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Lv D, Zhou H, Cui F, Wen J, Shuang W. Characterization of renal artery variation in patients with clear cell renal cell carcinoma and the predictive value of accessory renal artery in pathological grading of renal cell carcinoma: a retrospective and observational study. BMC Cancer 2023; 23:274. [PMID: 36966274 PMCID: PMC10039570 DOI: 10.1186/s12885-023-10756-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 03/20/2023] [Indexed: 03/26/2023] Open
Abstract
Objective To explore the characteristics of renal artery variation in patients with renal cell carcinoma and to evaluate the predicting value of accessory renal artery in the pathological grading of renal cell carcinoma. Methods The clinicopathological data of patients with clear cell renal cell carcinoma diagnosed in the Department of Urology of the First Hospital of Shanxi Medical University from September 2019 to March 2023 were retrospectively analyzed. All patients underwent visual three-dimensional model reconstruction from computed tomography images. All kidneys were divided into two groups: the affected kidney and the healthy kidney, and the incidence of renal artery variation in the two groups was analyzed. Then, according to the existence of accessory renal artery in the affected kidney, the patients were divided into two groups, and the relationship between accessory renal artery and clinicopathological features of patients with clear cell renal cell carcinoma was analyzed. Finally, univariate and multivariate logistic regression analyses were performed to determine the predictors of Fuhrman grading of clear cell renal cell carcinoma, and the predictive ability of the model was evaluated by the receiver operating characteristic curve. Results The incidence of renal artery variation and accessory renal artery in the affected kidney was significantly higher than them in the healthy kidney. The patients with accessory renal artery in the affected kidney had larger tumor maximum diameter, higher Fuhrman grade and more exophytic growth. The presence of accessory renal artery on the affected kidney and the maximum diameter of tumor are independent predictors of high-grade renal cell carcinoma. The receiver operating characteristic curve suggests that the model has a good predictive ability. Conclusion The existence of accessory renal artery on the affected kidney may be related to the occurrence and development of clear cell renal cell carcinoma, and can better predict Fuhrman grade of clear cell renal cell carcinoma. The finding provides a reference for the future diagnostic evaluation of RCC, and provides a new direction for the study of the pathogenesis of RCC.
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Affiliation(s)
- Dingyang Lv
- grid.452461.00000 0004 1762 8478Department of Urology, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Yingze District, Taiyuan, Shanxi Province China
- grid.452461.00000 0004 1762 8478First Clinical Medical College of Shanxi Medical University, No. 56 Xinjian South Road, Yingze District, Taiyuan, Shanxi Province China
| | - Huiyu Zhou
- grid.452461.00000 0004 1762 8478Department of Urology, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Yingze District, Taiyuan, Shanxi Province China
- grid.452461.00000 0004 1762 8478First Clinical Medical College of Shanxi Medical University, No. 56 Xinjian South Road, Yingze District, Taiyuan, Shanxi Province China
| | - Fan Cui
- grid.452461.00000 0004 1762 8478Department of Urology, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Yingze District, Taiyuan, Shanxi Province China
- grid.452461.00000 0004 1762 8478First Clinical Medical College of Shanxi Medical University, No. 56 Xinjian South Road, Yingze District, Taiyuan, Shanxi Province China
| | - Jie Wen
- grid.452461.00000 0004 1762 8478Department of Urology, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Yingze District, Taiyuan, Shanxi Province China
- grid.452461.00000 0004 1762 8478First Clinical Medical College of Shanxi Medical University, No. 56 Xinjian South Road, Yingze District, Taiyuan, Shanxi Province China
| | - Weibing Shuang
- grid.452461.00000 0004 1762 8478Department of Urology, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Yingze District, Taiyuan, Shanxi Province China
- grid.452461.00000 0004 1762 8478First Clinical Medical College of Shanxi Medical University, No. 56 Xinjian South Road, Yingze District, Taiyuan, Shanxi Province China
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Li L, Zhu J, Shao H, Huang L, Wang X, Bao W, Sheng T, Chen D, He Y, Song B. Long-term outcomes of radiofrequency ablation vs. partial nephrectomy for cT1 renal cancer: A meta-analysis and systematic review. Front Surg 2023; 9:1012897. [PMID: 36684152 PMCID: PMC9852310 DOI: 10.3389/fsurg.2022.1012897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 11/02/2022] [Indexed: 01/08/2023] Open
Abstract
Background Partial nephrectomy (PN) is one of the most preferred nephron-sparing treatments for clinical T1 (cT1) renal cancer, while radiofrequency ablation (RFA) is usually used for patients who are poor surgical candidates. The long-term oncologic outcome of RFA vs. PN for cT1 renal cancer remains undetermined. This meta-analysis aims to compare the treatment efficacy and safety of RFA and PN for patients with cT1 renal cancer with long-term follow-up of at least 5 years. Method This meta-analysis was performed following the PRISMA reporting guidelines. Literature studies that had data on the comparison of the efficacy or safety of RFA vs. PN in treating cT1 renal cancer were searched in databases including PubMed, Embase, Web of Science, and the Cochrane Library from 1 January2000 to 1 May 2022. Only long-term studies with a median or mean follow-up of at least 5 years were included. The following measures of effect were pooled: odds ratio (OR) for recurrence and major complications; hazard ratio (HR) for progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS). Additional analyses, including sensitivity analysis, subgroup analysis, and publication bias analysis, were also performed. Results A total of seven studies with 1,635 patients were finally included. The treatment efficacy of RFA was not different with PN in terms of cancer recurrence (OR = 1.22, 95% CI, 0.45-3.28), PFS (HR = 1.26, 95% CI, 0.75-2.11), and CSS (HR = 1.27, 95% CI, 0.41-3.95) as well as major complications (OR = 1.31, 95% CI, 0.55-3.14) (P > 0.05 for all). RFA was a potential significant risk factor for OS (HR = 1.76, 95% CI, 1.32-2.34, P < 0.001). No significant heterogeneity and publication bias were observed. Conclusion This is the first meta-analysis that focuses on the long-term oncological outcomes of cT1 renal cancer, and the results suggest that RFA has comparable therapeutic efficacy with PN. RFA is a nephron-sparing technique with favorable oncologic efficacy and safety and a good treatment alternative for cT1 renal cancer.
