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Focal Ablation

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https://www.readbyqxmd.com/read/28935135/non-invasive-rapid-ablation-of-tissue-volume-using-histotripsy
#1
Jonathan E Lundt, Steven P Allen, Jiaqi Shi, Timothy L Hall, Charles A Cain, Zhen Xu
Histotripsy is a non-invasive, non-thermal ablation technique that uses high-amplitude, focused ultrasound pulses to fractionate tissue via acoustic cavitation. The goal of this study was to illustrate the potential of histotripsy with electronic focal steering to achieve rapid ablation of a tissue volume at a rate matching or exceeding those of current clinical techniques (∼1-2 mL/min). Treatment parameters were established in tissue-mimicking phantoms and applied to ex vivo tissue. Six-microsecond pulses were delivered by a 250-kHz array...
September 18, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28927782/development-and-internal-validation-of-prediction-models-for-biochemical-failure-and-composite-failure-after-focal-salvage-high-intensity-focused-ultrasound-for-local-radiorecurrent-prostate-cancer-presentation-of-risk-scores-for-individual-patient-prognoses
#2
Max Peters, Abi Kanthabalan, Taimur T Shah, Neil McCartan, Caroline M Moore, Manit Arya, Jochem R van der Voort van Zyp, Marinus A Moerland, Richard G Hindley, Mark Emberton, Hashim U Ahmed
PURPOSE: Patient selection for focal salvage remains difficult. Therefore, we developed and internally validated prediction models for biochemical failure (BF) and a composite endpoint (CE) following focal salvage high intensity focused ultrasound (HIFU) for radiorecurrent prostate cancer. MATERIALS AND METHODS: A prospective HIFU registry identified 150 cases (November 2006-August 2015). Recurrence was assessed with multiparametric magnetic resonance imaging (MRI) combined with template prostate mapping biopsies, targeted biopsies, or systematic transrectal ultrasound-guided biopsies...
September 15, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28924476/clinical-validation-of-real-time-tissue-change-monitoring-during-prostate-tissue-ablation-with-high-intensity-focused-ultrasound
#3
Narendra T Sanghvi, Wo-Hsing Chen, Roy Carlson, Clint Weis, Ralf Seip, Toyoaki Uchida, Michael Marberger
BACKGROUND: The purpose of these clinical studies was to validate a Tissue Change Monitoring (TCM) algorithm in vivo. TCM is a quantitative tool for the real-time assessment of HIFU dose. TCM provides quantitative analysis of the backscatter pulse echo signals (pre and immediately post HIFU) for each individual ablative site, using ultrasonic tissue characterization as a surrogate for monitoring tissue temperature. Real-time analysis generates an energy difference parameter (ΔE in dB) that is proportional to tissue temperature...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28895562/focal-ablation-therapy-for-renal-cancer-in-the-era-of-active-surveillance-and-minimally-invasive-partial-nephrectomy
#4
REVIEW
Serge Ginzburg, Jeffrey J Tomaszewski, Alexander Kutikov
Partial nephrectomy is the optimal surgical approach in the management of small renal masses (SRMs). Focal ablation therapy has an established role in the modern management of SRMs, especially in elderly patients and those with comorbidities. Percutaneous ablation avoids general anaesthesia and laparoscopic ablation can avoid excessive dissection; hence, these techniques can be suitable for patients who are not ideal surgical candidates. Several ablation modalities exist, of which radiofrequency ablation and cryoablation are most widely applied and for which safety and oncological efficacy approach equivalency to partial nephrectomy...
