Interventional radiology Flashcards Preview

Year 2 Hematology > Interventional radiology > Flashcards

Flashcards in Interventional radiology Deck (25)
1

what is the advantage of cryoablation over thermoablation?

can monitor ablation zone during procedure

2

what is the disadvantage of cryoablation over thermoablation?

cryoshock - systemic inflammatory response leading to hypotension, respiratory compromise, DIC, multiorgan failure (rare)

3

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

4

renal cell carcinomas make up what % of all adult cancers?

2%

5

what indicates a stage 1A renal cell carcinoma?

1. tumor less than 4 cm in greatest dimension
2. confined to kidney

6

what kind of tumor diagnosis can be made on imaging only?

hepatoma

7

what is the best option for long term life expectancy in patients with hepatomas?

liver transplant

8

what is the US incidence of hepatocellular carcinoma?

3.4 / 100,000

9

what is the #1 worldwide risk factor for hepatocellular carcinoma?

hepatitis B

10

what is the top risk factor for hepatocellular carcinoma in the US?

hepatitis C

11

what is the mainstay treatment for hepatocellular carcinoma?

local regional therapy

12

what hepatocellular carcinoma treatments are curative?

1. transplant
2. surgical resection
3. percutaneous ablation

13

when is surgical resection of the liver contraindicated?

cirrhosis

14

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

15

in liver tumors the blood supply comes from which system?

hepatic artery

16

TACE is indicated for what patient population?

patients who do not qualify for transplantation, resection, or local ablation

17

what is the mechanism of radiofrequency ablation?

directed alternating current to create ionic agitation, frictional heat, and cell death

18

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

19

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

20

what is radioembolization?

intra-arterially delivered microspheres emitting high dose radiation (Yttrium 90) for treatment of unresectable liver tumors

21

radioembolization is indicated for what three types of tumors?

1. metastatic colon
2. primary hepatoma
3. metastatic neuroendocrine to the liver

22

what is the mechanism for radioembolization?

microspheres lodge preferentially in neo-vessels of tumor - minimizes radiation exposure to the liver

23

when does malignant pleural effusion occur?

up to 15% of malignancy cases

24

what are the most common cancers associated with malignant pleural effusion?

1. lung
2. breast
3. ovarian

25

how is malignant pleural effusion managed?

1. periodic thora/paracentesis
2. chest tube with chemical pleurodesis
3. tunneled pleural / peritoneal catheter placement for home fluid drainage