Review
Oncology
Timothy C. Huber, Teodora Bochnakova, Yilun Koethe, Brian Park, Khashayar Farsad
Summary: Percutaneous ablation is a key treatment for early stage, unresectable hepatocellular carcinoma, with recent technological advances offering multiple ablative options for this common malignancy. This review aims to introduce readers to both existing and emerging percutaneous treatment options for HCC.
JOURNAL OF HEPATOCELLULAR CARCINOMA
(2021)
Review
Radiology, Nuclear Medicine & Medical Imaging
Pankaj Gupta, Muniraju Maralakunte, Sathya Sagar, Praveen Kumar-M, Harish Bhujade, Sreedhara B. Chaluvashetty, Naveen Kalra
Summary: A systematic review of studies on irreversible electroporation (IRE) for liver malignancies showed that IRE is associated with favorable overall survival (OS) and progression-free survival (PFS), despite a high overall complication rate, with most complications being minor.
EUROPEAN RADIOLOGY
(2021)
Article
Medicine, General & Internal
Evgenia Efthymiou, Argyris Siatelis, Christos Liakouras, Georgios Makris, Michael Chrisofos, Alexis Kelekis, Elias Brountzos, Nikolaos Kelekis, Dimitrios Filippiadis
Summary: The study evaluated the safety and efficacy of CT-guided percutaneous microwave ablation (MWA) for renal cell carcinoma (RCC) and identified prognostic factors. T1a RCC showed high progression free survival rates, while T1b tumors had higher progression rates. Larger tumor size was associated with a significantly greater hazard for progression.
Article
Radiology, Nuclear Medicine & Medical Imaging
Mohamed E. Abdelsalam, Sharjeel H. Sabir, Samuel B. Kusin Ba, Jose A. Karam, Surena F. Matin, Christopher G. Wood, Kamran Ahrar
Summary: The study investigated the oncologic effectiveness and survival outcomes of percutaneous image-guided thermal ablation for clinical T1a RCC in patients with other primary nonrenal malignancies. Three cohorts were studied: patients with RCC only, patients with RCC and other primary malignancy in remission, and patients with RCC and other primary malignancy under treatment. The results showed that thermal ablation is an effective and safe treatment for T1a RCC in patients with other primary malignancies, with no significant differences in survival outcomes for RCC among the three groups.
AMERICAN JOURNAL OF ROENTGENOLOGY
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Raphael Lehrer, Francois Cornelis, Jean-Christophe Bernhard, Pierre Bigot, Cecile Champy, Franck Bruyere, Morgan Roupret, Nicolas Doumerc, Charles-Karim Bensalah, Jonathan Olivier, Francois Audenet, Thibault Tricard, Bastien Parier, Xavier Durand, Matthieu Durand, Thomas Charles, Nicolas Branger, Louis Surlemont, Evanguelos Xylinas, Jean-Baptiste Beauval, Matthias Barral
Summary: This study compared the oncological and perioperative outcomes of robot-assisted partial nephrectomy (RPN) and percutaneous thermal ablation (PTA) for T1 renal cell cancer (RCC) in elderly patients. The results showed similar oncological outcomes between PTA and RPN in elderly patients.
EUROPEAN RADIOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Jianhai Guo, Ronald S. Arellano
Summary: CT-guided percutaneous microwave ablation shows high technical success rates, excellent local progression-free survival and overall survival for category T1a renal cell carcinoma, with a low complication rate.
AMERICAN JOURNAL OF ROENTGENOLOGY
(2021)
Article
Medicine, General & Internal
Gaetano Aurilio, Giovanni Mauri, Duccio Rossi, Paolo Della Vigna, Guido Bonomo, Gianluca Maria Varano, Daniele Maiettini, Maria Cossu Rocca, Elena Verri, Daniela Cullura, Franco Nole, Franco Orsi
Summary: Renal cell carcinoma is a common tumor with high recurrence and metastasis rates. Image-guided ablation techniques, such as microwave, radiofrequency, cryo, and laser, can effectively control tumor progression. Systemic treatment can be initiated at a certain time after the ablation. The primary success and efficacy rates were high, and no significant complications occurred.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Islam A. S. Elhelf, Hashim Armashi, Arthur Freedman
Summary: Percutaneous cryoablation is a safe and effective method for treating larger-sized renal cell carcinoma (RCC), particularly for patients who are not suitable for surgery or have tumors in unfavorable locations. This article shares institutional experience in using percutaneous cryoablation for treating RCCs larger than 4 cm, discussing strategies to maximize the ablation zone and techniques to protect surrounding structures.
Article
Oncology
Feng Pan, Thuy D. Do, Dominik F. Vollherbst, Philippe L. Pereira, Goetz M. Richter, Michael Faerber, Karl H. Weiss, Arianeb Mehrabi, Hans U. Kauczor, Christof M. Sommer
Summary: In this study, ethiodized oil tumor marking combined with irreversible electroporation (IRE) was found to be a feasible and safe treatment option for small hepatocellular carcinomas that were invisible on unenhanced CT. The approach enabled complete visualization of target HCCs post-marking and achieved successful ablation with no residual tumors observed during follow-up, indicating a high two-year overall survival rate.