September 12, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28887361/technical-considerations-on-phase-mapping-for-identification-of-atrial-reentrant-activity-in-direct-and-inverse-computed-electrograms
#5
Miguel Rodrigo, Andreu M Climent, Alejandro Liberos, Francisco Fernández-Avilés, Omer Berenfeld, Felipe Atienza, Maria S Guillem
BACKGROUND: Phase mapping has become a broadly used technique to identify atrial reentrant circuits for ablative therapy guidance. This work studies the phase mapping process and how the signal nature and its filtering affect the reentrant pattern characterization in electrogram (EGM), body surface potential mapping, and electrocardiographic imaging signals. METHODS AND RESULTS: EGM, body surface potential mapping, and electrocardiographic imaging phase maps were obtained from 17 simulations of atrial fibrillation, atrial flutter, and focal atrial tachycardia...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28887076/microstructural-mechanisms-of-analgesia-in-percutaneous-cervical-cordotomy-revealed-by-diffusion-tensor-imaging
#6
Stephen S Gebarski, Srinivas Chiravuri, Bradley R Foerster, Parag G Patil
The purpose of this study is to demonstrate the potential of diffusion tensor imaging (DTI) to reveal structural mechanisms underlying spinal ablative procedures, including percutaneous radiofrequency cordotomy (PRFC). PRFC is a surgical procedure that produces analgesia through focal ablation of the lateral spinothalamic tract (STT), thereby interrupting the flow of pain information from the periphery to the brain. To date, studies regarding mechanisms of analgesia after PRFC have been limited to postmortem cadaveric dissection and histology...
September 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28885207/effect-of-irreversible-electroporation-of%C3%A2-prostate-cancer-on-microcirculation-imaging-findings-in-contrast-enhanced-t1-weighted-3d-mri
#7
L P Beyer, B Pregler, N Verloh, K Brünn, M Haimerl, C Stroszczynski, E M Jung, P Wiggermann
OBJECTIVES: Irreversible electroporation (IRE) is a novel focal ablation technique applicable for treatment of prostate cancer (PCa). We aim to evaluate imaging findings of T1-weighted contrast-enhanced MRI after percutaneous IRE of low-risk PCa. METHODS: A total of 13 male patients underwent IRE of focal low-risk PCa and were included in this analysis. Prostate IRE was conducted using 2-4 electrodes being placed under CT-fluoroscopy guidance. Dynamic contrast-enhanced 3D isotropic fat-saturated T1-weighted MRI (DCE-MRI) was performed 24-72 hours before and 24-72 hours after ablation...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28881895/balloon-based-esophageal-cryoablation-with-a-novel-focal-ablation-device-dose-finding-and-safety-in-porcine-and-human-models
#8
D W Schölvinck, S Friedland, G Triadafilopoulos, T Valli, M I van Berge Henegouwen, J J G H M Bergman, Bas L A M Weusten
The new Cryoballoon Focal Ablation System (CbFAS), a through-the-scope catheter with battery-powered handle that delivers cryogenic fluid into an inflated balloon, differs from current cryotherapy methods used for treatment of Barrett's epithelium. In this dose-finding study, short- and long-term histopathological effects and safety of the CbFAS were evaluated. Cryoablations with (supra)therapeutic durations (4-24 seconds) were performed in pigs that survived for 12 or 48 hours or 4 or 28 days. Next, cryoablations (durations based on animal data) were performed in normal mucosa of esophageal cancer patients scheduled to undergo esophagectomy...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28869200/irreversible-electroporation-and-thermal-ablation-of-tumors-in-the-liver-lung-kidney-and-bone-what-are-the-differences
#9
REVIEW
L G P H Vroomen, E N Petre, F H Cornelis, S B Solomon, G Srimathveeravalli
Focal treatment with radiofrequency, microwave and cryoablation has been increasingly used for the treatment of tumors in patients who cannot undergo surgical resection and in select patients with early stage or oligometastatic disease. Each of these ablation modalities has a unique working principle and biophysics underlying the ablative effect, which largely determines the clinical indication for its application. Irreversible electroporation, a relatively new ablation technique with a predominantly nonthermal cell killing mechanism has emerged as an alternative treatment technique for tumors that are contraindicated for thermal ablation because of safety or efficacy considerations...
September 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28866013/contrasting-cellular-damage-after-blue-iris-and-femto-lasik-in-cat-cornea
#10
Kaitlin T Wozniak, Noah Elkins, Daniel R Brooks, Daniel E Savage, Scott MacRae, Jonathan D Ellis, Wayne H Knox, Krystel R Huxlin
Blue-intra-tissue refractive index shaping (Blue-IRIS) is a new approach to laser refractive correction of optical aberrations in the eye, which alters the refractive index of the cornea rather than changing its shape. Before it can be implemented in humans, it is critical to establish whether and to what extent, Blue-IRIS damages the cornea. Here, we contrasted the impact of -1.5 D cylinder refractive corrections inscribed using either Blue-IRIS or femtosecond laser in-situ keratomileusis (femto-LASIK) on corneal cell viability...