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Affiliation(s)
- Linjin Li
- Department of Urology, the Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, China
| | - Jianlong Zhu
- Department of Urology, the Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, China
| | - Huan Shao
- Department of Urology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
| | - Laijian Huang
- Department of Urology, the Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, China
| | - Xiaoting Wang
- Department of Urology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
| | - Wenshuo Bao
- Department of Urology, the Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, China
| | - Tao Sheng
- Department of Urology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
| | - Dake Chen
- Department of Urology, the Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, China
| | - Yanmei He
- Department of Urology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
| | - Baolin Song
- Department of Urology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China,Correspondence: Baolin Song
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Salib A, Halpern E, Eisenbrey J, Chandrasekar T, Chung PH, Forsberg F, Trabulsi EJ. The evolving role of contrast-enhanced ultrasound in urology: a review. World J Urol 2022; 41:673-678. [PMID: 35969244 DOI: 10.1007/s00345-022-04088-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Ultrasound's versatility and ease of use has expanded its application in many clinical settings. Technological advancements with contrast-enhanced ultrasound (CEUS) have allowed high quality imaging similar to CT or MRI with lower risk of contrast toxicity and radiation exposure. In this review article we examine the development of CEUS and its vast applications in the field of urology. METHODS A PubMed literature search was performed using keywords: contrast enhanced ultrasound, prostate cancer, renal cancer, and multiparametric ultrasound. RESULTS The development of CEUS has improved transrectal ultrasound imaging with increased detection of prostate cancer (PCa). Further enhancements of CEUS such as subharmonic imaging (SHI), flash replenishment imaging (FRI) and contrast ultrasound dispersion imaging (CUDI) allow improved PCa diagnosis. CEUS has also emerged as an important tool in characterizing suspicious renal mass without compromising renal function with contrast imaging. CONCLUSION CEUS has modernized imaging and diagnosis of prostate and renal cancer. Future advancements and utilization of CEUS will allow its expansion into other urological subspecialties.
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Affiliation(s)
- Andrew Salib
- Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St. Ste. 1100, Philadelphia, PA, 19107, USA
| | - Ethan Halpern
- Department of Radiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - John Eisenbrey
- Department of Radiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Thenappan Chandrasekar
- Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St. Ste. 1100, Philadelphia, PA, 19107, USA
| | - Paul H Chung
- Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St. Ste. 1100, Philadelphia, PA, 19107, USA
| | - Flemming Forsberg
- Department of Radiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Edouard J Trabulsi
- Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St. Ste. 1100, Philadelphia, PA, 19107, USA.
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Kim S, Chughtai K, Brahmbhatt A, Rubens D, Dogra V. Contrast-Enhanced Ultrasound as a Problem-Solving Modality: Tips and Tricks. Ultrasound Q 2022; 38:103-115. [PMID: 35426378 DOI: 10.1097/ruq.0000000000000604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Contrast-enhanced ultrasound (CEUS) continues to be an ever-growing tool in radiation-free imaging. While it has been widely used in cardiac imaging, CEUS has only recently become an Food and Drug Administration-approved and viable modality for evaluation of abdominal structures. Ultrasound contrast agents are nontoxic, microbubble-based vascular agents and can be used to reliably assess enhancement patterns of various lesions in real time. In particular, it's non nephrotoxic nature makes CEUS a particularly important tool in renal failure patients requiring serial follow-up. This review provides a comprehensive discussion on the utility of CEUS agents, imaging techniques, comparison with traditional cross-sectional imaging modalities, and its application in diagnosing kidney and liver lesions. This pictorial review is illustrated with cases of renal and hepatic lesions that the practicing radiologist should become familiar with as CEUS becomes increasingly popular.
