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Focal Ablation

Saima Riaz, Humayun Bashir, Aamna Hassan, Sajid Mushtaq, Arif Jamshed, Ahmad Murtaza
We report an aggressive papillary thyroid carcinoma (PTC) with focal undifferentiated component in a 32-year-old female. She had limited disease confined within the thyroid gland at diagnosis. Within 12 months of thyroidectomy and radioiodine ablation, thyroglobulin (Tg) levels were elevated. Second radioiodine ablative dose was given, however, stimulated Tg levels showed an upward trend with negative iodine scan within 12 months. An 18F fludeoxyglucose-avid solitary pulmonary nodule that was detected on positron emission tomography/computed tomography scan was resected followed by empiric radioiodine therapy...
October 5, 2016: Molecular Imaging and Radionuclide Therapy
Nathan McDannold, Margaret Livingstone, Can Barış Top, Jonathan Sutton, Nick Todd, Natalia Vykhodtseva
This study investigated thermal ablation and skull-induced heating with a 230 kHz transcranial MRI-guided focused ultrasound (TcMRgFUS) system in nonhuman primates. We evaluated real-time acoustic feedback and aimed to understand whether cavitation contributed to the heating and the lesion formation. In four macaques, we sonicated thalamic targets at acoustic powers of 34-560 W (896-7590 J). Tissue effects evaluated with MRI and histology were compared to MRI-based temperature and thermal dose measurements, acoustic emissions recorded during the experiments, and acoustic and thermal simulations...
October 14, 2016: Physics in Medicine and Biology
Melanie P Caserta, Candice Bolan, M Jennings Clingan
The purpose of this pictorial review is to describe the normal appearance of the endometrium and to provide radiologists with an overview of endometrial pathology utilizing case examples. The normal appearance of the endometrium varies by age, menstrual phase, and hormonal status with differing degrees of acceptable endometrial thickness. Endometrial pathology most often manifests as either focal or diffuse endometrial thickening, and patients frequently present with abnormal vaginal bleeding. Endovaginal ultrasound (US) is the first-line modality for imaging the endometrium...
October 12, 2016: Abdominal Radiology
Bingbo Hou, Lihui Zheng, Guodong Niu, Lingmin Wu, Yu Qiao, Wei Sun, Ligang Ding, Gang Chen, Shu Zhang, Reginald Liew, Yan Yao
AIMS: This study was aimed to report the characteristics and treatment of ventricular tachycardia (VT) following surgical treatment of pulmonary stenosis with intact ventricular septum. METHODS AND RESULTS: Five patients underwent radiofrequency catheter ablation for sustained monomorphic left bundle branch block (LBBB) type VT who previously underwent surgical treatment of pulmonary stenosis. Except stimulation, voltage and activation mapping was performed using three-dimensional (3D) electro-anatomic mapping and ablation was applied accordingly...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Romuald Zdrojowy, Janusz Dembowski, Bartosz Małkiewicz, Krzysztof Tupikowski, Wojciech Krajewski
INTRODUCTION: Prostate cancer is the most frequent cancer among males in Europe and a leading cause of cancer deaths, with similar proportion in other developed countries. For more than twenty years, external-beam radiation therapy, alongside with radical prostatectomy, has been used as a primary radical therapeutic approach for localized prostate cancer. Yet, EBRT failures relate to 22-69% following curative radiotherapy (± androgen deprivation therapy). Additionally, a proportion of these men will have a biopsy-proven local recurrence...
2016: Central European Journal of Urology
Ahmed Karim Talib, Akihiko Nogami, Itsuro Morishima, Yasushi Oginosawa, Kenji Kurosaki, Shinya Kowase, Yuki Komatsu, Kenji Kuroki, Miyako Igarashi, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: The most common form of idiopathic Purkinje-related ventricular tachycardia (VT) is the reentrant type. We describe the clinical and electrophysiological characteristics of focal non-reentrant fascicular tachycardia. METHODS AND RESULTS: Among 530 idiopathic VT patients who were referred for ablation, we identified 15 (2.8%) with non-reentrant fascicular tachycardia (11 men, 45±21 years). Sinus rhythm ECG showed normal conduction intervals with a His-ventricular interval of 41±4 ms...
October 2016: Circulation. Arrhythmia and Electrophysiology
Tonye A Jones, Shyam Natarajan, Alan M Priester, Leonard S Marks
Herein, we describe a case of a 63-year-old male who underwent MRI-guided biopsy of a suspicious lesion in the prostate followed by focal laser ablation. Radical prostatectomy was performed 15 months following focal laser ablation for persistent cancer adjacent to the treatment zone. We provide images from the initial MRI, post-ablation MRI, and the whole-mount radical prostatectomy specimen. The present case demonstrates the confined, localized effect of focal laser ablation, and also illustrates the advantage of expanded treatment margins...
