Key points In general, the higher the cholangiocarcinoma (type 3 and type 4) and the more multifocal the disease/obstruction, the more likely the patient is to require percutaneous therapy/drainage rather than endoscopic drainage. The two chief indications for preoperative biliary…
Key points Although relatively rare, cholangiocarcinoma is the second most common primary hepatobiliary malignancy in the United States, and its incidence is increasing. Surgical treatment remains the cornerstone of curative therapy. Resection frequently requires a major procedure but can be…
Key points Cytotoxic chemotherapy has not proven effective in hepatocellular carcinoma (HCC). Sorafenib is the only approved agent for advanced, unresectable disease. Current studies are evaluating a wide range of targeted agents covering the spectrum of molecular aberrations in HCC.…
Key points Image guided techniques are the most common invasive therapy for unresectable hepatocellular carcinoma (HCC). Level 1 evidence supports survival benefit chemoembolization. New embolic devices may offer benefits not currenlty realized. Background Hepatocellular carcinoma (HCC) is the fifth most…
Key points Patients with cirrhosis are at highest risk of developing hepatocellular carcinoma (HCC) and screening with sonography every 6 months is recommended. Early-stage HCC should be treated by resection, liver transplantation, or ablation. The best modality depends on tumor…
Introduction Research in interventional radiology has historically been driven by innovation and technological development leading to the conceptualization, investigation, validation, and application of a myriad of novel procedures into clinical practice. The development of new techniques and therapies is critical…
Key points The pathologic endpoint for percutaneous thermal or ethanol treatment of unresectable tumors is coagulation necrosis. Similarly, the goals of transarterial therapy are cell necrosis and apoptosis. Although specific follow-up imaging protocols differ among practitioners and institutions, contrast-enhanced computed…
Key points The clinical application of radiation oncology balances the dual goals of improved tumor control with reduced treatment-related morbidity. Over time, technological and biological advances have offered many opportunities to further reduce normal tissue complications and improve tumor control…
Key points Regional perfusion is a method of delivering high-dose chemotherapy to a region burdened with cancer. Isolated limb perfusion and hepatic perfusion are traditional open surgical methods of regional therapy in treating melanoma confined to an extremity or the…
Key points Percutaneous image-guided tumor ablation uses the cytotoxic properties of thermal energy or electric field strength to cause cell death. The thermal ablative effect due to coagulation necrosis is generated by the Radiofrequency probe, which acts as the cathode…