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Affiliation(s)
- Solomon Kim
- Department of Imaging Sciences, Strong Memorial Hospital, Rochester, NY
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5
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Contrast-enhanced ultrasound of the kidneys: principles and potential applications. Abdom Radiol (NY) 2022; 47:1369-1384. [PMID: 35150315 DOI: 10.1007/s00261-022-03438-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 02/07/2023]
Abstract
Contrast-enhanced ultrasound (CEUS) is an extension and an enhanced form of ultrasound that allows real-time evaluation of the various structures in different vascular phases. The last decade has witnessed a widespread expansion of CEUS applications beyond the liver. It has shown fair potential in kidneys and its diagnostic efficacy is comparable to CT and MRI. Ultrasound is the well-accepted screening modality for renal pathologies, however, it underperforms in the characterization of the renal masses. CEUS can be beneficial in such cases as it can help in the characterization of such incidental masses in the same sitting. It has an excellent safety profile with no risk of radiation or contract-related nephropathy. It can aid in the correct categorization of renal cysts into one of the Bosniak classes and has proven its worth especially in complex cysts or indeterminate renal masses (especially Bosniak Category IIF and III). Few studies also describe its potential role in solid masses and in differentiating benign from malignant masses. Other areas of interest include infections, infarctions, trauma, follow-up of local ablative procedures, and VUR. Through this review, the readers shall get an insight into the various applications of CEUS in kidneys, with imaging examples.
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6
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Du YQ, Bai XM, Yang W, Zhang ZY, Wang S, Wu W, Yan K, Chen MH. Percutaneous ultrasound-guided radiofrequency ablation for patients with liver metastasis from pancreatic adenocarcinoma. Int J Hyperthermia 2022; 39:517-524. [PMID: 35311422 DOI: 10.1080/02656736.2022.2048907] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Yu-qing Du
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiu-mei Bai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing, China
| | - Wei Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing, China
| | - Zhong-yi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing, China
| | - Song Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing, China
| | - Wei Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing, China
| | - Kun Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing, China
| | - Min-hua Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing, China
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7
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Kaneko M, Lenon MSL, Storino Ramacciotti L, Medina LG, Sayegh AS, La Riva A, Perez LC, Ghoreifi A, Lizana M, Jadvar DS, Lebastchi AH, Cacciamani GE, Abreu AL. Multiparametric ultrasound of prostate: role in prostate cancer diagnosis. Ther Adv Urol 2022; 14:17562872221145625. [PMID: 36601020 PMCID: PMC9806443 DOI: 10.1177/17562872221145625] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 11/25/2022] [Indexed: 12/28/2022] Open
Abstract
Recent advances in ultrasonography (US) technology established modalities, such as Doppler-US, HistoScanning, contrast-enhanced ultrasonography (CEUS), elastography, and micro-ultrasound. The early results of these US modalities have been promising, although there are limitations including the need for specialized equipment, inconsistent results, lack of standardizations, and external validation. In this review, we identified studies evaluating multiparametric ultrasonography (mpUS), the combination of multiple US modalities, for prostate cancer (PCa) diagnosis. In the past 5 years, a growing number of studies have shown that use of mpUS resulted in high PCa and clinically significant prostate cancer (CSPCa) detection performance using radical prostatectomy histology as the reference standard. Recent studies have demonstrated the role mpUS in improving detection of CSPCa and guidance for prostate biopsy and therapy. Furthermore, some aspects including lower costs, real-time imaging, applicability for some patients who have contraindication for magnetic resonance imaging (MRI) and availability in the office setting are clear advantages of mpUS. Interobserver agreement of mpUS was overall low; however, this limitation can be improved using standardized and objective evaluation systems such as the machine learning model. Whether mpUS outperforms MRI is unclear. Multicenter randomized controlled trials directly comparing mpUS and multiparametric MRI are warranted.
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Affiliation(s)
- Masatomo Kaneko
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Maria Sarah L. Lenon
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lorenzo Storino Ramacciotti
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Luis G. Medina
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Aref S. Sayegh
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anibal La Riva
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laura C. Perez
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alireza Ghoreifi
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Maria Lizana
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Donya S. Jadvar
- Dornsife School of Letters and Science, University of Southern California, Los Angeles, CA, USA
| | - Amir H. Lebastchi
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giovanni E. Cacciamani
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Andre Luis Abreu
- Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, USC Institute of Urology and Catherine & Joseph Aresty
- Department of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA 90089, USADepartment of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Haroon M, Sathiadoss P, Hibbert RM, Jeyaraj SK, Lim C, Schieda N. Imaging considerations for thermal and radiotherapy ablation of primary and metastatic renal cell carcinoma. Abdom Radiol (NY) 2021; 46:5386-5407. [PMID: 34245341 DOI: 10.1007/s00261-021-03178-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 10/20/2022]
Abstract
Ablative (percutaneous and stereotactic) thermal and radiotherapy procedures for management of both primary and metastatic renal cell carcinoma are increasing in popularity in clinical practice. Data suggest comparable efficacy with lower cost and morbidity compared to nephrectomy. Ablative therapies may be used alone or in conjunction with surgery or chemotherapy for treatment of primary tumor and metastatic disease. Imaging plays a crucial role in pre-treatment selection and planning of ablation, intra-procedural guidance, evaluation for complications, short- and long-term post-procedural surveillance of disease, and treatment response. Treatment response and disease recurrence may differ considerably after ablation, particularly for stereotactic radiotherapy, when compared to conventional surgical and chemotherapies. This article reviews the current and emerging role of imaging for ablative therapy of renal cell carcinoma.
