of the probe, precise localization of the tumor, and real-time intraoperative monitoring of outcomes.
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