August 31, 2017: Experimental Eye Research
https://www.readbyqxmd.com/read/28864163/-image-guided-tumor-ablation
#11
G Koch, R L Cazzato, J Caudrelier, X Cathelineau, H Lang, A Gangi
INTRODUCTION: Ablatives techniques for destroying in situ a tumoral process aim tissular necrosis by the application of several physical principles. MATERIAL AND METHODS: We searched MEDLINE(®), Embase(®), using (MeSH) words; from January 2005 through May 2017, and we looked for all the studies. Investigators graded the strength of evidence in terms of methodology, language and relevance. RESULTS: Forty-seven articles were analyzed. We described ablative techniques and sorted them in thermal and non-thermal therapies according to the used physical principle and their frequency of use in the urological pathology...
August 31, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28857936/radiofrequency-ablation-therapy-for-anal-intraepithelial-neoplasia-results-from-a-single-center-prospective-pilot-study-in-hiv-participants
#12
Robert N Goldstone, Shirin R Hasan, Stephen E Goldstone
BACKGROUND: HIV-positive individuals have high incidence of anal high-grade squamous intraepithelial lesions (HSIL) at the squamocolumnar junction (SCJ), which can progress to cancer.1 Focal radiofrequency ablation (RFA) treats HSIL, but metachronous recurrence remains high and may be improved with circumferential treatment. SETTING: The study was performed at a single center. METHODS: This was a prospective trial of circumferential anal RFA using Barrx™ 60 RFA focal catheters in participants with ≥1 anal SCJ HSIL...
August 26, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28856283/surgical-treatment-of-liver-tumors-own-experience-and-literature-review
#13
REVIEW
Aliaksandr Tarasik, Jerzy Jaroszewicz, Marcin Januszkiewicz
Despite advances, the treatment of focal liver lesions is still challenging. It requires the experience of a surgeon, improvement of existing and the development of new techniques. The aim of this article is to present a literature review and summarize our experience in liver surgery. Twenty-one patients with various liver tumors were treated in 2015 at the Department of Surgical Oncology of Bialystok Center for Oncology. Mostly patients were diagnosed with colorectal cancer liver metastases or hepatocellular carcinoma...
March 2017: Clin Exp Hepatol
https://www.readbyqxmd.com/read/28852646/the-role-of-hysteroscopy-in-the-diagnosis-and-treatment-of-adenomyosis
#14
REVIEW
Attilio Di Spiezio Sardo, Gloria Calagna, Fabrizia Santangelo, Brunella Zizolfi, Vasilis Tanos, Antonino Perino, Rudy Leon De Wilde
Uterine adenomyosis is a common gynecologic disorder in women of reproductive age, characterized by the presence of ectopic endometrial glands and stroma within the myometrium. Dysmenorrhea, abnormal uterine bleeding, chronic pelvic pain, and deep dyspareunia are common symptoms of this pathological condition. However, adenomyosis is often an incidental finding in specimens obtained from hysterectomy or uterine biopsies. The recent evolution of diagnostic imaging techniques, such as transvaginal sonography, hysterosalpingography, and magnetic resonance imaging, has contributed to improving accuracy in the identification of this pathology...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28843747/arrhythmogenic-right-ventricular-cardiomyopathy-arvc-in-a-young-female-athlete-at-36-weeks-gestation-a-case-report
#15
Hae Yoon Grace Choung, Monika Vyas, Daniel Jacoby, Brian West
A 26year old east African professional athlete presented to the obstetric clinic for a routine visit at 36 weeks gestation. She had a history of Right Ventricular Outflow Tract - Ventricular Tachycardia (RVOT-VT) with an episode of cardiac arrest in the past, and had been treated with ablation 4 years earlier. Her current visit was uneventful, her pregnancy progressing normally. Following the visit she went to a local restaurant where she suffered a cardiac arrest that was unresponsive to therapy. Chest compressions were continued from the time of her collapse until an emergency caesarian section was performed, delivering a healthy female infant...