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Yu Z, Li G, Yuan N, Ding W. Comparison of ultrasound guided versus CT guided radiofrequency ablation on liver function, serum PIVKA-II, AFP levels and recurrence in patients with primary hepatocellular carcinoma. Am J Transl Res 2021; 13:6881-6888. [PMID: 34306439 PMCID: PMC8290813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/24/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study aimed to compare the effects of ultrasound and CT-guided radiofrequency ablation (RFA) on liver function, serum antagonist-II (PIVKA-II), alpha-fetoprotein (AFP) levels, and disease recurrence in patients with primary hepatocellular carcinoma (PHC). METHODS Ninety-eight patients with PHC were enrolled and treated with RFA. They were grouped as the ultrasound-guided group (n=51) and the CT-guided group (n=47) according to the specific guidance methods. The clinical efficacy, recurrence and survival after treatment, as well as the changes of liver function, serum PIVKA-II and AFP levels before and after treatment were compared between the two groups. RESULTS The total effective rate of the CT-guided group (87.23%) was significantly higher than that of the ultrasound-guided group (62.75%) (P < 0.05). Total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were reduced in both groups after treatment (P < 0.05) and were lower in the CT-guided group than in the ultrasound-guided group (P < 0.05). Albumin (ALB) levels were elevated in both groups after treatment (P < 0.05) and were higher in the CT-guided group than in the ultrasound-guided group (P < 0.05). PIVKA-II and AFP levels decreased in both groups after treatment (P < 0.05) and were significantly lower in the CT-guided group than in the ultrasound-guided group (P < 0.05). The 2-year and 3-year recurrence rates in the CT-guided group were 4.26% and 8.51%, respectively, significantly lower than 17.65% and 27.45% in the ultrasound-guided group (P < 0.05), and the 2-year and 3-year survival rates in the CT-guided group were 89.36% and 72.34%, respectively, significantly higher than 72.55% and 50.98% in the ultrasound-guided group (P < 0.05). CONCLUSION Compared with ultrasound guidance, CT-guided RFA can more effectively improve liver function, reduce serum IVKA-II and AFP levels, reduce recurrence rate, and improve survival time in the treatment of PHC.
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Affiliation(s)
- Zusheng Yu
- Department of Hepatobiliary Surgery, The First People's Hospital of Fuyang Hangzhou Hangzhou 311400, Zhejiang, China
| | - Guowei Li
- Department of Hepatobiliary Surgery, The First People's Hospital of Fuyang Hangzhou Hangzhou 311400, Zhejiang, China
| | - Nianyong Yuan
- Department of Hepatobiliary Surgery, The First People's Hospital of Fuyang Hangzhou Hangzhou 311400, Zhejiang, China
| | - Wei Ding
- Department of Hepatobiliary Surgery, The First People's Hospital of Fuyang Hangzhou Hangzhou 311400, Zhejiang, China
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10
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Lesnyak O, Stroy O, Banyra O, Nikitin O, Grytsyna Y, Hayda I, Chaplia M, Borzhievskyy A. Assessment of the effectiveness of radiofrequency ablation as a technique for destroying small renal tumors in patients older than 70. Cent European J Urol 2021; 73:416-422. [PMID: 33552565 PMCID: PMC7848822 DOI: 10.5173/ceju.0310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction During the past few decades, the percentage of older people in the population has been steadily growing due to the tendency of extended life expectancy. The efficacy of radiofrequency ablation (RFA) and tumor enucleoresection (TE) in the treatment of selected older patients with renal cell carcinoma (RCC) T1aN0M0 sized ≤4.0 cm has been a popular topic in many recent studies. The aim of this study was to access the effectiveness of radiofrequency ablation in patients older than 70 with T1aN0M0 RCC. Material and methods A total of 86 patients aged 70–84 with histologically confirmed solitary kidney tumors T1aN0M0 who underwent RFA (n = 39) and TE (n = 47) were been included in this study. The patients were assigned to groups based on the impact of their comorbidities. Rockwood’s Clinical Frailty Scale Score (FS) and Charlson Comorbidity Index score (CCI) were used to separate fit from unfit older patients. The RFA group was characterized by an FS and CCI of 4–5 while the TE group had scores of ≤3. Five-year disease-specific survival (DSS), 5-yrs overall survival (OS) and relapse-free survival (RFS) were considered as criteria of treatment. Results The 5-yr DSS in the RFA group was 97.4% vs. 95.7% in the TE group (p >0.05), while 5-yr OS was 74.4% vs. 80.9% (p <0.05) and RFS – 94.9% vs. 93.6% (p >0.05) respectively. Functioning of the operated kidneys did not deteriorate at the 6th and 12th month after RFA/TE as assessed by radioisotope renography. Conclusions In patients over 70 years of age, percutaneous RFA might be considered as an effective option for the successful treatment of T1aN0M0 RCC, as it preserves the functioning of the treated kidney and has oncological outcomes similar to TE.