October 6, 2016: Urology
Fabrizio Drago, Mario Salvatore Russo, Irma Battipaglia, Gino Grifoni, Massimo Stefano Silvetti, Romolo Remoli, Vincenzo Pazzano, Fabio Anselmo Saputo, Michele Ciani
AIMS: Transcatheter cryoablation is a well-established technique for the treatment of AV nodal reentry tachycardia (AVNRT) in children. Nevertheless, A-V nodal slow pathway conduction may recur after an acutely successful procedure. The aim of this study was to evaluate the long-term outcome of acutely successful AVNRT cryoablations in pediatric patients in case of focal cryolesion and in case of need for High Density Linear Lesion (HDLL) cryoablation due to focal failure. METHODS: ...
September 22, 2016: Pacing and Clinical Electrophysiology: PACE
Valentina Zilioli, Alessia Peli, Maria Beatrice Panarotto, Giancarlo Magri, Ahmed Alkraisheh, Christiane Wiefels, Carlo Rodella, Raffaele Giubbini
The purpose of this prospective study was to determine the incremental diagnostic value of single photon emission computed tomography/computed tomography with iodine-131 over planar whole body scan in the staging of patients with differentiated thyroid carcinoma. A total of 365 patients (270 female, 95 male) with differentiated thyroid carcinoma were treated with radioiodine therapy for thyroid remnant ablation with radical intent after thyroidectomy between January 2013 and November 2014. In addition to planar whole body scan, single photon emission computed tomography/computed tomography of neck and chest were performed...
September 29, 2016: Endocrine
Zhaoye Zhou, Qi Jin, Long Yu, Liqun Wu, Bin He
BACKGROUND: Knowledge of atrial electrophysiological properties is crucial for clinical intervention of atrial arrhythmias and the investigation of the underlying mechanism. This study aims to evaluate the feasibility of a novel noninvasive cardiac electrical imaging technique in imaging bi-atrial activation sequences from body surface potential maps (BSPMs). METHODS: The study includes 7 subjects, with 3 atrial flutter patients, and 4 healthy subjects with normal atrial activations...
2016: PloS One
Marc Napoleone, Ania Z Kielar, Rebecca Hibbert, Sameh Saif, Benjamin Y M Kwan
PURPOSE: We aimed to evaluate patterns of local tumor progression (LTP) after radiofrequency ablation (RF ablation) of colorectal cancer liver metastases (CRCLM) and to highlight the percentage of LTP not attributable to lesion size or RF ablation procedure-related factors (heat sink or insufficient ablation margin). METHODS: CRCLM treated by RF ablation at a single tertiary care center from 2004-2012, with a minimum of six months of post-procedure follow-up, were included in this retrospective study...
October 3, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Xinhua Wang, Zheng Li, Jialiang Mao, Ben He
AIMS: Frequent premature atrial contractions (PACs) are associated with increased risk of atrial fibrillation (AF), stroke, and death. This study aimed to explore the electrophysiological features of PACs with and without inducing AF and to evaluate the effectiveness of catheter ablation for PACs. METHODS AND RESULTS: Thirty-five consecutive patients with symptomatic, frequent, and drug-refractory PACs in the absence of AF (group A) and 35 patients with PACs-induced AF (group B) were enrolled...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Steven E Williams, Nick W F Linton, Steven Niederer, Mark D O'Neill
AIMS: Complex ablation procedures are supported by accurate representation of an increasing variety of electrophysiological and imaging data within electroanatomic mapping systems (EMS). This study aims to develop a novel method for representing multiple complementary datasets on a single cardiac chamber model. Validation of the system and its application to both atrial and ventricular arrhythmias is examined. METHODS AND RESULTS: Dot mapping was conceived to display multiple datasets by utilizing quantitative surface shading to represent one dataset and finely spaced dots to represent others...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Tomofumi Nakamura, Kaoru Okishige, Toshiro Kanazawa, Mitsumi Yamashita, Naohiko Kawaguchi, Nobutaka Kato, Hideshi Aoyagi, Yasuteru Yamauchi, Tetsuo Sasano, Kenzo Hirao
AIMS: Pulmonary vein (PV) isolation (PVI) utilizing a cryoballoon (CB) has become one of the standard therapeutic options for atrial fibrillation (AF). However, it connotes a potential risk of cerebral ischaemic events (CIEs). This study aimed to clarify the prevalence of CIEs after PVI using second-generation CBs assessed by magnetic resonance imaging (MRI) of the brain. METHODS: This prospective observational study consisted of 160 patients that underwent PVI with second-generation CBs for drug-refractory AF...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Jie Yu, Ping Liang
Tumor ablation is defined as the direct application of chemical or thermal therapy to eradicate or substantially destroy a tumor. Currently, minimally invasive ablation techniques are available for the local destruction of focal tumors in multiple organ sites. Microwave ablation is premised on the biological response of solid tumors to tissue hyperthermia, and it is a relatively low-risk procedure. Due to several advantages of microwave ablation, including higher thermal efficiency, higher capability for coagulating blood vessels, faster ablation time, and the simultaneous application of multiple antennae, microwave ablation could be a promising minimally invasive ablation technique for the treatment of solid tumors...
