Combined transarterial chemoembolization and thermal ablation in candidates to liver transplantation with hepatocellular carcinoma: pathological findings and post-transplant outcome.

Objectives: Evaluating the pathological response and the survival outcomes of combined thermal ablation (TA) and transarterial chemoembolization (TACE) as a bridge or downstaging for liver transplantation (LT) in patients with hepatocellular carcinoma (HCC) > 3 cm.

Materials And Methods: A retrospective review encompassed 36 consecutive patients who underwent combined TA-TACE as bridging or downstaging before LT. Primary objectives included necrosis of the target lesion at explant pathology, post-LT overall survival (OS) and post-LT recurrence-free survival (RFS).

All-in-one diagnostic and therapeutic precision thoracic surgery using a hybrid operating theatre: the triple-marking technique.

Background: The minimally invasive management of sub-centimetric and often sub-solid lung lesions is quite challenging for thoracic surgeons. As a matter of fact, thoracoscopic wedge resection can often require conversion to thoracotomy when pulmonary lesions cannot be visually identified. Hybrid operating rooms (ORs) can serve as a helpful tool in a multidisciplinary setting, providing real-time lesion imaging and targeting, allowing preoperative or intraoperative percutaneous placement of different lesions targeting techniques to help locate non-palpable lung nodules during video-assisted thoracic surgery.

Multi-institutional analysis of outcomes for thermosphere microwave ablation treatment of colorectal liver metastases: the SMAC study.

Objectives: Oligometastatic colorectal cancer benefits of locoregional treatments but data concerning microwave ablation (MWA) are limited and interactions with systemic therapy are still debated. The aim of this study is to evaluate safety and effectiveness of Thermosphere™ MWA (T-MWA) of colorectal liver metastases (CLM) and factors affecting local tumor progression-free survival (LTPFS).

Methods: In this multi-institutional retrospective study (January 2015-September 2019), patients who underwent T-MWA for CLM were enrolled.

Optimizing Loco Regional Management of Oligometastatic Colorectal Cancer: Technical Aspects and Biomarkers, Two Sides of the Same Coin.

Colorectal cancer (CRC) is the third most common cancer worldwide and has a high rate of metastatic disease which is the main cause of CRC-related death. Oligometastatic disease is a clinical condition recently included in ESMO guidelines that can benefit from a more aggressive locoregional approach. This review focuses the attention on colorectal liver metastases (CRLM) and highlights recommendations and therapeutic locoregional strategies drawn from the current literature and consensus conferences.

Interventional Radiology Approaches for Liver Metastases from Thyroid Cancer: A Case Series and Overview of the Literature.

Background: Liver metastases (LMs) from thyroid cancer (TC) are relatively uncommon in clinical practice and their management is challenging. Interventional radiology loco-regional treatments (LRTs), including radiofrequency ablation (RFA) and trans-arterial chemoembolization (TACE), have been successfully employed to treat LMs from various types of cancer.

Methods: We analyzed the role of LRTs in the management of unresectable LMs from differentiated and medullary TCs performed at our institution from 2015 to 2020.

The value of a combined radiological-surgical approach in allowing curative resection of a locally advanced type IIIa Klatskin tumor.

We report the case of a 53-year-old patient subjected to percutaneous embolization of right and middle hepatic veins to induce liver segments 2-3 hypertrophy before extended right hepatic resection for a locally advanced type IIIa perihilar cholangiocarcinoma. Hepatic vein embolization (HVE) was performed 3 weeks after surgical recanalization of left portal vein (severely narrowed at its origin due to tumor infiltration) interposing an internal jugular vein graft between main and distal left portal vein. Nine days after HVE, future liver remnant volume increased from 395 to 501 cc, i.

Oligometastatic Colorectal Cancer Management: A Survey of the Italian College of Interventional Radiology.

Aim: European Society for Medical Oncology (ESMO) and National Comprehensive Cancer Network guidelines (NCCN) have recently included interventional procedures among the standard treatments for the management of colorectal cancer (CRC) oligometastatic disease (OMD). This study overviews the practice of Interventional Radiology (IR) in Italian centers.

Methods: A practice focused questionnaire on locoregional treatments of CRC-OMD was submitted to all Italian IR centers to assess practice patterns.

Liquid biopsy, a paradigm shift in oncology: what interventional radiologists should know.