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Affiliation(s)
- Oleh Lesnyak
- Municipal Non-profit Enterprise 'Lviv Clinical Emergency Care Hospital', Department of Urology, Lviv, Ukraine
| | - Oleksandr Stroy
- Danylo Halytsky Lviv National Medical University, Department of Urology, Lviv, Ukraine
| | - Oleg Banyra
- St. Paraskeva Medical Centre, Lviv, Ukraine.,2 Lviv Municipal Polyclinic, Lviv, Ukraine
| | - Oleg Nikitin
- Bogomolets National Medical University, Department of Urology, Kyiv, Ukraine
| | - Yuriy Grytsyna
- Lviv Railway Clinical Hospital, Department of Urology, Lviv, Ukraine
| | - Ihor Hayda
- Danylo Halytsky Lviv National Medical University, Faculty of Post Graduate Education, Department of Radiology, Lviv, Ukraine.,St. Paraskeva Medical Centre, Ultrasound Department, Lviv, Ukraine
| | - Mykola Chaplia
- Danylo Halytsky Lviv National Medical University, Department of Urology, Lviv, Ukraine
| | - Andrii Borzhievskyy
- Danylo Halytsky Lviv National Medical University, Department of Urology, Lviv, Ukraine
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Kazmierski BJ, Sharbidre KG, Robbin ML, Grant EG. Contrast-Enhanced Ultrasound for the Evaluation of Renal Transplants. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:2457-2468. [PMID: 32412688 DOI: 10.1002/jum.15339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/21/2020] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
Contrast-enhanced ultrasound has emerged as a useful imaging modality for the evaluation of the transplant kidney. Advantages over traditional imaging modalities such as computed tomography and magnetic resonance imaging include the ability to visualize a lesion's enhancement pattern in real time, the lack of nephrotoxicity, and relatively low cost. Potential uses of contrast-enhanced ultrasound include characterization of solid and cystic transplant renal masses, assessment for pyelonephritis and identification of its complications, and evaluation of transplant complications in immediate and delayed settings. Contrast-enhanced ultrasound will likely play an increasing role for evaluating the transplant kidney, as an accurate diagnosis based on imaging can direct treatment and prevent unnecessary interventions.
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Affiliation(s)
| | - Kedar G Sharbidre
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Michelle L Robbin
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Edward G Grant
- Department of Radiology, Keck USC School of Medicine, Los Angeles, California, USA
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12
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Li Q, Li N, Luo Y, Yu H, Ma X, Zhang X, Tang J. Role of intraoperative ultrasound in robotic-assisted radical nephrectomy with inferior vena cava thrombectomy in renal cell carcinoma. World J Urol 2020; 38:3191-3198. [PMID: 32133570 DOI: 10.1007/s00345-020-03141-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 02/19/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To determine the impact of intraoperative ultrasound on robotic-assisted radical nephrectomy with inferior vena cava (IVC) tumor thrombectomy in renal cell carcinoma (RCC). METHODS We retrospectively analyzed intraoperative records of 27 patients with RCC and invasion of the IVC who underwent robotic-assisted nephrectomy with tumor thrombectomy at our center between December 2017 and July 2018. Diagnostic utility and impact of intraoperative transesophageal echocardiography (TEE), intraoperative robotic-assisted ultrasonography, and intraoperative contrast-enhanced ultrasound (CEUS) on surgical management were extracted from the surgical notes and intraoperative ultrasound reports. RESULTS Twenty-seven patients with thrombus had intraoperative ultrasound. Complete tumor removal was achieved in 22 patients, IVC transection in 5 patients, and no residual tumor was observed in all patients. Intraoperative TEE changed the robotic surgical strategy in three patients by monitoring thrombus-level regression. Downstaging of the thrombus level occurred in three patients: Levels IV to III in one and Levels III to II in two. Intraoperative robotic-assisted ultrasonography has facilitated safe VC clamp placement and identification and protection of collateral vessels during IVC transection in five patients. Intraoperative CEUS helped to differentiate the boundary between tumor thrombus (enhancement and small vessel pulsation) and bland thrombus (hypoechoic or no enhancement) in eight (29.6%) patients with bland thrombus. CONCLUSIONS Intraoperative ultrasound is a safe, minimally invasive technique that can provide accurate real-time information regarding the presence and extent of IVC involvement and guidance for placement of a vena cava clamp, confirming the character of the thrombus to plan an optimal surgical approach.
