Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:HonShideler; Curtis, Coffin, Breyen, Guez, David Pages: 241 - 245 Abstract: This review explores the applications of contrast-enhanced ultrasound (CEUS) in interventional radiology, focusing on its role in endoleak detection after endovascular abdominal aortic aneurysm repair (EVAR), periprocedural thermal ablation guidance, and transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). CEUS offers a dynamic assessment for the detection of endoleak following EVAR, facilitating accurate diagnosis and classification. In periprocedural thermal ablation, CEUS enhances target lesion delineation with the visualization of real-time perfusion changes, optimizing treatment strategies and reducing residual tumor rates. Finally, CEUS has demonstrated efficacy in intraprocedural evaluation and postprocedural follow-up in TACE for HCC, offering early detection of residual tumor enhancement and providing an alternative for patients with contraindications to contrast-enhanced computed tomography or magnetic resonance imaging. Overall, CEUS is a versatile and valuable tool with many applications to offer interventional radiologists enhanced diagnostic capabilities and improved patient management. Citation: Semin intervent Radiol 2024; 41: 241-245 PubDate: 2024-08-19T22:15:52+01:00 DOI: 10.1055/s-0044-1787833 Issue No:Vol. 41, No. 03 (2024)
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Authors:Rouzbahani; Maedeh, Husnain, Ali, Badar, Wali, Ahmed, Osman Pages: 246 - 251 Abstract: Osteoarthritis (OA) of the knee is a degenerative condition impacting numerous individuals globally. Genicular artery embolization (GAE) has emerged as an effective minimally invasive therapy for managing medically refractory OA-related pain in patients who are not eligible for surgery. This intervention works by disrupting the inflammatory and neoangiogenic pathways that contribute to pain. The efficacy of GAE has been demonstrated in various clinical trials, yielding promising results. This review aims to explore recent advancements in the embolic materials used during GAE, examining their properties and potential benefits. Additionally, it will describe the use of pre-, intra-, and postprocedural imaging—particularly magnetic resonance imaging and other modalities—to optimize GAE outcomes. Citation: Semin intervent Radiol 2024; 41: 246-251 PubDate: 2024-08-19T22:15:53+01:00 DOI: 10.1055/s-0044-1788029 Issue No:Vol. 41, No. 03 (2024)
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Authors:May; Benjamin J., Charalel, Resmi A. Pages: 252 - 257 Abstract: Transarterial treatment of liver tumors is becoming increasingly common and is considered first- or second-line therapy for many tumor types and stages. Such therapies are heavily dependent on imaging during the procedures; while angiography remains the mainstay of intraprocedural therapies, cone beam computed tomography (CBCT) is becoming increasingly commonly used to guide therapy. This article describes the role of CBCT during transarterial therapies and offers guidance as to how CBCT can be optimally used for these procedures. Citation: Semin intervent Radiol 2024; 41: 252-257 PubDate: 2024-08-19T22:15:53+01:00 DOI: 10.1055/s-0044-1788006 Issue No:Vol. 41, No. 03 (2024)
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Authors:Hammett; J. Tyler, Patel, Milan N., Odisio, Bruno C., Shah, Ketan Pages: 258 - 262 Abstract: Image-guided ablation procedures have become a mainstay in cancer therapy. Typically performed from a percutaneous approach, thermal-based ablation procedures rely heavily on imaging guidance both prior to and during the procedure itself. Advances in imaging as they relate to ablation procedures are as important to successful treatments as advancements in the ablation technology itself. Imaging as it relates to procedural planning, targeting and monitoring, and assessment of procedural endpoint is the focus of this article. Citation: Semin intervent Radiol 2024; 41: 258-262 PubDate: 2024-08-19T22:15:55+01:00 DOI: 10.1055/s-0044-1788058 Issue No:Vol. 41, No. 03 (2024)
