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Image-guided urological interventions: What the urologists must know.

Das CJ, Baliyan V, Sharma S - Indian J Urol (2015 Jul-Sep)

Bottom Line: Advances in imaging technology, especially in the last two decades, have led to a paradigm shift in the field of image-guided interventions in urology.Many urologic diseases that were earlier treated surgically are now effectively managed using minimally invasive image-guided techniques, often on a day care basis using only local anesthesia or conscious sedation.This article presents an overview of the technique and status of various image-guided urological procedures, including recent emerging techniques.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, All India Institute of Medical Sciences, New Delhi - 110 029, India.

ABSTRACT
Advances in imaging technology, especially in the last two decades, have led to a paradigm shift in the field of image-guided interventions in urology. While the traditional biopsy and drainage techniques are firmly established, image-based stone management and endovascular management of hematuria have evolved further. Ablative techniques for renal and prostate cancer and prostate artery embolization for benign prostatic hypertrophy have evolved into viable alternative treatments. Many urologic diseases that were earlier treated surgically are now effectively managed using minimally invasive image-guided techniques, often on a day care basis using only local anesthesia or conscious sedation. This article presents an overview of the technique and status of various image-guided urological procedures, including recent emerging techniques.

No MeSH data available.


Related in: MedlinePlus

Pre-radiofrequency ablation contrast enhanced CT image (a) showing a mass at the upper pole of the left kidney (arrow). The mass shows complete ablation (arrow) in post-ablation CECT axial image (b)
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Figure 12: Pre-radiofrequency ablation contrast enhanced CT image (a) showing a mass at the upper pole of the left kidney (arrow). The mass shows complete ablation (arrow) in post-ablation CECT axial image (b)

Mentions: Of all such techniques, RFA and cryo-ablation have been best studied. These provide local treatment for renal carcinomas in patients unsuitable for surgery [Figure 12]. Patients having renal insufficiency at presentation and tumors requiring a more nephron-conserving approach (solitary kidney, multiple synchronous RCC, von Hippel Lindau/familial RCC) are also candidates for these minimally ablative therapies. In the short term, 90–95% local control rates and 6% significant complication rates are seen for tumors <3.0 cm for both techniques.[3031] The major limitations for both these techniques are lack of prospective randomized clinical trials or long-term follow-up data. A meta-analysis of 46 series (28 percutaneous, 18 surgical) by Hui et al.[32] compared results of surgical and percutaneous treatment of renal tumors. The analysis showed a significantly lower primary effectiveness rate for the percutaneous group (87% vs. 94%; P < 0.05) compared with the surgical group. There was no significant difference in the retreatment rates (92% vs. 95%; P > 0.05). The major complication rate was significantly lower in the percutaneous treatment group (3% vs. 7%; P < 0.05) than the surgical treatment group. Microwave ablation has potential advantages of being able to treat cystic renal tumors, but has even lesser data available.[33]


Image-guided urological interventions: What the urologists must know.

Das CJ, Baliyan V, Sharma S - Indian J Urol (2015 Jul-Sep)

Pre-radiofrequency ablation contrast enhanced CT image (a) showing a mass at the upper pole of the left kidney (arrow). The mass shows complete ablation (arrow) in post-ablation CECT axial image (b)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4495494&req=5

Figure 12: Pre-radiofrequency ablation contrast enhanced CT image (a) showing a mass at the upper pole of the left kidney (arrow). The mass shows complete ablation (arrow) in post-ablation CECT axial image (b)
Mentions: Of all such techniques, RFA and cryo-ablation have been best studied. These provide local treatment for renal carcinomas in patients unsuitable for surgery [Figure 12]. Patients having renal insufficiency at presentation and tumors requiring a more nephron-conserving approach (solitary kidney, multiple synchronous RCC, von Hippel Lindau/familial RCC) are also candidates for these minimally ablative therapies. In the short term, 90–95% local control rates and 6% significant complication rates are seen for tumors <3.0 cm for both techniques.[3031] The major limitations for both these techniques are lack of prospective randomized clinical trials or long-term follow-up data. A meta-analysis of 46 series (28 percutaneous, 18 surgical) by Hui et al.[32] compared results of surgical and percutaneous treatment of renal tumors. The analysis showed a significantly lower primary effectiveness rate for the percutaneous group (87% vs. 94%; P < 0.05) compared with the surgical group. There was no significant difference in the retreatment rates (92% vs. 95%; P > 0.05). The major complication rate was significantly lower in the percutaneous treatment group (3% vs. 7%; P < 0.05) than the surgical treatment group. Microwave ablation has potential advantages of being able to treat cystic renal tumors, but has even lesser data available.[33]

Bottom Line: Advances in imaging technology, especially in the last two decades, have led to a paradigm shift in the field of image-guided interventions in urology.Many urologic diseases that were earlier treated surgically are now effectively managed using minimally invasive image-guided techniques, often on a day care basis using only local anesthesia or conscious sedation.This article presents an overview of the technique and status of various image-guided urological procedures, including recent emerging techniques.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, All India Institute of Medical Sciences, New Delhi - 110 029, India.

ABSTRACT
Advances in imaging technology, especially in the last two decades, have led to a paradigm shift in the field of image-guided interventions in urology. While the traditional biopsy and drainage techniques are firmly established, image-based stone management and endovascular management of hematuria have evolved further. Ablative techniques for renal and prostate cancer and prostate artery embolization for benign prostatic hypertrophy have evolved into viable alternative treatments. Many urologic diseases that were earlier treated surgically are now effectively managed using minimally invasive image-guided techniques, often on a day care basis using only local anesthesia or conscious sedation. This article presents an overview of the technique and status of various image-guided urological procedures, including recent emerging techniques.

No MeSH data available.


Related in: MedlinePlus