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Affiliation(s)
- Qiuyang Li
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Nan Li
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yukun Luo
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Hongkai Yu
- Department of Urology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xin Ma
- Department of Urology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xu Zhang
- Department of Urology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jie Tang
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to describe current advances in pediatric precision therapy through innovations in technology and engineering. A multimodal approach of chemotherapy, surgery and/or radiation therapy has improved survival outcomes for pediatric cancer but with significant early and late toxicities. The pediatric population is particularly vulnerable given their age during treatment. Advances in precision interventions discussed include image guidance, ablation techniques, radiation therapy and novel drug delivery mechanisms that offer the potential for more targeted approach approaches with improved efficacy while limiting acute and late toxicities. RECENT FINDINGS Image-guidance provides improved treatment planning, real time monitoring and targeting when combined with ablative techniques and radiation therapy. Advances in drug delivery including radioisotopes, nanoparticles and antibody drug conjugates have shown benefit in adult malignancies with increasing use in pediatrics. These therapies alone and combined may lead to augmented local antitumor effect while sparing systemic exposure and potentially limiting early and late toxicities. SUMMARY Pediatric cancer medicine often requires a multimodal approach, each with early and late toxicities. Precision interventions and therapies offer promise for more targeted approaches in treating pediatric malignancies and require further investigation to determine long-term benefit.
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14
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Li Q, Wang Z, Ma X, Tang J, Luo Y. Diagnostic accuracy of contrast-enhanced ultrasound for detecting bland thrombus from inferior vena cava tumor thrombus in patients with renal cell carcinoma. Int Braz J Urol 2020; 46:92-100. [PMID: 31851465 PMCID: PMC6968914 DOI: 10.1590/s1677-5538.ibju.2019.0304] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/11/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate the role of contrast-enhanced ultrasound (CEUS) in differentiating bland thrombus from tumor thrombus of the inferior vena cava (IVC) in patients with renal cell carcinoma (RCC). MATERIALS AND METHODS We retrospectively investigated 30 consecutive patients who underwent robot-assisted radical nephrectomy with IVC thrombectomy and had pathologically confirmed RCC. All patients underwent US and CEUS examination. Two offline readers observed and recorded thrombus imaging information and enhancement patterns. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value for bland thrombus were assessed. RESULTS Of the 30 patients, no adverse events occurred during administration of the contrast agent. Early enhancement of the mass within the IVC lumen on CEUS was na indicator of tumor thrombus. Bland thrombus showed no intraluminal flow on CEUS. There were eight (26.7%) patients with bland thrombus, including three level II, two level III, and three level IV. There were three cases with cephalic bland thrombus and five cases with caudal bland thrombus. Three caudal bland thrombi extended to the iliac vein and underwent surgical IVC interruption. Based on no intraluminal flow, for bland thrombus, CEUS had 87.5% sensitivity, 100% specificity, 96.7% accuracy, 100% positive predictive value and 95.6% negative predictive value. CONCLUSION Our study demonstrates the potential of CEUS in the differentiation of bland and tumor thrombus of the IVC in patients with RCC. Since CEUS is an effective, inexpensive, and non-invasive method, it could be a reliable tool in the evaluation of IVC thrombus in patients with RCC.
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Affiliation(s)
- Qiuyang Li
- Department of Ultrasound, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhongxin Wang
- Department of Urology, Chinese PLA General Hospital, Beijing 100853, China
| | - Xin Ma
- Department of Urology, Chinese PLA General Hospital, Beijing 100853, China
| | - Jie Tang
- Department of Ultrasound, Chinese PLA General Hospital, Beijing 100853, China
| | - Yukun Luo
- Department of Ultrasound, Chinese PLA General Hospital, Beijing 100853, China
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15
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Wośkowiak P, Lewicka K, Bureta A, Salagierski M. Active surveillance and focal ablation for small renal masses: a better solution for comorbid patients. Arch Med Sci 2020; 16:1111-1118. [PMID: 32864000 PMCID: PMC7444719 DOI: 10.5114/aoms.2019.86190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/01/2018] [Indexed: 01/04/2023] Open
Abstract
The natural history of small renal masses (SRM) is still not well understood and they are frequently incidentally diagnosed in elderly patients. Therefore, there is a need for less invasive options sparing the patient from the side-effects related to conventional surgical treatment. PubMed and Medline database search was performed to look for new findings on active surveillance and focal therapy for SRM. Sixty-one articles published between 2002 and 2018 were selected for the purpose of the review. There is growing evidence confirming the safety of active surveillance in patients at surgical risk and there appears to be a satisfactory intermediate-term outcome of focal treatment of SRM. In the group of elderly patients with a decreased life expectancy active surveillance appears to be the most appropriate approach. The future of minimally invasive therapy appears bright, especially with the improvement of new imaging modalities.