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Authors:Lindquist; Jonathan, Hart, James, Marchak, Katherine, Bent Robinson, Eduardo, Trivedi, Premal Pages: 263 - 269 Abstract: Hemorrhoid disease is very common, affecting greater than one-third of adults. Conservative management and several office-based procedures are useful in the treatment of internal hemorrhoids. Patients with refractory hemorrhoid disease have traditionally been treated with surgical hemorrhoidectomy. Rectal artery embolization has emerged as an alternative to surgical hemorrhoidectomy and has been shown to be safe and effective in case series and clinical trials completed over the past decade. Embolization has significantly less postprocedure pain when compared with surgical hemorrhoidectomy with similar outcomes. Pre- and postprocedure imaging are not routinely performed. Intraprocedural imaging consists of selective catheterization of the superior rectal arteries from the inferior mesenteric artery, and the middle rectal arteries from the internal iliac artery. The inferior rectal artery is seldom embolized due to the supply of the levator ani muscle and skin. To date, intermediate and large particles and fibered and nonfibered coils have been used successfully. Citation: Semin intervent Radiol 2024; 41: 263-269 PubDate: 2024-08-19T22:15:53+01:00 DOI: 10.1055/s-0044-1788056 Issue No:Vol. 41, No. 03 (2024)
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Authors:Kumari; Divya, Bruyn, Elise de, Al-Qawasmi, Faisal Pages: 270 - 277 Abstract: Neuroendocrine tumors are an indolent, heterogeneous group of tumors that primarily arise from the gastropancreatic tract and lungs. Most patients present with liver metastases at the time of diagnosis, which cause significant morbidity and mortality due to excess hormone secretion, bile duct obstruction, and liver damage. A small percentage of these patients are eligible for potential cure through surgical resection. However, interventional radiology provides liver-directed therapies, such as percutaneous ablation, transarterial embolization, chemoembolization, and radioembolization, for palliative care and potential bridging to debulking and surgical resection of neuroendocrine liver metastases. This article aims to provide a brief overview of these liver-directed therapies focusing on the pre-, intra-, and postprocedural imaging findings. Citation: Semin intervent Radiol 2024; 41: 270-277 PubDate: 2024-08-19T22:15:54+01:00 DOI: 10.1055/s-0044-1788338 Issue No:Vol. 41, No. 03 (2024)
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Authors:Husnain; Ali, Aadam, Aziz, Borhani, Amir, Riaz, Ahsun Pages: 278 - 292 Abstract: Percutaneous endoscopy of the biliary system (cholangioscopy) and gallbladder (cholecystoscopy) has significantly impacted diagnostic and therapeutic approaches to many diseases in interventional radiology, overcoming previous challenges related to scope size and rigidity. The current endoscopes offer enhanced maneuverability within narrow tubular structures such as bile ducts. Before endoscopy, reliance on 2D imaging modalities limited real-time visualization during percutaneous procedures. Percutaneous endoscopy provides 3D perspectives, enabling a better appreciation of normal structures, targeted biopsy of lesions, and accurate deployment of therapeutic interventions. This review aims to explore percutaneous endoscopic findings across various biliary and gallbladder pathologies. Citation: Semin intervent Radiol 2024; 41: 278-292 PubDate: 2024-08-19T22:15:55+01:00 DOI: 10.1055/s-0044-1788340 Issue No:Vol. 41, No. 03 (2024)
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Authors:Park; Tyler, Huber, Timothy, Marchak, Katherine, Hart, James, Walker, Lisa Pages: 293 - 301 Abstract: Thyroid radiofrequency ablation (RFA) is a minimally invasive procedure that can be used to treat patients with benign thyroid nodules and is a good alternative to thyroidectomy or radioactive iodine. Thyroid RFA is commonly performed with local lidocaine or minimal/moderate sedation and has a minimal risk profile and few side effects. The efficacy of thyroid RFA has been well documented in the literature, with a volume reduction rate of 67 to 75% at 1 year. Another emerging technique for nodule size reduction is thyroid artery embolization which is a minimally invasive procedure that may be performed in patients with nodular goiters, particularly with substernal thyroid nodule extension, and who are either poor surgical candidates or do not want surgery. This article reviews thyroid RFA, focusing on the relevant preprocedural, procedural, and postprocedural imaging, as well as a discussion on the emerging role of thyroid artery embolization. Citation: Semin intervent Radiol 2024; 41: 293-301 PubDate: 2024-08-19T22:15:56+01:00 DOI: 10.1055/s-0044-1788339 Issue No:Vol. 41, No. 03 (2024)
