Purpose: The treatment of renal tumors is dictated by the results acquired from renal imaging, which play a crucial role in determining the appropriate strategy and surgical plan. Radiofrequency ablation, microwave ablation, and cryoablation are established percutaneous thermal ablation procedures that have widespread recognition. The objective of this scholarly article is to present a comprehensive summary of the application of the primary thermal protection strategies of the structures adjacent to renal tumors, in particular the effectiveness in terms of safety of hydrodissection and pyeloperfusion, in the context of percutaneous thermal ablation for renal tumors.
View Article and Find Full Text PDF(1) Background: In the last decade, the number of detected renal cancer cases has increased, with the highest incidence in Western countries. Although renal biopsy is reported as a safe procedure, it is not adopted in all centres. As it is not possible to accurately distinguish benign tumours using imaging, this may lead to overtreatment.
View Article and Find Full Text PDFThe efficacy and complication rates of percutaneous radiofrequency ablation (RFA) and cryoablation (CA) in the treatment of T1 renal masses in two Northern Italy hospitals were retrospectively investigated. Eighty-two patients with 80 T1a tumors and 10 T1b tumors treated with thermal ablation from 2015 through 2020 were included. A total of 43 tumors in 38 patients were treated with RFA (2.
View Article and Find Full Text PDF(1) Background and (2) Methods: In this retrospective, observational, monocentric study, we selected a cohort of eighty-five patients (age range 38-87 years old, 51 men), enrolled between January 2014 and December 2020, with a newly diagnosed renal mass smaller than 4 cm (SRM) that later underwent nephrectomy surgery (partial or total) or tumorectomy with an associated histopatological study of the lesion. The radiomic features (RFs) of eighty-five SRMs were extracted from abdominal CTs bought in the portal venous phase using three different CT scanners. Lesions were manually segmented by an abdominal radiologist.
View Article and Find Full Text PDFIntroduction: Although prostate cancer (PCa) is one of the most common cancers among men, the impact of modifiable risk and protective factors is still being debated. This review aims to qualitatively summarize the most recent studies related to potential healthy lifestyle factors affecting the development of PCa.
Methods For Data Acquisition: The literature focusing on modifiable risk factors for prostate cancer was reviewed.
Background: Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is coming up as a superior imaging tool for prostate cancer (PCa). However, its use in primary staging is still debated. The aim of this study was to assess accuracy of 68Ga-PSMA PET/CT in staging patients with intermediate and high risk PCa candidates to radical prostatectomy managed in the Prostate Cancer Unit of our institution.
View Article and Find Full Text PDFRetrocaval ureter (RCU) is a rare malformation of the inferior vena cava. We report a case of a 60-years-old female presented with right flank pain and computed tomography scan diagnosis of (RCU). She underwent robotic transposition and ureteroureterostomy of RCU.
View Article and Find Full Text PDFObjective: The major strengths of surgical treatment of benign prostatic hyperplasia with laser are reduced morbidity compared to endoscopic resection. No studies analysed the different risk of intra/peri-operative events between patients undergoing Thulium and GreenLight procedures.
Materials And Methods: We retrospectively reviewed 100 consecutive cases undergoing GreenLight vaporization and Thulium procedures performed during the learning curve of two expert endoscopic surgeons.
Over the last two decades the detection rate of small renal masses has increased, due to improving diagnostic accuracy, and nephron-sparing treatments have become the first-choice curative option for small renal masses. As a minimally invasive alternative, thermal ablation has increased in popularity, offering a good clinical outcome and low recurrence rate. Radiofrequency ablation, Cryoablation, and Microwave ablation are the main ablative techniques.
View Article and Find Full Text PDFSmall renal masses (SRM) are increasingly detected incidentally during imaging. They vary widely in histology and aggressiveness, and include benign renal tumors and renal cell carcinomas that can be either indolent or aggressive. Imaging plays a key role in the characterization of these small renal masses.
View Article and Find Full Text PDFObjectives: To test reproducibility and predictive value of a simplified score for assessment of extraprostatic tumor extension (sEPE grade).
Methods: Sixty-five patients (mean age ± SD, 67 years ± 6.3) treated with radical prostatectomy for prostate cancer who underwent 1.
Unlabelled: In the last decades, the refinements in the imaging techniques led to an increased number of detected renal tumors. If radical and partial nephrectomy remain the gold standard for the treatment of renal cancer, Radio-Frequency Ablation (RFA) has emerged as a therapeutic option for renal masses. Even if this technique is minimally-invasive, it requires a proper preoperative anatomic study and in some cases RFA treatment is technically challenging.
