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01 julio 2013

RADIOLOGY. Breast Intervention: How I Do It

Mary C. Mahoney, MD, and , Mary S. Newell, MD

The development and widespread use of percutaneous image-guided breast biopsies has expanded the role of breast imaging and changed the management of breast disease. Validation of the safety, accuracy, and cost-effectiveness of these biopsies has led to their replacement of the surgical biopsy for most breast lesions requiring a tissue diagnosis (1–17). The advantages of the minimally invasive core-needle biopsy (CNB) over surgical biopsy include less scarring, fewer complications, lower cost, and faster recovery. The success of a breast CNB program depends on both the performance of the procedure and the appropriate postbiopsy management. In this article, we outline a general approach to the image-guided percutaneous breast biopsy and discuss specifics of the various acquisition devices and imaging modalities used for guidance.

01 julio 2014

DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY. Internal jugular and common femoral venous access for the removal of a long-term embedded vena cava filter

Umer Salati , Pradeep Govender , William Torreggiani , Ronan Browne. Department of Radiology, Tallaght Hospital, Dublin, Ireland

We describe an inferior vena cava filter retrieval technique requiring triple venous access performed in a 35-year-old male who was referred for filter removal 16 months after its insertion. The filter showed a right-sided tilt with endothelialization of the distal filter struts into the caval wall. Access was required via both internal jugular veins to straighten the filter using a snared-loop technique. Further 18 F right common femoral vein access was required to snare and remove the filter, which could not be completely collapsed distally due to endothelialized tissue, precluding normal removal via the jugular venous route.

01 julio 2014

DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY. Management of visceral artery embolization using 0.010-inch detachable microcoils

Masamichi Koganemaru , Toshi Abe , Masaaki Nonoshita , Ryoji Iwamoto , Masashi Kusumoto , Asako Kuhara , Tomoko Kugiyama

Transcatheter coil embolization is used primarily to treat arterial hemorrhages, tumors, aneurysms, and vascular malformations. However, conventional microcatheter systems cannot always be employed in difficult cases. In this technical note, we describe how small-diameter primary coils and microcatheter tips that are thinner than normal can be used to increase the safety and reliability of coil embolization.

01 julio 2014

DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY. CT-guided percutaneous cryoablation of central lung tumors

Errol Colak , Servet Tatlı , Paul B. Shyn , Kemal Tuncalı , Stuart G. Silverman

PURPOSE: Cryoablation has been successfully used to treat lung tumors. However, the safety and effectiveness of treating tumors adjacent to critical structures has not been fully established. We describe our experience with computed tomography (CT)-guided percutaneous cryoablation of central lung tumors and the role of ice ball monitoring.

01 julio 2014

DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY. The effect of using different embolic agents on survival in transarterial chemoembolization of hepatocellular carcinoma: gelfoam versus polyvinyl alcohol

Ali Koçyiğit , Oğuz Dicle , Yiğit Göktay , İbrahim Astarcıoğlu

PURPOSE: We aimed to compare the effect of using different embolic agents such as gelfoam and polyvinyl alcohol (PVA) on survival, tumor response, and complications in transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) patients.

01 julio 2013

AMERICAN JOURNAL OF ROENTGENOLOGY. Multiphase CT Enterography Evaluation of Small-Bowel Vascular Lesions

James E.Huprich, John M.Barlow, Stephanie L.Hansel, Jeffrey A.Alexander and Jeff L.Fidler

OBJECTIVE. By use of multiphase CT enterography (CTE), small-bowel vascular lesions associated with gastrointestinal bleeding can be classified into three categories—angioectasias, arterial lesions, and venous abnormalities—on the basis of common morphology and enhancement patterns. This article will review the unique patterns of enhancement and lesion morphology seen on multiphase CTE and how those findings enable detection and characterization of specific lesions in many cases.

01 julio 2013

AMERICAN JOURNAL OF ROENTGENOLOGY. Imaging Assessment of Hepatocellular Carcinoma Response to Locoregional and Systemic Therapy

Vahid Yaghmai, Cecilia Besa, Edward Kim, Joseph L. Gatlin, Nasir A. Siddiqui1 and Bachir Taouli

OBJECTIVE. This article focuses on imaging techniques and imaging findings after locoregional and systemic therapy in patients with hepatocellular carcinoma (HCC). We discuss currently available locoregional and systemic therapies for HCC, imaging modalities and protocols used to assess HCC response, criteria for assessing HCC response, imaging appearances of treated HCC, and future directions.

01 julio 2013

AMERICAN JOURNAL OF ROENTGENOLOGY. Liver Metastases in the Era of Molecular Targeted Therapy: New Faces of Treatment Response

Atul Bhanudas Shinagare, Jyothi P. Jagannathan, Katherine M. Krajewski and Nikhil H. Ramaiya

OBJECTIVE. The liver is one of the most common sites of metastatic disease. The increasing use of molecular targeted therapy, including antiangiogenic agents, mammalian target of rapamycin inhibitors, and various monoclonal antibodies, for the treatment of various carcinomas and sarcomas has rendered use of simple size measurements for the assessment of treatment response inadequate. Several atypical patterns of treatment response, at times mimicking tumor progression, are increasingly seen, leading to confusion. The purpose of this article is to familiarize the reader with the unusual patterns in which liver metastases respond to molecular targeted therapy and help differentiate treatment response mimicking progression (pseudo-progression) from true progression.

01 julio 2013

AMERICAN JOURNAL OF ROENTGENOLOGY. Fluoroscopically Guided Balloon Dilation or Temporary Stent Placement for Patients With Gastric Conduit Strictures After Esophagectomy With Esophagogastrostomy

Jongjin Lee, Ho-Young Song, Heung Kyu Ko, Jung-Hoon Park, Han Kyu Na, Yong Hee Kim and Hwoon-Yong Jung

OBJECTIVE. The purpose of this study was to evaluate the clinical features of patients with gastric conduit strictures after esophagectomy and to report our initial experience in the management of these strictures with fluoroscopically guided balloon dilation, temporary stent placement, or both.

01 julio 2013

AMERICAN JOURNAL OF ROENTGENOLOGY. Abdominopelvic and Lower Extremity Deep Venous Thrombosis: Evaluation With Contrast-Enhanced MR Venography With a Blood-Pool Agent

Steven Y. Huang, Charles Y. Kim, Michael J. Miller, Rajan T. Gupta, Mark L. Lessne, Jeffrey J. Horvath, Daniel T. Boll1, Paul D. Evans, Nicholas T. Befera, Pranay Krishnan, Johanna L. Chan and Elmar M. Merkle

OBJECTIVE. The purpose of this article is to evaluate contrast-enhanced (CE) MR venography (MRV) with a blood-pool agent for detection of abdominopelvic and lower extremity deep venous thrombosis (DVT) compared with a conventional unenhanced gradient-recalled echo (GRE) MRV technique.

01 julio 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Radiofrequency Ablation of T1 Lung Carcinoma: Comparison of Outcomes for First Primary, Metachronous, and Synchronous Lung Tumors

Carole A. Ridge, FFRRCSI, Mikhail Silk, BS , Elena N. Petre, MD , Joseph P. Erinjeri, MD, PhD , William Alago, MD , Robert J. Downey, MD , Constantinos T. Sofocleous, MD, PhD , Raymond H. Thornton, MD , Stephen B. Solomon, MD

Purpose: To report and compare outcomes after radiofrequency ablation for treatment-naïve first primary, metachronous, and synchronous T1 lung tumors.

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