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Authors:Bibok; Andras, Kis, Bela, Parikh, Nainesh Pages: 302 - 308 Abstract: Prostate artery embolization (PAE) is a technically challenging angiographic therapy that has been shown to have excellent clinical outcomes for men with benign prostatic hyperplasia and lower urinary tract symptoms. Although clinical outcomes have been well documented, several questions remain regarding various technical details of the procedure. This article is a brief review of indications and technical parameters of PAE as well as commonly debated topics throughout the literature. Finally, the article serves to report tips and tricks from a high-volume center. Citation: Semin intervent Radiol 2024; 41: 302-308 PubDate: 2024-08-19T22:15:56+01:00 DOI: 10.1055/s-0044-1788622 Issue No:Vol. 41, No. 03 (2024)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:Freeman; Toliver, Pena, Olivia, Sag, Alan Alper, Young, Shamar Pages: 105 - 112 Abstract: Thyroid cancer is the most common endocrine malignancy, and its incidence is increasing, driven in part by the advent of ultrasound, and subsequent increased detection of small, early thyroid cancers. Yet even for small tumors, thyroidectomy with lymph node dissection remains standard of care. Specific to well-differentiated thyroid cancer, surgery has come under scrutiny as a possible overtreatment, in light of stable and favorable survival rates even as guidelines have allowed fewer radical resections and lymph node dissections over time. Moreover, thyroid cancer unfortunately has a known recurrence rate regardless of therapy, and surgical re-intervention for local structural recurrence is eventually limited by scar. Radioactive iodine therapy, another accepted treatment, is minimally invasive but can only treat patients with iodine-avid tumors. For all of these reasons, image-guided thermal ablation has emerged as a valuable complementary tool as a thyroid-sparing, parathyroid-sparing, voice-sparing, repeatable, minimally invasive outpatient focal therapy for both primary and recurrent well-differentiated thyroid cancers. However, the data are still evolving, and this represents a new patient cohort for some interventional radiologists. Therefore, the goal of this review is to discuss the technique and evidence for ablation of patients with thyroid cancer. Citation: Semin intervent Radiol 2024; 41: 105-112 PubDate: 2024-07-10T22:43:33+01:00 DOI: 10.1055/s-0044-1786537 Issue No:Vol. 41, No. 02 (2024)
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Authors:Chlorogiannis; David-Dimitris, Charalampopoulos, Georgios, Bale, Reto, Odisio, Bruno, Wood, Bradford J., Filippiadis, Dimitrios K. Pages: 113 - 120 Abstract: Interventional oncology is routinely tasked with the feat of tumor characterization or destruction, via image-guided biopsy and tumor ablation, which may pose difficulties due to challenging-to-reach structures, target complexity, and proximity to critical structures. Such procedures carry a risk-to-benefit ratio along with measurable radiation exposure. To streamline the complexity and inherent variability of these interventions, various systems, including table-, floor-, gantry-, and patient-mounted (semi-) automatic robotic aiming devices, have been developed to decrease human error and interoperator and intraoperator outcome variability. Their implementation in clinical practice holds promise for enhancing lesion targeting, increasing accuracy and technical success rates, reducing procedure duration and radiation exposure, enhancing standardization of the field, and ultimately improving patient outcomes. This narrative review collates evidence regarding robotic tools and their implementation in interventional oncology, focusing on clinical efficacy and safety for nonhepatic malignancies. Citation: Semin intervent Radiol 2024; 41: 113-120 PubDate: 2024-07-10T22:43:33+01:00 DOI: 10.1055/s-0044-1786724 Issue No:Vol. 41, No. 02 (2024)
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Authors:Fish; Adam G., Madoff, David C. Pages: 121 - 128 Abstract: Lung cancer continues to be the third leading cause of cancer and the leading cause of cancer deaths. As the field of interventional oncology continues to grow, interventional radiologists are increasingly treating lung cancer patients. Involvement begins with tissue diagnosis for which biomarkers and immunohistochemistry are used to guide selective and advanced medical therapies. An interventional radiologist must be aware of the rationale behind tissue diagnosis and techniques to minimize biopsy complications. Staging is an important part of tumor board conversations and drives treatment pathways. Surgical therapy remains the gold standard for early-stage disease but with an aging population the need for less invasive treatments such as radiation therapy and ablation continue to grow. The interventionalist must be aware of the indications, techniques, and pre- and posttherapy managements for percutaneous ablation. Endovascular therapy is broadly divided into therapeutic treatment of lung cancer, which is gaining traction, and treatment of lung cancer complications such as hemoptysis. This review aims to provide a good basis for interventional radiologists treating lung cancer patients. Citation: Semin intervent Radiol 2024; 41: 121-128 PubDate: 2024-07-10T22:43:35+01:00 DOI: 10.1055/s-0044-1786725 Issue No:Vol. 41, No. 02 (2024)