July 25, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28838547/arrhythmias-originating-in-the-atria
#16
REVIEW
Fabio Leonelli, Giuseppe Bagliani, Giuseppe Boriani, Luigi Padeletti
Atrial flutter, atrial tachycardias, and atrial fibrillation are the main sustained atrial tachycardias. Reentry, increased automaticity, and triggered activity are atrial arrhythmia's main mechanisms. Atrial flutter is the clinical and theoretical model of reentry. Its classification is based on the atrial chamber involved and the arrhythmia's anatomic path. Ablative procedures for atrial fibrillation have created several new reentrant tachycardias. Electrocardiography (ECG) identifies the site of origin of focal atrial tachycardias and the mechanism of these arrhythmias...
September 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28836494/fibrillar-collagen-injection-for-organ-protection-during-thermal-ablation-of-hepatic-malignancies
#17
Bill S Majdalany, Jonathan Willatt, Jeffrey Forris Beecham Chick, Ravi N Srinivasa, Wael A Saad
Percutaneous image-guided ablation is performed throughout many areas of the body for various pathologies including hepatic malignancies. Heat and cold-based ablative technologies are effective and well-tolerated with an acceptable safety profile. However, ablative therapies may be technically more challenging and cause collateral thermal injury if the targeted lesion is adjacent to critical organs. Previously, techniques including artificial ascites and pneumoperitoneum have been utilized to displace or insulate critical structures from the ablation zone...
September 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28835836/atrial-flutter-typical-and-atypical-a-review
#18
Francisco G Cosío
Clinical electrophysiology has made the traditional classification of rapid atrial rhythms into flutter and tachycardia of little clinical use. Electrophysiological studies have defined multiple mechanisms of tachycardia, both re-entrant and focal, with varying ECG morphologies and rates, authenticated by the results of catheter ablation of the focal triggers or critical isthmuses of re-entry circuits. In patients without a history of heart disease, cardiac surgery or catheter ablation, typical flutter ECG remains predictive of a right atrial re-entry circuit dependent on the inferior vena cava-tricuspid isthmus that can be very effectively treated by ablation, although late incidence of atrial fibrillation remains a problem...
June 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28830850/irreversible-electroporation-for-the-treatment-of-localized-prostate-cancer-a-summary-of-imaging-findings-and-treatment-feedback
#19
Matthijs J Scheltema, Arnoud W Postema, Daniel M de Bruin, Mara Buijs, Marc R Engelbrecht, M Pilar Laguna, Hessel Wijkstra, Theo M de Reijke, Jean J M C H de la Rosette
PURPOSE: Imaging plays a crucial role in ablative therapies for prostate cancer (PCa). Irreversible electroporation (IRE) is a new treatment modality used for focal treatment of PCa. We aimed to demonstrate what imaging modalities can be used by descriptively reporting contrast-enhanced ultrasonography (CEUS), multiparametric magnetic resonance imaging (mpMRI), and grey-scale transrectal ultrasound (TRUS) results. Furthermore, we aimed to correlate quantitatively the ablation zone seen on mpMRI and CEUS with treatment planning to provide therapy feedback...
September 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28830058/contrast-enhanced-ultrasonography-of-the-liver-using-sonovue
#20
Giovanna Ferraioli, Maria Franca Meloni
This review focuses on the use of contrast-enhanced ultrasonography (CEUS) with SonoVue Epub ahead of print (Bracco Imaging) for the diagnosis of focal liver lesions (FLLs), guidance during ablative treatment, and follow-up of liver tumors. Multicenter trials have shown that the performance of CEUS for the characterization of FLLs is similar to that of contrast-enhanced computed tomography or contrast-enhanced magnetic resonance imaging. CEUS with SonoVue has been effectively used for guiding the percutaneous treatment of malignant liver tumors that are invisible or poorly visualized in traditional gray-scale ultrasonography...
July 12, 2017: Ultrasonography
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