offers metastatic recurrence-free survival and cancerspecific survival similar to that of radiofrequency ablation and cryoablation.
was not impacted by the advent of hand-assisted laparoscopic radical nephrectomy.
is the predominant treatment modality employed in the United States for the management of small renal masses.
when performed laparoscopically is associated with fewer complications than radiofrequency ablation (RFA) or cryoablation.
offers equivalent cancer-specific and overall survival when compared with radical nephrectomy.
treatment under real-time image guidance.
achieving a critical target temperature.
all of the above.
a double freeze-thaw cycle.
treatment to beyond 1â•¯cm of the targeted lesion.
inability to monitor treatment under image guidance.
higher risk of hemorrhage following RFA.
inferior cancer-specific survival.
inability to use RFA laparoscopically.
none of the above.
a lack of uniformity regarding evaluation, patient selection, treatment, and follow-up of patients undergoing renal tumor ablation.
higher local recurrence rates with ablative technologies when compared with partial or radical nephrectomy.
comparable or fewer complications with renal tumor ablation compared with extirpative treatments.
conflicting results regarding the superiority of cryoablation versus RFA.
applying RF currents faster to achieve better heating.
reducing impedance by improving current conductivity.
using higher RF currents.
clamping hilar vessels.
using bipolar electrodes.
Animal and human studies have demonstrated consistent tissue necrosis following treatment.
The most commonly cited complication following HIFU for the treatment of renal lesions is post-treatment hemorrhage.
Preliminary data suggests equivalent oncologic outcomes with HIFU when compared with alternative ablative technologies or extirpative options.
HIFU acts through local thermal and cavitary processes to generate tissue temperatures in excess of 65°
Because renal HIFU is performed under real-time image guidance, targeting is not significantly impacted by respiratory movement.
follow-up CT or MRI with contrast that demonstrates complete loss of contrast enhancement and stable or decreased size of the treated area.
follow-up CT or MRI without contrast that demonstrates a decrease in size of the treated area.
all of the above.
biopsy of the treatment area with hematoxylin and eosin (H&E) staining.
biopsy of the treatment area with reduced nicotinamide adenine dinucleotide (NADH) diaphorase staining.
Its use in the management of renal cell carcinoma remains investigational and should be performed under protocol.
Stereotactic treatment systems compensate for respiratory movement and radiation scatter by automatically tracking, detecting, and correcting for tumor and/or organ movement without interrupting the treatment or repositioning the patient.
Stereotactic radiosurgery employs 3-dimensional coordinates to target and focally ablate tissue using high-dose external beam radiation.
Radiation scatter is minimized, and higher doses may therefore be applied in a focal manner that effectively ablates masses in the kidney without compromising overall renal function.
Renal cell carcinoma (RCC) is radioresistant, and stereotactic radiosurgery has consistently demonstrated poor outcomes with treatment of RCC.
a 64-year-old woman with a 1.7-cm enhancing mass concerning for RCC in her transplant allograft. She has previously undergone bilateral native nephrectomy.
a 54-year-old man who has undergone prior left nephrectomy, right partial nephrectomy, and prior right tumor ablation for pathologically proven RCC. He now presents with an independent 2-cm enhancing renal lesion abutting the psoas muscle.
an otherwise healthy 81-year-old woman with a 3.2-cm lower pole enhancing renal mass that is anterior to the axis of the kidney. The patient desires treatment.
a 47-year-old man who is otherwise healthy and demonstrates a 3.1-cm mesophytic enhancing lesion of the right kidney.
a 74-year-old man with a 2.5-cm enhancing renal mass oriented posterior to the axis of the kidney. The patient has multiple comorbidities and desires a minimally invasive treatment approach.
選擇要在Apple App Store上查看的Topgrade應用程序。