The acquisition of adequate tumor sample is required to verify primary tumor type and specific biomarkers and to assess response to therapy. Historically, invasive surgical procedures were the standard methods to acquire tumor samples until advancements in imaging and minimally invasive equipment facilitated the paradigm shift image-guided biopsy. Image-guided biopsy has improved sampling yield and minimized risk to the patient; however, there are still limitations, such as its invasive nature and its consequent limitations to longitudinal tumor monitoring.

Intrahepatic Administration of Human Liver Stem Cells in Infants with Inherited Neonatal-Onset Hyperammonemia: A Phase I Study.

Previous studies have shown that human liver stem-like cells (HLSCs) may undergo differentiation in vitro into urea producing hepatocytes and in vivo may sustain liver function in models of experimentally induced acute liver injury. The aim of this study was to assess the safety of HLSCs intrahepatic administration in inherited neonatal-onset hyperammonemia. The study was approved by the Agenzia Italiana del Farmaco on favorable opinion of the Italian Institute of Health as an open-label, prospective, uncontrolled, monocentric Phase I study (HLSC 01-11, EudraCT-No.

Thermal ablation with fusion imaging guidance of hepatocellular carcinoma without conspicuity on conventional or contrast-enhanced US: surrounding anatomical landmarks matter.

Aim: Evaluating clinical and technical factors affecting thermal ablation of B-Mode/CEUS inconspicuous HCC nodules, relying only on fusion imaging (FI) performed under conscious sedation and using previously acquired CT or MR.

Materials And Methods: Among 367 HCC nodules treated in the study period, data of 37 B-mode/CEUS undetectable HCC nodules treated with FI-guided ablation were extracted from our prospectively collected institutional database. Analyzed variables included patients' sex, age, cirrhosis etiology, Child-Pugh status, size of the lesion, liver segment, subcapsular or central liver site, type of imaging used for fusion (MR/CT), and the presence of surrounding anatomical landmarks (SAL) < 3 cm from the index lesion.

Fusion Imaging and Virtual Navigation to Guide Percutaneous Thermal Ablation of Hepatocellular Carcinoma: A Review of the Literature.

As medical imaging advancements have improved the detectability of hepatocellular carcinoma (HCC) in early stages, the approach to percutaneous thermal ablation for curative treatment has concomitantly advanced. Although many centers are adopting cross-sectional imaging to guide percutaneous ablation, the majority of procedures are still performed under ultrasound (US) guidance worldwide. Challenges to ultrasound guidance may present due to relatively poor resolution particularly with small or isoechoic lesions, or due to intervening structures such as the bowel or diaphragm that obstruct lesional visualization.

Post-surgical recurrence of hepatocellular carcinoma along resection margin treated by percutaneous US-guided ablation.

Background: The aim of this study was to evaluate the safety and efficacy of percutaneous ablation for hepatocellular carcinoma (HCC) hepatic recurrence along surgical resection margins to achieve complete cure or bridge for additional treatment. No current recommendations exist for these lesions.

Methods: Retrospective review of post-surgical recurrent HCC located along surgical margins treated by percutaneous ultrasound-guided ablation from 2006-2014.

Ablation of colorectal liver metastasis: Interaction of ablation margins and RAS mutation profiling on local tumour progression-free survival.

Objectives: To investigate effects of ablation margins on local tumour progression-free survival (LTPFS) according to RAS status in patients with colorectal liver metastases (CLM).

Methods: This two-institution retrospective study from 2005-2016 included 136 patients (91 male, median age 60 years) with 218 ablated CLM. LTPFS was performed using the Kaplan-Meier method and evaluated with the log-rank test.

Radiofrequency Ablation for Renal Cancer in Von Hippel-Lindau Syndrome Patients: A Prospective Cohort Analysis.

Introduction: Management of renal-cell carcinoma (RCC) in patients with Von Hippel-Lindau syndrome (VHL) represents a clinical dilemma: the oncologic outcomes must be weighed against preservation of renal function. Radiofrequency ablation (RFA) is currently used in selected cases for treatment of small-size RCC. The aim of this study was to evaluate the safety, complications, and functional and oncologic outcomes of RFA in the treatment of RCC in VHL patients.

Treatment of multiple synchronous misdiagnosed renal cell cancers in a young patient affected by a "de novo" Von Hippel-Lindau syndrome.

