Health

Minimally invasive percutaneous ablative therapies for HCC Percutaneous ablative techniques for local control of HCC can be divided into two categories: thermal ablation and chemical ablation. Thermal ablation techniques alter the temperature of the tumor to cause cell death and include heat-based methods (radiofrequency ablation [RFA], microwave ablation, laser ablation, high-intensity focused US) and cold-based …

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Can cysts in polycystic liver disease be treated with sclerotherapy?  Yes, although solitary hepatic cysts are more often successfully sclerosed than cysts in patients with polycystic liver disease. In polycystic liver disease, cysts tend not to collapse, presumably because the surrounding liver is less pliable, making cyst wall apposition and subsequent scarring of the cavity …

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Treatment of simple, benign, epithelialized hepatic cysts.  Epithelialized hepatic cysts can be drained successfully and obliterated with sclerotherapy. A self-retaining, pigtail catheter can be used. After catheter placement with US or CT guidance, and complete cyst aspiration, samples are sent for culture and cytologic examination. Contrast is injected through the catheter under fluoroscopic guidance to …

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Is image guided PFA indicated for treatment of hydatid cyst disease?  Cystic echinococcosis is caused by Echinococcus granulosus.  Previously PFA/PCD of a suspected echinococcal cyst or hydatid cyst disease was an absolute contraindication because of fatal anaphylaxis from spillage of the scolices. However, published series describe favorable results with oral albendazole treatment combined with PCD or …

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When is image guided PFA indicated for treatment of amebic abscesses Amebic abscesses respond well to appropriate antibiotic treatment regardless of size, and PCD is usually not required unless response to medical treatment is inadequate. PCD should be considered for large amebic abscesses in a peripheral location or in the left hepatic lobe as these …

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How are pyogenic hepatic abscesses treated?  At least 90% of pyogenic hepatic abscesses can be successfully drained percutaneously. Most pyogenic abscesses smaller than 3 cm in diameter are treated with antibiotics either alone or in combination with needle aspiration, with excellent success rates. For pyogenic abscesses larger than 4 cm in diameter, image-guided PCD is …

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Is FNA safe for all liver masses Is FNA or core biopsy safe or necessary for all hepatic masses?  Benign masses such as hemangiomas, focal nodular hyperplasia, and adenomas often have distinguishing characteristics on high-quality cross-sectional imaging modalities. When these masses are present in patients with classic corresponding clinical features, obtaining specimens for cytologic or …

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