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Affiliation(s)
- Piotr Wośkowiak
- The Faculty of Medicine and Health Sciences, University of Zielona Gora, Zielona Gora, Poland
| | - Katarzyna Lewicka
- The Faculty of Medicine and Health Sciences, University of Zielona Gora, Zielona Gora, Poland
| | - Adrianna Bureta
- The Faculty of Medicine and Health Sciences, University of Zielona Gora, Zielona Gora, Poland
| | - Maciej Salagierski
- The Faculty of Medicine and Health Sciences, University of Zielona Gora, Zielona Gora, Poland
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16
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Larghi A, Rimbaș M, Tringali A, Boškoski I, Rizzatti G, Costamagna G. Endoscopic radiofrequency biliary ablation treatment: A comprehensive review. Dig Endosc 2019; 31:245-255. [PMID: 30444547 DOI: 10.1111/den.13298] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/12/2018] [Indexed: 02/08/2023]
Abstract
Radiofrequency ablation (RFA) functions by delivering thermal energy within tissue, the result of a high-frequency alternating current released from an active electrode, leading to coagulative necrosis and cellular death. Recently, a biliary catheter working on a guidewire has been developed and a number of studies have so far been carried out. The present article provides a comprehensive review of the literature on the results of the use of RFA for the clinical management of patients with unresectable malignant biliary strictures, benign biliary strictures, and residual adenomatous tissue in the bile duct after endoscopic papillectomy. Available data show that biliary RFA treatment is a promising adjuvant therapy in patients with unresectable malignant biliary obstruction. The procedure is safe, well tolerated and improves stent patency and survival, even though more studies are warranted. In patients with residual endobiliary adenomatous tissue after endoscopic papillectomy, a significant rate of neoplasia eradication after a single RFA session has been reported, thus favoring this treatment over surgical intervention. In these patients, as well as in those with benign biliary strictures, dedicated probes with a short electrode able to focus the RF current on the short stenosis are needed to expand RFA treatment for these indications.
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Affiliation(s)
- Alberto Larghi
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Mihai Rimbaș
- Gastroenterology Department, Colentina Clinical Hospital, Carol Davila University of Medicine, Bucharest, Romania
| | - Andrea Tringali
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University, Rome, Italy
| | - Ivo Boškoski
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Gianenrico Rizzatti
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Guido Costamagna
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University, Rome, Italy.,IHU-USIAS, University of Strasbourg, Strasbourg, France
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17
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The value of Cone-Beam CT-guided radiofrequency ablation in the treatment of pulmonary malignancies (≤3 cm). Biosci Rep 2019; 39:BSR20181230. [PMID: 30765612 PMCID: PMC6390123 DOI: 10.1042/bsr20181230] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/16/2019] [Accepted: 02/13/2019] [Indexed: 11/25/2022] Open
Abstract
The aim of this study is to explore the safety and efficacy of Cone-Beam computed tomography (CBCT) guided radiofrequency ablation (RFA) in the treatment of pulmonary malignancies. Thirty-one patients with pulmonary malignant tumors (≤3 cm in diameter) were enrolled to this study. Total 43 CBCT guided RFA treatments were performed, including 7 patients undergoing multiple treatments. The target tumor puncture success rate, tumor remission rate, postoperative cumulative survival rate, tumor-free survival rate and complication rate were analyzed. All 43 CBCT guided RFA procedures successfully punctured the target tumors. Complications included five cases of pneumothorax and three cases of hemoptysis. For the 31 patients who underwent CBCT guided RFA, the 1- and 2-year cumulative survival rates were 80.6 and 54.8%, respectively. The 1- and 2-year disease-free survival rates were 54.8 and 32.3%, respectively. The 1-, 3- and 6-month remission rates were 78.4, 68.7 and 63.3%, respectively. The average cumulative radiation dose and average effective radiation dose were 194.62 ± 105.51 mGy and 5.41 ± 3.45 mSv, respectively. CBCT help to shorten the operation time, reduce the unnecessary interventions and also reduce the incidence of complications. CBCT guided RFA is one safe and efficacious treatment for pulmonary malignancies.
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18
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Saccomandi P, Lapergola A, Longo F, Schena E, Quero G. Thermal ablation of pancreatic cancer: A systematic literature review of clinical practice and pre-clinical studies. Int J Hyperthermia 2018; 35:398-418. [PMID: 30428728 DOI: 10.1080/02656736.2018.1506165] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Pancreatic cancer is a challenging malignancy with low treatment option and poor life expectancy. Thermal ablation techniques were proposed as alternative treatment options, especially in advanced stages and for unfit-for-surgery patients. This systematic review describes the thermal ablative techniques -i.e., Laser (LA), Radiofrequency (RFA), Microwave (MWA) Ablation, High-Intensity Focused Ultrasound (HIFU) and cryoablation- available for pancreatic cancer treatment. Additionally, an analysis of the efficacy, complication rate and overall survival for each technique is conducted. MATERIAL AND METHODS This review collects the ex vivo, preclinical and clinical studies presenting the use of thermal techniques in the pancreatic cancer treatment, searched up to March 2018 in PubMed and Medline. Abstracts, letters-to-the-editor, expert opinions, reviews and non-English language manuscripts were excluded. RESULTS Sixty-five papers were included. For the ex vivo and preclinical studies, there are: 12 records for LA, 8 for RFA, 0 for MWA, 6 for HIFU, 1 for cryoablation and 3 for hybrid techniques. For clinical studies, 1 paper for LA, 14 for RFA, 1 for MWA, 17 for HIFU, 1 for cryoablation and 1 for hybrid techniques. CONCLUSIONS Important technological advances are presented in ex vivo and preclinical studies, as the real-time thermometry, nanotechnology and hybrid techniques to enhance the thermal outcome. Conversely, a lack of standardization in the clinical employment of the procedures emerged, leading to contrasting results on the safety and feasibility of some analyzed techniques. Uniform conclusions on the safety and feasibility of these techniques for pancreatic cancer will require further structured investigation.