Introduction: Von Hippel-Lindau (VHL) disease is an autosomal dominant inherited syndrome occurring in one out of 36,000 live births. Diagnosis could be a challenge in patients with no familial VHL history. Renal cancer (RCC) represents one of the most important manifestations.

Percutaneous treatment of Hepatocellular carcinoma exceeding 3 cm: combined therapy or microwave ablation? Preliminary results.

Purpose: To compare MWA and RFA combined with TACE for HCC nodules exceeding 3 cm.

Methods: 19 lesions submitted to MWA (G1) were retrospectively compared with a combined treatment group (G2) matching by tumor characteristics (mean size 43 and 45 mm in G1 and G2, respectively). Technical success, complications, complete ablation (CA), and maintained CA (mCA) were evaluated.

Utilility of flow cytometry as ancillary study to improve the cytologic diagnosis of thyroid lymphomas.

Background: To evaluate the efficacy of the use of flow cytometry (FC) immunophenotyping together with fine-needle aspiration cytology (FNAC) in the diagnosis of thyroid lymphoma.

Methods: FC was performed in parallel with FNAC in 35 samples of suspected thyroid lymphoma over a 12 years period. Results were correlated with histological or molecular findings and follow-up, when available.

Role of paravertebral block anaesthesia during percutaneous transhepatic thermoablation.

Purpose: This paper discusses the technique and preliminary results of right thoracic paravertebral block (TPVB) for percutaneous thermal ablation of liver tumours.

Materials And Methods: Between October 2011 and August 2012 we treated 36 lesions (25 hepatocellular carcinoma and 11 metastases) in 30 patients aged 47-85 years (mean 67.5).

T1a as the sole selection criterion for RFA of renal masses: randomized controlled trials versus surgery should not be postponed.

Purpose: To evaluate the long-term effects of radiofrequency ablation (RFA) of renal masses (RM) and compare them with surgery.

Methods: A total of 203 RM (193 malignant; mean size 30 mm) in 137 patients (95 male subjects; average age 64 years) underwent RFA. Complications and technique effectiveness were evaluated.

Radiofrequency thermal ablation (RFA) of hepatic metastases (METS) from breast cancer (BC): an adjunctive tool in the multimodal treatment of advanced disease.

Purpose: The study was done to analyse the results of a series of radiofrequency ablation (RFA) procedures performed on hepatic metastases (METS) from breast cancer in order to evaluate the clinical impact of this therapy.

Materials And Methods: We analysed 45 patients (mean age 55 years) with 87 METS (mean size 23 mm), in terms of adverse events (AE), complete ablation (CA) at initial follow-up assessment and during the subsequent follow-up (mean 30 months), time to progression, and survival. The correlation between local effectiveness and METS size was investigated.

Flow cytometry significantly improves the diagnostic value of fine needle aspiration cytology of lymphoproliferative lesions of salivary glands.

Objective: Lymphoid proliferations of the salivary glands can be either reactive or malignant. Diagnosis based solely on fine needle aspiration (FNA) cytology may be troublesome in view of the difficulty in distinguishing low-grade B-cell and mucosa-associated lymphoid tissue (MALT) lymphomas from reactive lymphoid proliferations. We report our experience with FNA cytology combined with flow cytometry (FC) immunophenotyping for the diagnosis of lymphoproliferative processes affecting the salivary glands.

Ultrasound-guided transhepatic puncture of the hepatic veins for TIPS placement.

Purpose: This retrospective analysis was carried out to assess the feasibility and results of transjugular intrahepatic portal systemic shunt (TIPS) performed with ultrasound (US)-guided percutaneous puncture of the hepatic veins.

Material And Methods: Over a period of 3 years, 153 patients were treated with TIPS at our centre. In eight cases, a percutaneous puncture of the middle (n=7) or right (n=1) hepatic vein was required because the hepatic vein ostium was not accessible.

Long-term outcome of radiofrequency thermal ablation (RFA) of liver metastases from colorectal cancer (CRC): size as the leading prognostic factor for survival.

Purpose: The aim of this study was to review some prognostic factors for survival after radiofrequency ablation (RFA) of metastases from colorectal cancer (CRC).

Materials And Methods: From 1996 to 2009, 262 patients with metastases from CRC were treated with RFA. Fourteen were lost to follow-up.