October 4, 2016: International Journal of Hyperthermia
Massimo Valerio, Louise Dickinson, Afia Ali, Navin Ramachadran, Ian Donaldson, Neil Mccartan, Alex Freeman, Hashim U Ahmed, Mark Emberton
PURPOSE: Irreversible electroporation (IRE) has attractive attributes for focal ablation, namely non-thermal effect, precise demarcation of treatment, and tissue-selectivity. We report on a prospective development study investigating focal IRE. MATERIALS AND METHODS: 20 men with the following characteristics were recruited: anterior MR-visible index lesion concordant with transperineal targeted and template prostate mapping biopsy, absence of clinically significant disease elsewhere (UCL definition 2), and PSA </= 15 ng/ml...
September 30, 2016: Journal of Urology
Lei Qi, Naser Jafari, Xiang Li, Zaozao Chen, Liqing Li, Vesa P Hytönen, Benjamin T Goult, Chang-Guo Zhan, Cai Huang
Talin binds to β-integrin tails to activate integrins, regulating cell migration, invasion and metastasis. There are two talin genes, TLN1 and TLN2, encoding talin1 and talin2, respectively. Talin1 regulates focal adhesion dynamics, cell migration and invasion, whereas the biological function of talin2 is not clear and, indeed, talin2 has been presumed to function redundantly with talin1. Here, we show that talin2 has a much stronger binding to β-integrin tails than talin1. Replacement of talin2 Ser339 with Cys significantly decreased its binding to β1-integrin tails to a level comparable to that of talin1...
October 1, 2016: Journal of Cell Science
Pallav L Shah, Felix J Herth, Wouter H van Geffen, Gaetan Deslee, Dirk-Jan Slebos
Advanced emphysema is a lung disease in which alveolar capillary units are destroyed and supporting tissue is lost. The combined effect of reduced gas exchange and changes in airway dynamics impairs expiratory airflow and leads to progressive air trapping. Pharmacological therapies have limited effects. Surgical resection of the most destroyed sections of the lung can improve pulmonary function and exercise capacity but its benefit is tempered by significant morbidity. This issue stimulated a search for novel approaches to lung volume reduction...
September 29, 2016: Lancet Respiratory Medicine
Teerapat Ungtrakul, Chulabhorn Mahidol, Pattra Chun-On, Charlie Laohapand, Surachate Siripongsakun, Akeanong Worakitsitisatorn, Sirachat Vidhayakorn, Wariya Boonchuay, Jiraporn Dechma, Gaidganok Sornsamdang, Kamonwan Soonklang, Tassanee Sriprayoon, Tawesak Tanwandee, Chirayu U Auewarakul
AIM: To determine the role of screening and surveillance of hepatocellular carcinoma (HCC) in treatment-naïve chronic hepatitis B (CHB) patients. METHODS: We recruited 2293 CHB patients (both males and females; aged 20-65 years). All patients were screened and underwent surveillance using abdominal ultrasonography (AUS) and serum alpha-fetoprotein (AFP) assay every 6 mo. The diagnosis, staging and treatment of HCC followed the American Association for the Study of Liver Diseases practice guidelines and the Barcelona Clinic Liver Cancer guidelines...
September 14, 2016: World Journal of Gastroenterology: WJG
Marlon Perera, Nishanth Krishnananthan, Uri Lindner, Nathan Lawrentschuk
Globally, the increased uptake of serum PSA level screening led to an increase in the number of diagnoses of low-risk and intermediate-risk prostate cancer. Traditionally, these patients have been considered for either active surveillance programmes or radical whole-gland therapies, such as prostatectomy or radiotherapy. Focal therapy is an emerging treatment option that involves the focal ablation of prostate cancer with preservation of surrounding healthy tissue. This approach might result in reduced morbidity when compared with whole-gland therapies...
September 27, 2016: Nature Reviews. Urology
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