Article
Oncology
Takuya Wada, Katsutoshi Sugimoto, Kentaro Sakamaki, Hiroshi Takahashi, Tatsuya Kakegawa, Yusuke Tomita, Masakazu Abe, Yu Yoshimasu, Hirohito Takeuchi, Takao Itoi
Summary: This study compared the outcomes of radiofrequency ablation (RFA), microwave ablation (MWA), and irreversible electroporation (IRE) in treating early stage hepatocellular carcinoma (HCC). The results showed that IRE had a significantly lower 2-year local tumor progression (LTP) rate compared to RFA. There were no significant differences in LTP rates between IRE and MWA, and between RFA and MWA. Therefore, IRE may be a better first-line treatment option for small perivascular HCC.
Article
Urology & Nephrology
Jordan R. Krieger, Fred T. Lee, Timothy McCormick, Timothy J. Ziemlewicz, J. Louis Hinshaw, Shane A. Wells, Paul E. Laeseke, Lindsay Stratchko, Marci Alexander, Sean P. Hedican, Sara L. Best, Tudor Borza, Stephen Y. Nakada, E. Jason Abel
Summary: Management options for small renal masses include active surveillance, surgery, and thermal ablation. Microwave ablation is preferred for its rapid heating and reproducible cell kill, while cryoablation is favored for central tumors. Surgical steps involve high-frequency jet ventilation, initial imaging and targeting, probe insertion, hydrodissection, the ablation process, and postoperative care. Follow-up typically includes imaging and laboratory tests. Overall, percutaneous microwave ablation is effective and safe for renal cell carcinoma.
JOURNAL OF ENDOUROLOGY
(2021)
Review
Urology & Nephrology
Angela Pecoraro, Riccardo Campi, Michele Marchioni
Summary: Small renal masses suspected to be malignant have little potential for metastasis and disease-related mortality. Surgery remains the standard care but represents overtreatment in many cases. Percutaneous ablative technique, especially thermal ablation has emerged as a valid alternative.
CURRENT OPINION IN UROLOGY
(2023)
Review
Radiology, Nuclear Medicine & Medical Imaging
Raul N. Uppot, Tze Min Wah, Peter R. Mueller
Summary: Image-guided ablation is a well-accepted treatment option for renal cell carcinoma, providing minimally invasive treatment and preserving renal function. Recent advances in tools and techniques have enhanced safety and patient outcomes. This article provides a comprehensive review of percutaneous ablation in the management of renal cell carcinoma.
JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Min Hwan Kwak, Min Woo Lee, Seong Eun Ko, Hyunchul Rhim, Tae Wook Kang, Kyoung Doo Song, Jong Man Kim, Gyu-Seong Choi
Summary: This study compared the therapeutic outcomes of laparoscopic radiofrequency ablation (LRFA) and percutaneous radiofrequency ablation (PRFA) for subphrenic hepatocellular carcinoma (HCC). The results showed that LRFA had better outcomes in terms of local tumor progression (LTP) and overall survival (OS), making it a preferred first-line treatment option for subphrenic HCC.
Article
Biochemistry & Molecular Biology
Heber Ivan Condori Leandro, Elena G. Koshevaya, Lubov B. Mitrofanova, Aleksandr D. Vakhrushev, Natalia S. Goncharova, Lev E. Korobchenko, Elizaveta M. Andreeva, Dmitry S. Lebedev, Evgeny N. Mikhaylov
Summary: The study found differences in pulmonary artery nerve distribution between sheep and humans, with pigs and sheep sharing similar characteristics. Laser PADN induced intimal necrosis and local hemorrhages, with 20W ablation energy being safer and 30W causing collateral organ damage.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Letter
Urology & Nephrology
Mohammed Said, Chad R. Tracy, Ryan L. Steinberg
JOURNAL OF ENDOUROLOGY
(2021)
Article
Education, Scientific Disciplines
Austin G. Kazarian, Holly K. Conger, Chad R. Tracy
Summary: The survey results indicate that students prefer virtual advanced electives that are two weeks or shorter and last 5 hours or less per day. Most respondents expressed a desire for structural components in the courses such as networking with a program, didactics, departmental conferences, and operating room interaction.
JOURNAL OF SURGICAL EDUCATION
(2021)
Article
Oncology
Justin N. Drobish, Mark D. Bevill, Chad R. Tracy, Shawn M. Sexton, Maheen Rajput, Catherine M. Metz, Paul T. Gellhaus
Summary: For PI-RADS 5 lesions, systematic biopsy (SB) offers minimal additional clinical value when performing MRI-TB and could potentially be omitted.
