Health

What cross sectional image guided interventions are possible in the spleen?  When clinically indicated given the increased risk of complications such as bleeding, percutaneous image-guided biopsy and catheter drainage can be performed safely in the spleen. Focal splenic masses are uncommon, so splenic biopsy is rarely performed. Splenic abscesses also are not common although the …

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What other liver tumors have been treated with percutaneous thermal ablative techniques?  Liver metastases from neuroendocrine, gastric, pancreatic, pulmonary, renal, uterine, or ovarian cancer and melanoma have all been successfully treated with RFA. Besides HCC, the majority of percutaneous thermal ablative procedures are performed for the treatment of colorectal liver metastases. Percutaneous RFA has also …

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Survival outcomes of RFA versus surgical resection in HCC In the treatment of HCC, how do survival outcomes of RFA compare with surgical resection?  Most studies evaluating surgical resection and RFA show similar long-term outcomes for HCC smaller than 3 cm. In a randomized control trial of 112 patients with a solitary HCC less than …

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Risks of thermal ablation related to the anatomic location of the tumor Superficial tumors adjacent to the gastrointestinal tract are at risk for thermal injury to the bowel wall. The colon appears to be at greater risk for perforation than the stomach and small bowel because of the thinner wall thickness and its lesser mobility. …

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Contraindications of RFA or percutaneous thermal ablative techniques The only absolute contraindications are uncorrectable coagulopathy or a noncompliant patient. RFA and other percutaneous ablative techniques are local treatments and are usually not performed in patients with vascular invasion or extrahepatic metastases. Patients with colonization of the biliary tract from bilioenteric anastomoses, endoscopic sphincterotomy, or bilioenteric …

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Advantages of RFA and other methods of percutaneous thermal ablation Low mortality and complication rates (Multicenter surveys report mortality rates ranging from 0.1% to 0.5%, major complication rates ranging from 2.2% to 3.1%, and minor complication rates ranging from 5% to 8.9%.) Repeatability Minimally invasive and shorter recovery times compared with surgery Can be used …

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What temperatures must be achieved to be cytotoxic for tumor destruction?  Irreversible damage with cellular protein denaturation, cell membrane dysfunction, and coagulation necrosis occurs at temperatures between 60 ° C and 100 ° C. Above 100 ° C to 110 ° C, tissue carbonization and charring occurs which results in diminished volume of the ablation …

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