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Affiliation(s)
- Paola Saccomandi
- a IHU-Strasbourg Institute of Image-Guided Surgery , Strasbourg , France.,b Departement of Mechanical Engineering, Politecnico di Milano , Milan , Italy
| | - Alfonso Lapergola
- a IHU-Strasbourg Institute of Image-Guided Surgery , Strasbourg , France.,c Università G. D'Annunzio , Chieti , Italy
| | - Fabio Longo
- a IHU-Strasbourg Institute of Image-Guided Surgery , Strasbourg , France.,d Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Rome , Italy
| | | | - Giuseppe Quero
- d Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Rome , Italy
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Ashrafi AN, Nassiri N, Gill IS, Gulati M, Park D, de Castro Abreu AL. Contrast-Enhanced Transrectal Ultrasound in Focal Therapy for Prostate Cancer. Curr Urol Rep 2018; 19:87. [PMID: 30155585 PMCID: PMC9084632 DOI: 10.1007/s11934-018-0836-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Contrast-enhanced transrectal ultrasound (CeTRUS) is an emerging imaging technique in prostate cancer (PCa) diagnosis and treatment. We review the utility and implications of CeTRUS in PCa focal therapy (FT). RECENT FINDINGS CeTRUS utilizes intravenous injection of ultrasound-enhancing agents followed by high-resolution ultrasound to evaluate tissue microvasculature and differentiate between benign tissue and PCa, with the latter demonstrating increased enhancement. The potential utility of CeTRUS in FT for PCa extends to pre-, intra- and post-operative settings. CeTRUS may detect PCa, facilitate targeted biopsy and aid surgical planning prior to FT. During FT, the treated area can be visualized as a well-demarcated non-enhancing zone and continuous real-time assessment allows immediate re-treatment if necessary. Following FT, the changes on CeTRUS are immediate and consistent, thus facilitating repeat imaging for comparison during follow-up. Areas suspicious for recurrence may be detected and target-biopsied. Enhancement can be quantified using time-intensity curves allowing objective assessment and comparison. Based on encouraging early outcomes, CeTRUS may become an alternative imaging modality in prostate cancer FT. Further study with larger cohorts and longer follow-up are needed.
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Affiliation(s)
- Akbar N Ashrafi
- USC Institute of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
| | - Nima Nassiri
- USC Institute of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
| | - Inderbir S Gill
- USC Institute of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
| | - Mittul Gulati
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniel Park
- USC Institute of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
| | - Andre L de Castro Abreu
- USC Institute of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA.
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Liu B, Zhan Y, Chen X, Xie Q, Wu B. Laparoscopic ultrasonography: The wave of the future in renal cell carcinoma? Endosc Ultrasound 2018; 7:161-167. [PMID: 29941724 PMCID: PMC6032702 DOI: 10.4103/eus.eus_27_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Laparoscopic or robotic surgery is the main method of treating renal cell carcinoma (RCC). Laparoscopic surgery can accurately target lesions and shorten patient recovery time. Renal endogenous tumors or inferior vena cava tumor thrombi are very difficult to remove using the laparoscopic approach. The emergence of laparoscopic ultrasonography (LUS) has solved this problem. LUS can assist in the detection of tumor boundaries and the extent of tumor thrombi. The lack of tactile feedback may hinder the development of laparoscopic surgery for the treatment of renal cancer. LUS has become an important tool that has improved the rates of successful surgery. LUS is applied in not only early and locally advanced RCC treatment but also in monitoring ablation therapy, testing renal blood perfusion, and exposing renal pedicles. Sonographic techniques used for LUS include initial B-mode, Doppler, and contrast-enhanced ultrasound (CEUS). Contrast agents applied for CEUS do not induce nephrotoxicity and can display renal perfusion more accurately than the regular color Doppler ultrasound. According to current literature, LUS is a promising technique for the treatment of RCC, especially for endogenous RCC or RCC with thrombosis, and for monitoring the effectiveness of radiofrequency ablation, although further well-designed studies are warranted.
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Affiliation(s)
- Bitian Liu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yunhong Zhan
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Xiaonan Chen
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Qingpeng Xie
- Department of Urology, Cancer Hospital of China Medial University, Liaoning Cancer Hospital, Shenyang, Liaoning Province, China
| | - Bin Wu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
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