Flashcards in Interventional radiology Deck (25)
what is the advantage of cryoablation over thermoablation?
can monitor ablation zone during procedure
what is the disadvantage of cryoablation over thermoablation?
cryoshock - systemic inflammatory response leading to hypotension, respiratory compromise, DIC, multiorgan failure (rare)
what are the stages of the cryoablation procedure?
1. cell shrinkage and dehydration (freeze)
2. cell swelling and bursting (thaw)
3. apoptosis, cleaning up of cellular debris
renal cell carcinomas make up what % of all adult cancers?
what indicates a stage 1A renal cell carcinoma?
1. tumor less than 4 cm in greatest dimension
2. confined to kidney
what kind of tumor diagnosis can be made on imaging only?
what is the best option for long term life expectancy in patients with hepatomas?
what is the US incidence of hepatocellular carcinoma?
3.4 / 100,000
what is the #1 worldwide risk factor for hepatocellular carcinoma?
what is the top risk factor for hepatocellular carcinoma in the US?
what is the mainstay treatment for hepatocellular carcinoma?
local regional therapy
what hepatocellular carcinoma treatments are curative?
2. surgical resection
3. percutaneous ablation
when is surgical resection of the liver contraindicated?
what are the featuers of transarterial chemoembolization (TACE)?
1. delivery of highly concentrated chemotherapy in a lipid medium combined with arterial embolization resulting in tissue hypoxia and death
2. takes advantage of dual blood supply of liver with tumor supply exclusively from hepatic artery
in liver tumors the blood supply comes from which system?
TACE is indicated for what patient population?
patients who do not qualify for transplantation, resection, or local ablation
what is the mechanism of radiofrequency ablation?
directed alternating current to create ionic agitation, frictional heat, and cell death
what is the mechanism of microwave ablation?
delivery of electromagnetic radiation causing agitation of water molecules in surrounding tissue producing friction and heat resulting in cell death
what are the criteria for choosing radiofrequency / microwave ablation therapy?
1. tumors 3 cm or less
2. must have ablation zone of 5-10 mm
what is radioembolization?
intra-arterially delivered microspheres emitting high dose radiation (Yttrium 90) for treatment of unresectable liver tumors
radioembolization is indicated for what three types of tumors?
1. metastatic colon
2. primary hepatoma
3. metastatic neuroendocrine to the liver
what is the mechanism for radioembolization?
microspheres lodge preferentially in neo-vessels of tumor - minimizes radiation exposure to the liver
when does malignant pleural effusion occur?
up to 15% of malignancy cases
what are the most common cancers associated with malignant pleural effusion?