Cancer concepts and principles: primer for the interventional oncologist-part II.

This is the second of a two-part overview of the fundamentals of oncology for interventional radiologists. The first part focused on clinical trials, basic statistics, assessment of response, and overall concepts in oncology. This second part aims to review the methods of tumor characterization; principles of the oncology specialties, including medical, surgical, radiation, and interventional oncology; and current treatment paradigms for the most common cancers encountered in interventional oncology, along with the levels of evidence that guide these treatments.

Cancer concepts and principles: primer for the interventional oncologist-part I.

A sophisticated understanding of the rapidly changing field of oncology, including a broad knowledge of oncologic disease and the therapies available to treat them, is fundamental to the interventional radiologist providing oncologic therapies, and is necessary to affirm interventional oncology as one of the four pillars of cancer care alongside medical, surgical, and radiation oncology. The first part of this review intends to provide a concise overview of the fundamentals of oncologic clinical trials, including trial design, methods to assess therapeutic response, common statistical analyses, and the levels of evidence provided by clinical trials.

Angiographically documented hemorrhagic conversion of a left middle cerebral artery embolic stroke during intra-arterial thrombolysis.

Background And Purpose: The clinical benefits of intra-arterial thrombolysis for ischemic stroke must be weighed against the risks, including hemorrhagic conversion.

Summary Of Case: A case of angiographically documented hemorrhagic conversion of an ischemic stroke during intra-arterial thrombolysis is presented. Discussion focuses on recognition and management of risk factors for hemorrhagic conversion during performance of stroke thrombolysis.

Kidney neoplasms: renal halo sign after percutaneous radiofrequency ablation--incidence and clinical importance in 101 consecutive patients.

Purpose: To describe the incidence and clinical importance of the renal halo sign after percutaneous radiofrequency ablation (RFA) of renal neoplasms.

Materials And Methods: Institutional review board approval was obtained for this HIPAA-compliant retrospective study. The study population consisted of 101 consecutive patients with 106 solid renal neoplasms that were treated with percutaneous RFA.

Endovenous laser ablation of the saphenous veins: bilateral versus unilateral single-session procedures.

Purpose: To assess the feasibility of bilateral endovenous laser ablation (EVLA) of saphenous veins in a single session with use of diluted lidocaine for tumescent anesthesia.

Materials And Methods: Among 122 consecutive EVLA procedures (112 patients; mean age, 49 years; 75% women) over a 12-month period, there were 75 unilateral procedures (n = 67) and 47 bilateral interventions (n = 45). Tumescent anesthesia consisted of lidocaine diluted to 0.

Image-guided thermal ablation of nonresectable hepatic tumors using the Cool-Tip radiofrequency ablation system.

Percutaneous thermal ablation techniques have gained considerable attention as an alternative to surgery for the treatment of malignant liver tumors in selected patients. In particular, image-guided radiofrequency ablation (RFA) is increasingly being used for the local treatment of hepatocellular carcinoma, as well as for metastases to the liver. As a minimally invasive treatment option, this technique has several advantages compared with surgical resection.

Solitary fibrous tumor of the buccal space: treatment with percutaneous cryoablation.

Solitary fibrous tumors are rare spindle cell neoplasms that typically occur in the thorax but have been described in various locations within the abdomen and head and neck region. The most common extrapleural site is the oral cavity, but these tumors have been also described in the orbit, nasopharynx, paranasal sinuses, salivary glands, and larynx. We describe a case of a solitary fibrous tumor of the buccal space successfully treated with percutaneous CT-guided cryoablation.