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
(2021)
Article
Oncology
Chad R. Tracy, Kevin J. Flynn, Daniel D. Sjoberg, Paul T. Gellhaus, Catherine M. Metz, Behfar Ehdaie
Summary: The optimal number of targeted biopsy cores for MRI-targeted prostate biopsy remains unclear. Increasing the number of targeted biopsy cores can improve the detection of clinically significant prostate cancer, especially for urologists early in their learning curve.
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
(2021)
Article
Oncology
Mark D. Bevill, Victoria Troesch, Justin N. Drobish, Kevin J. Flynn, Maheen Rajput, Catherine M. Metz, Paul T. Gellhaus, Chad R. Tracy
Summary: The number of cores required for detecting prostate cancer during MRI-targeted biopsy decreases with experience, with 3 cores per lesion being sufficient after approximately 100 cases to detect clinically significant prostate cancer.
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
(2022)
Article
Urology & Nephrology
Mark D. Bevill, Morgan E. Schubbe, Kevin J. Flynn, Mohammed A. Said, Patrick Ten Eyck, Chad R. Tracy
Summary: This study aimed to evaluate the impact of a nonopioid treatment regimen on opioid usage, healthcare utilization, and pain following ureteroscopy. The results showed that patients had adequate postoperative pain control with the improved treatment regimen, although some patients still required opioids.
JOURNAL OF ENDOUROLOGY
(2022)
Editorial Material
Urology & Nephrology
Courtney Yond, Chad R. Tracy, Ryan L. Steinberg
Editorial Material
Urology & Nephrology
Aaron C. Smith, Chad R. Tracy, Ryan L. Steinberg
Article
Urology & Nephrology
Elizabeth B. Takacs, Chad R. Tracy
Summary: This review discusses the use of situational judgment tests (SJT) and personality assessment tools (PAT) to enhance the evaluation of medical students, with findings showing that SJTs have more original research and can reduce bias and increase diversity. PATs are easier to teach and can assess fit to program and traits of high-performing residents.
CURRENT UROLOGY REPORTS
(2022)
Article
Urology & Nephrology
Ilana Bergelson, Chad Tracy, Elizabeth Takacs
Summary: Structured interviews using standardized questions, behaviorally or situationally anchored, have been shown to improve interrater agreements and reduce biases compared to traditional interviews. Blinded interviews further eliminate biases like halo, horn, and affinity bias. Adoption of structured formats, including in virtual interviews, can increase diversity and recruit successful residents. Further research is needed to assess the full impact of incorporating these methods into residency interviews.
CURRENT UROLOGY REPORTS
(2022)
Review
Urology & Nephrology
Paige De Rosa, Elizabeth B. Takacs, Linder Wendt, Chad R. Tracy
Summary: This study aims to examine the Urology residency application process, with a focus on the interview. Historically, the residency interview has been prone to bias and has not been proven to predict future residency performance. The goal is to determine the correlation between pre-interview metrics and post-interview ranking using best practices such as holistic review, blinded interviews, and structured behaviorally anchored questions.
Editorial Material
Urology & Nephrology
Thomas Stout, Chad R. Tracy, Ryan L. Steinberg
Article
Urology & Nephrology
Aaron C. Smith, Catherine Metz, Maheen Rajput, Chad R. Tracy, Ryan L. Steinberg
Summary: This study aimed to assess the difference in cranio-caudal renal position in different body positions and the effect of arm position, using magnetic resonance imaging in subjects with BMI < 30. The results showed that prone position led to significant cephalad right renal movement and caudal left renal movement, while arm position had no effect on renal location.
Review
Urology & Nephrology
Thomas E. Stout, Paul T. Gellhaus, Chad R. Tracy, Ryan L. Steinberg
Summary: T3a renal masses include various tumors invading the perirenal and/or sinus fat, pelvicaliceal system, or renal vein. Radical nephrectomy has been the traditional treatment for cT3a renal masses, but with minimally invasive approaches, partial nephrectomy has become an option. This review discusses the role of robot-assisted partial nephrectomy and robot-assisted radical nephrectomy in managing T3a renal masses.
JOURNAL OF ENDOUROLOGY
(2023)
Article
Andrology
Mohammed A. Said, Hayden Warner, Thomas E. Stout, Robert Harrison, Bradley Loeffler, Michael D. Stifelman, Vignesh T. Packiam, Chad R. Tracy, Paul T. Gellhaus
Summary: This study evaluated the safety and efficacy of intraoperative gemcitabine instillation immediately following bladder cuff closure during RNU, and compared the outcomes with non-gemcitabine intravesical chemotherapy agents. The results showed that using gemcitabine at the end of the surgery had similar bladder recurrence-free survival rates compared to using non-gemcitabine chemotherapy agents at the beginning of the surgery. There were no adverse events potentially attributable to gemcitabine within 30 days postoperatively.
TRANSLATIONAL ANDROLOGY AND UROLOGY
(2023)