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Authors:Deipolyi; Amy R., Ward, Robert C. Pages: 129 - 134 Abstract: Percutaneous image-guided locoregional therapies are emerging in the treatment of primary and metastatic breast cancer. Cryoablation has emerged as the dominant ablative approach as an alternative to surgery for primary breast cancer in patients who do not wish to have surgery or are poor surgical candidates. Cryoablation is well tolerated and provides excellent local control and cosmesis. Thermal ablation may also be used in the treatment of oligometastatic breast cancer, allowing patients to achieve long disease-free intervals. Transarterial therapies have been studied in the treatment of oligoprogressive hepatic metastasis, though further supportive data would be helpful to demonstrate its efficacy. Citation: Semin intervent Radiol 2024; 41: 129-134 PubDate: 2024-07-10T22:43:34+01:00 DOI: 10.1055/s-0044-1786730 Issue No:Vol. 41, No. 02 (2024)
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Authors:Quek; Lawrence Han Hwee, Chan, Lester Wai Mon, Pua, Uei Pages: 135 - 143 Abstract: Desmoid tumors (DTs) are rare fibroblastic proliferations, characterized by infiltrative growth and a propensity for local recurrence. Traditional strategies such as surgery, radiotherapy, and chemotherapy are the mainstays of treatment, each with its limitations and associated risks. The trend in DT management leans toward a “wait-and-see” strategy, emphasizing active surveillance supported by continuous MRI monitoring. This approach acknowledges the unpredictable nature of the disease, and a multidisciplinary management of DT requires a nuanced approach, integrating traditional therapies with emerging interventional techniques. This review highlights the emerging role of minimally invasive interventional radiological technologies and discusses interventional radiology techniques, including chemical, radiofrequency, microwave, cryoablation, and high-intensity focused ultrasound ablations as well as transarterial embolization. Citation: Semin intervent Radiol 2024; 41: 135-143 PubDate: 2024-07-10T22:43:36+01:00 DOI: 10.1055/s-0044-1786813 Issue No:Vol. 41, No. 02 (2024)
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Authors:Chan; Vinson Wai-Shun, Ng, Helen Hoi-Lam, Wah, Tze Min Pages: 144 - 153 Abstract: Image-guided ablation (IGA) is a rapidly developing field in interventional oncology. There is some evidence suggesting IGA's non-inferiority compared with partial or radical nephrectomy for the treatment of small renal masses (SRM). However, these are mostly limited to retrospective cohort studies. This review article outlines the evidence comparing IGA to partial nephrectomy by collating the different survival measures and evaluates the challenges of producing clinical trials and high-quality evidence. The main challenges are due to the heterogeneity of SRM, patient selection bias, unstandardized endpoint and outcomes, and the lack of global practice standards. Despite the evidence thus far demonstrating that IGA stands as a non-inferior treatment modality for SRMs, exhibiting favorable short- and long-term outcomes, further robust research is needed to integrate ablation techniques into routine clinical practice with a multidisciplinary approach. There is emerging evidence that suggests randomized controlled trial in SRMs is possible, and technologies such as histotripsy as well as artificial intelligence are used in IGA. Citation: Semin intervent Radiol 2024; 41: 144-153 PubDate: 2024-07-10T22:43:34+01:00 DOI: 10.1055/s-0044-1787163 Issue No:Vol. 41, No. 02 (2024)
