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Current Role of Focal Therapy for Prostate Cancer
Published in Ayman El-Baz, Gyan Pareek, Jasjit S. Suri, Prostate Cancer Imaging, 2018
H. Abraham Chiang, George E. Haleblian
The adoption of less radical therapies has already occurred for the management most other solid organ malignancies. Within the field of urology, this transition can be appreciated in the management of small renal masses. Classically, small renal masses suspicious for malignancy were managed with radical nephrectomy. While this was associated with favorable oncologic outcomes, the consequences of being left with a solitary kidney can be significant, and patients with impaired baseline renal function may not be operative candidates for radical nephrectomy. With development of less radical treatment options, such as partial nephrectomy and percutaneous ablation therapies, patients now have less morbid yet oncologically sound options.
Thermal Therapy Applications of Electromagnetic Energy
Published in Ben Greenebaum, Frank Barnes, Biological and Medical Aspects of Electromagnetic Fields, 2018
P.R. Stauffer, D.B. Rodrigues, D. Haemmerich, C.-K. Chou
Standard radical or partial nephrectomy may be excessively invasive for small kidney tumors, and RFA can offer an alternative minimally invasive treatment [211,218]. Similar to applications in liver, RFA is most effective in treating kidney tumors less than 3 cm in diameter [218]. With increasing size, there is an increased risk of local recurrence. The number of patients treated is relatively small. However, early short-term results suggest a 70–90% success rate in small kidney tumors [211].
Urinary system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
In some cases of renal cell carcinoma, when nephrectomy is planned, renal artery embolisation may be used prior to surgery to minimise the risk of peri-operative haemorrhage. Embolic agents used can vary but commonly polyvinyl alcohol particles, embolic spheres, vascular plugs or a combination of agents is used.
Kidney tracking for live augmented reality in stereoscopic mini-invasive partial nephrectomy
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2023
Kilian Chandelon, Rasoul Sharifian, Salomé Marchand, Abderrahmane Khaddad, Nicolas Bourdel, Nicolas Mottet, Jean-Christophe Bernhard, Adrien Bartoli
Partial nephrectomy (PN) is the surgical resection of part of the kidney, usually to remove tumours. PN is nowadays largely performed mini-invasively (MIPN) by laparoscopy or robot-assistance (RAPN) instead of open surgery. MIPN reduces hospital stay, intraoperative blood loss, and operative time. Modern MIPN facilities provide enhanced 3D vision via a stereo endoscope. However, they challenge the surgeon in the localisation of the kidney’s internal anatomical structures, including the endophytic tumours, which are hidden in the parenchyma, and other important internal elements including the arteries, veins and urinary excretory tracts. Consequently, discerning the boundary between tumourous and healthy parenchyma, hence finding the optimal resection plane, can be extremely difficult. The use of intraoperative ultrasound (IOUS) partially mitigates these challenges but remains highly operator-dependent. This owes to the IOUS image being 2D and difficult to mentally re-position in the real surgical field. In other words, defining a resection path in the IOUS image does not directly translate to gesture guidance. A high level of expertise is thus required to achieve optimal endophytic tumour resection while maintaining sufficient tumour margins and sparring as much healthy tissue as possible.