AIM: To present clinical characteristics, diagnosis and treatment strategies in elderly patients with biliary diseases.
Traditional brachytherapy refers to the placement of radioactive sources on or inside the cancer tissues. Based on the type of sources, brachytherapy can be classified as radionuclide and electronic brachytherapy. Electronic brachytherapy uses miniaturized X-ray sources instead of radionuclides to deliver high doses of radiation. The advantages of electronic brachytherapy include low dose to organs at risk, reduced dose to treating staff, no leakage radiation in off state, less shielding, and no radioactive waste. Most of these systems operate between 50 and 100 kVp and are widely used in the treatment of skin cancer. Intrabeam, Xoft and Papillon systems are also used in the treatment of intra-operative radiotherapy to breast in addition to other treatment sites. The rapid fall-off in the dose due to its low energy is a highly desirable property in brachytherapy and results in a reduced dose to the surrounding normal tissues compared to the Ir-192 source. The Xoft Axxent brachytherapy system uses a 2.25 mm miniaturized X-ray tube and the source almost mimics the high dose rate Ir-192 source in terms of dose rate and it is the only electronic brachytherapy system specifically used in the treatment of cervical cancers. One of the limiting factors that impede the use of electronic brachytherapy for interstitial application is the source dimension. However, it is highly anticipated that the design of miniaturized X-ray tube closer to the dimension of an Ir-192 wire is not too far away, and the new era of electronic brachytherapy has just begun.
Interventional radiology (IR) has become an integral part in the management of traumatic injuries. There is an ever-increasing role of IR in traumatic injuries of solid abdominal organs, pelvic and peripheral arteries to control active bleeding by therapeutic embolization or vascular reconstruction using stent grafts. Traditionally, these endovascular treatments have been offered to hemodynamically stable patients. However, in recent times endovascular approach has become preferable to surgery even in hemodynamically unstable patients with injury of surgically difficult-to-access sites. With shifting trends towards non operative management coupled with availability of the current state-of-the-art equipments, hardware and technical expertise, IR has gained an impeccable role in trauma management. However, due to lack of awareness and widespread acceptance, IR continues to remain an ocean of unexplored potentialities.
AIM: To evaluate the correlation between degree of kinetic growth (kGR) of the liver following portal vein embolization (PVE) liver and the enhancement of the during the hepatobiliary phase of contrast administration and to evaluate if the enhancement can be used to predict response to PVE prior to the procedure.
AIM: To retrospectively compare the outcomes of catheter drainage, urokinase and ozone in management of empyema.
Radiofrequency ablation (RFA) is currently the most popular and used ablation modality for the treatment of non surgical patients with primary and secondary liver tumors, but in the last years microwave ablation (MWA) is being technically improved and widely rediscovered for clinical use. Laser thermal ablation (LTA) is by far less investigated and used than RFA and MWA, but the available data on its effectiveness and safety are quite good and comparable to those of RFA and MWA. All the three hyperthermia-based ablative techniques, when performed by skilled operators, can successfully treat all liver tumors eligible for thermal ablation, and to date in most centers of interventional oncology or interventional radiology the choice of the technique usually depends on the physician’s preference and experience, or technical availability. However, RFA, MWA, and LTA have peculiar advantages and limitations that can make each of them more suitable than the other ones to treat patients and tumors with different characteristics. When all the three thermal ablation techniques are available, the choice among RFA, MWA, and LTA should be guided by their advantages and disadvantages, number, size, and location of the liver nodules, and cost-saving considerations, in order to give patients the best treatment option.
Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient’s work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions.
Centrally located hepatocellular carcinoma (HCC) is sited in the central part of the liver and adjacent to main hepatic vascular structures. This special location is associated with an increase in the difficulty of surgery, aggregation of the recurrence disease, and greater challenge in disease management. This review summarizes the evolution of our understanding for centrally located HCC and discusses the development of treatment strategies, surgical approaches and recurrence prevention methods. To improve patient survival, a multi-disciplinary modality is greatly needed throughout the whole treatment period.
AIM: To assess for passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts (TIPS) and compare outcomes with maximally dilated TIPS.
Purpose: To compare survival outcomes of small solitary hepatocellular carcinomas (HCCs) treated with thermal ablation vs resection in the Surveillance, Epidemiology, and End Results (SEER) cohort.
Purpose: To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC).
In the high-volume and increasingly complex world of image-guided therapy and medical imaging, awareness of the potential risks secondary to occupational radiation exposure in medical professionals needs greater focus. One of these risks is radiation-induced cataracts, a recently recognized entity, which may impact the physician’s professional proficiency, quality of life, and career span. This review article aims to explain the pathogenesis of radiation-induced cataracts, exploring emerging evidence regarding their development. It also explores the existing monitoring and protection measures available to protect against such radiation-induced pathologic conditions.
Purpose: To evaluate the safety and efficacy of arteriovenous fistula (AVF) creation with a thermal resistance anastomosis device (TRAD).
PURPOSE: We aimed to evaluate the efficacy of magnetic resonance imaging (MRI)-directed cognitive fusion transrectal ultrasonography (TRUS)-guided anterior prostate biopsy for diagnosis of anterior prostate tumors and to illustrate this technique.
OBJECTIVE. The objective of the present study was to prospectively evaluate the frequency of false-positive tumor enhancement after cryoablation of renal cell carcinoma (RCC).
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