View Article and Find Full Text PDFIntroduction And Importance: Adrenal insufficiency (AI) is common after adrenalectomy for Primary Adrenal Cushing's syndrome (PACS), due to the inhibition of the Hypothalamic-Pituitary-Adrenal Axis (HPAA) by the functioning adrenal mass. The treatment of post-surgical AI is based mainly on glucocorticoid supplementation therapy. To date, however, there is no known predicting factor of the duration of supplementation therapy in patients treated with laparoscopic adrenalectomy for PACS.
View Article and Find Full Text PDFThe Prostate Specific Antigen (PSA) is the first filter in the diagnosis of prostate cancer. Unfortunately, it is organ-specific but not cancer-specific. In addition, some prostate cancers are not clinically-significant and their diagnosis and treatment may lead to overdiagnosis and overtreatment.
View Article and Find Full Text PDFMetastatic renal cell carcinoma (mRCC) may present with a wide range of clinical pictures. Reportedly, paraneoplastic syndromes are the first sign in 20% of cases and only 15% of cases show the classic triad (flank pain, gross hematuria, and palpable abdominal mass) at presentation. The remaining cases present with signs and symptoms related to the site of distant metastases.
View Article and Find Full Text PDFIntroduction: External Beam Radiation Therapy (EBRT) is one of the option available for the treatment of clinically localized prostate cancer. In patients with radiorecurrent localized prostate cancer, Androgen Deprivation Therapy (ADT) is one of the most common therapeutic strategies. However, in the last decades, other salvage treatment options have been investigated, such as brachytherapy, cryoablation and High Intensity Focused Ultrasound (Hifu).
View Article and Find Full Text PDFCT-guided percutaneous drainage is a safe and effective procedure that allows minimally invasive treatment of abdominopelvic abscesses and fluid collections. This technique has become an alternative for surgery with lower morbility and mortality rates. In this pictorial essay, we aim at providing an overview of the technical approaches, the main clinical indications and complications of CT-guided percutaneous drainage, in order to provide a practical guide for interventional radiologists, with a review of the recent literature.
View Article and Find Full Text PDFMüllerianosis is an extremely rare entity consisting of an admixture of 2 or more müllerian tissues. We report the case of a 61 years old woman who came to our attention with hypogastric pain and dysuria. She was in menopause and had a previous history of cesarean section.
View Article and Find Full Text PDFThe growing interest in multiparametric MRI is leading to important changes in the diagnostic process of prostate cancer. MRI-targeted biopsy is likely to become a standard for the diagnosis of prostate cancer in the next years. Despite it is well known that MRI has no role as a staging technique, it is clear that multiparametric MRI may be of help in active surveillance protocols.
View Article and Find Full Text PDFSince its first reported application, renal biopsy became an important part of the diagnostic algorithm, considered advantages and risks, to better manage therapeutic options. The biopsy can be performed with different techniques (open, laparoscopic, transjugular, transurethral and percutaneous). Currently, the percutaneous approach is the modality of choice.
View Article and Find Full Text PDFIntroduction: Prostate cancer is considered one of the most important health problems. Due to the increased number of diagnosed patients and the inability to distinguish aggressive tumors, minimally-invasive procedures have become increasingly interesting. High-intensity focused ultrasound (HIFU) is an alternative option to radical surgery to treat prostate cancer.
View Article and Find Full Text PDFPurpose: We investigate the use of ratio of lesion to cortex (L/C) attenuation and aorta-lesion attenuation difference (ALAD) on multiphase contrast-enhanced CT to help distinguish oncocytoma from clear cell RCC in small renal masses (diameter < 4 cm).
Methods: We retrospectively identified 76 patients that undergo CT before surgery for a suspicious small renal mass between January 2014 and December 2018 with pathological diagnosis of 21 oncocytomas (ROs), 25 clear cell RCCs, 7 chromophobe RCCs, 7 papillary RCCs, 7 multilocular cystic RCCs, 7 angiomyolipomas and 2 leiomyomas. CT attenuation values were obtained for the tumor, the normal renal cortex and the aorta, placing a circular region of interest (ROI) in the same slice by two radiologists, independently.
Introduction: To retrospectively evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) with multitined expandable electrodes externally cooled with saline solution in patients with T1a renal cell carcinoma (RCC).
Materials And Methods: In this retrospective study, we evaluated 39 RCC in 35 patients treated with CT-guided RFA in 41 procedures (2011-2017). All patients were staged T1a, N0, M0 prior to RFA.
In the era of biochemical tests and algorithms, the management of prostate cancer from prevention to treatment is still controversial. The debate is focused on clinically-significant and clinically-insignificant prostate cancer. As it is well known, the diagnostic tools available are not able to distinguish between the two, thus leading to men treated for prostate cancer even if not strictly necessary.
View Article and Find Full Text PDFBackground: Pheochromocytoma is well-known for sudden initial presentations, particularly in younger patients. Hemodynamic instability may cause serious complications and delay a patient's ability to undergo surgical resection. Larger tumors present a further challenge because of the risk of catecholamine release during manipulations.
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