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Authors:Jiang; Will, Lee, Sangmin, Caruana, Dennis, Zhuang, Kun Da, Cazzato, Roberto, Latich, Igor Pages: 154 - 169 Abstract: Painful skeletal osteolytic metastases, impending pathological fractures, and nondisplaced fractures present as a devastating clinical problem in advanced stage cancer patients. Open surgical approaches provide excellent mechanical stabilization but are often associated with high complication rates and slow recovery times. Percutaneous minimally invasive interventions have arisen as a pragmatic and logical treatment option for patients with late-stage cancer in whom open surgery may be contraindicated. These percutaneous interventions minimize soft tissue dissection, allow for the immediate initiation or resumption of chemotherapies, and present with fewer complications. This review provides the most up-to-date technical and conceptual framework for the minimally invasive management of osseous metastases with particular focus on periacetabular lesions. Fundamental topics discussed are as follows: (1) pathogenesis of cancer-induced bone loss and the importance of local cytoreduction to restore bone quality, (2) anatomy and biomechanics of the acetabulum as a weight-bearing zone, (3) overview of ablation options and cement/screw techniques, and (4) combinatorial approaches. Future studies should include additional studies with more long-term follow-up to better assess mechanical durability of minimally invasive interventions. An acetabulum-specific functional and pain scoring framework should be adopted to allow for better cross-study comparison. Citation: Semin intervent Radiol 2024; 41: 154-169 PubDate: 2024-07-10T22:43:36+01:00 DOI: 10.1055/s-0044-1787165 Issue No:Vol. 41, No. 02 (2024)
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Authors:Tomasian; Anderanik, Levy, Jason, Jennings, Jack W. Pages: 170 - 175 Abstract: Vertebral augmentation and thermal ablation offer radiologists a robust minimally invasive option for treatment of patients with spinal metastases. Such interventions are commonly combined and have proved safe and effective in the management of selected patients with vertebral metastases with durable treatment effects. Special attention to procedure techniques including choice of vertebral augmentation technique, choice of ablation modality, and thermal protection is essential for improved patient outcomes. This article provides a review of the most recent advances in vertebral augmentation and thermal ablation for the treatment of spinal metastases. Citation: Semin intervent Radiol 2024; 41: 170-175 PubDate: 2024-07-10T22:43:35+01:00 DOI: 10.1055/s-0044-1787166 Issue No:Vol. 41, No. 02 (2024)
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Authors:Vos; Danielle J. W., Ruarus, Alette H., Timmer, Florentine E. F., Geboers, Bart, Bagla, Sandeep, Belfiore, Giuseppe, Besselink, Marc G., Leen, Edward, Martin II, Robert C. G., Narayanan, Govindarjan, Nilsson, Anders, Paiella, Salvatore, Weintraub, Joshua L., Wiggermann, Philipp, Scheffer, Hester J., Meijerink, Martijn R. Pages: 176 - 219 Abstract: Since no uniform treatment protocol for pancreatic irreversible electroporation (IRE) exists, the heterogeneity throughout literature complicates the comparison of results. To reach agreement among experts, a consensus study was performed. Eleven experts, recruited according to predefined criteria regarding previous IRE publications, participated anonymously in three rounds of questionnaires according to a modified Delphi technique. Consensus was defined as having reached ≥80% agreement. Response rates were 100, 64, and 64% in rounds 1 to 3, respectively; consensus was reached in 93%. Pancreatic IRE should be considered for stage III pancreatic cancer and inoperable recurrent disease after previous local treatment. Absolute contraindications are ventricular arrhythmias, implantable stimulation devices, congestive heart failure NYHA class 4, and severe ascites. The inter-electrode distance should be 10 to 20 mm and the exposure length should be 15 mm. After 10 test pulses, 90 treatment pulses of 1,500 V/cm should be delivered continuously, with a 90-µs pulse length. The first postprocedural contrast-enhanced computed tomography should take place 1 month post-IRE, and then every 3 months. This article provides expert recommendations regarding patient selection, procedure, and follow-up for IRE treatment in pancreatic malignancies through a modified Delphi consensus study. Future studies should define the maximum tumor diameter, response evaluation criteria, and the optimal number of preoperative FOLFIRINOX cycles. Citation: Semin intervent Radiol 2024; 41: 176-219 PubDate: 2024-07-10T22:43:37+01:00 DOI: 10.1055/s-0044-1787164 Issue No:Vol. 41, No. 02 (2024)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
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