Uncategorized – Pagina 5

Settembre 9, 2023

Image guided thermal ablation of T1 renal cell cancer: A single centre experience.

Image guided thermal ablation of T1 renal cell cancer: A single centre experience. Purpose: To evaluate the oncological outcomes and survival times after ablation of T1 renal cell carcinoma (RCC) in our unit over a 9-year period. Materials and Methods: We retrospectively reviewed all patients with biopsy proven RCC who underwent image guided tumour ablation (IGTA) of a T1 tumour between 1st March 2013 and 1st August 2022. Data collected included: patient demographics, tumour size and histology, pre and post procedure creatinine, ablation technique, complications, oncological outcomes, disease free survival and overall survival. Results: 50 ablative procedures were performed on 46 RCC (mean tumour size 2.6cm) in 45 patients. Technical success was achieved in 100% of tumours (n=46/46). Complications occurred in 8% of procedures (n=4/50). Median clinical follow-up was 27.5 months (range 3 - 88). There was no significant change in creatinine due to IGTA. Primary efficacy of ablation was 94% (43/46 tumours). Microwave ablation (MVA) was less likely to achieve local tumour control when compared to radiofrequency ablation (RFA) (82% (14/17) vs 100% (28/28) respectively, (p=0.02). Larger median RCC diameter was associated with failed primary efficacy in the MWA group (3.8 cm vs 2.4 cm respectively, p= 0.045). Overall survival at 1, 5 and 9 years was 97.4%, 66.7% and 40% respectively. Conclusion: IGTA is a highly efficacious modality and provides an effective durable treatment option for patients with T1 RCCs. Primary efficacy was greater with RFA than MWA. Primary efficacy failure in the MWA group is associated with greater median RCC size.

Settembre 9, 2023

IMAGING FINDING IN RENAL CELL CARCINOMA – DIAGNOSIS AND STAGING

RCC, Urogenital, CT, MR, AJCC TNM.

Settembre 9, 2023

Imaging findings of primary prostatic lymphoma

[1] Wang K, Wang N, Sun J, Fan Y, Chen L. Primary prostate lymphoma: A case report and literature review. Int J Immunopathol Pharmacol. 2019 Jan-Dec;33:2058738419863217. doi: 10.1177/2058738419863217. [2] Taleb A, Ismaili N, Belbaraka R, Bensouda A, Elghissassi I, Elmesbahi O, Droz JP, Errihani H., Primary lymphoma of the prostate treated with rituximab-based chemotherapy: a case report and review of the literature. Cases J. 2009 Aug 11;2:8875. doi: 10.1186/1757-1626-0002-0000008875. [3] Hu S, Wang Y, Yang L, Yi L, Nian Y. Primary non-Hodgkin's lymphoma of the prostate with intractable hematuria: A case report and review of the literature. Oncol Lett. 2015 Mar;9(3):1187-1190. doi: 10.3892/ol.2014.2829. [4] D'souza MM, Jaimini A, Bansal A, Tripathi M, Sharma R, Mondal A, Tripathi RP. Indian J Radiol Imaging. 2013 Oct;23(4):354-65. doi: 10.4103/0971-3026.125626. [5] Al Tabaa Y, Bailly C, Kanoun S. FDG-PET/CT in Lymphoma: Where Do We Go Now? Cancers (Basel). 2021 Oct 18;13(20):5222. doi: 10.3390/cancers13205222. [6] Jadvar H. FDG PET in Prostate Cancer. PET Clin. 2009 Apr 1;4(2):155-61. doi: 10.1016/j.cpet.2009.05.002. [7] Han C, Zhu L, Liu X, Ma S, Liu Y, Wang X. Insights Imaging. 2021 Jun 16;12(1):79. doi: 10.1186/s13244-021-01024-3. [8] Bostwick DG, Iczkowski KA, Amin MB, Discigil G, Osborne B. Malignant lymphoma involving the prostate: report of 62 cases. Cancer 1998 Aug 15;83(4):732-8. doi: 10.1002/(sici)1097-0142(19980815)83:43.0.co;2-t.

Settembre 9, 2023

Imaging in renal cell carcinoma – (a)typical findings

Renal cell carcinoma (RCC) constitutes 2%-3% of adult malignancies and can be familial or sporadic. The incidence of RCC is increasing because of the increased use of abdominal imaging. The main histological subtypes of RCC are clear cell, papillary and chromophobe tumors accounting for 70%, 10%-15% and 5% of RCCs respectively, with different imaging features, prognosis and response to treatment. The clear cell subtype of RCC is the most common variant and has the least favourable prognosis. Their imaging findings are in accordance to their histopathological features (hypervascularized and heterogeneous lesions). Papillary RCCs tend to be solid, well defined and slow growing lesions. These tumors are typically homogeneous and hypovascular. The chromophobe subtype of RCC shares histopathological and imaging features to oncocytomas. They are more homogeneous than clear cell carcinomas and can exhibit a central scar (like oncocytomas). Imaging is also useful to detect local recurrence and metastatic disease. The main differential diagnoses include benign tumors like oncocytoma, angiomyolipoma; others malignant renal tumors and pseudotumors. The RCC subtypes have different imaging features that should be recognized by radiologists because of implications for clinical management.

Settembre 9, 2023

Impact of body composition on clinical outcomes in patients with metastatic hormone sensitive prostate cancer treated with androgen deprivation therapy plus second-generation antiandrogen.

This comprehensive investigation delves deeply into the multifaceted interplay between second-generation antiandrogen treatments, body composition dynamics, and clinical outcomes in mHSPC. Our findings raise intriguing questions about the potential clinical significance of changes in BMI and BCPs, as well as the varying impacts of ABI and APA on disease progression and response. These insights have the potential to inform personalized treatment strategies and enhance our understanding of the intricate relationship between body composition and mHSPC management, ultimately striving for improved therapeutic outcomes and patient well-being.

Settembre 9, 2023

Incidental detection on imaging in patients with a diagnosis of prostate cancer – lucky find or poisoned chalice?

This study showed that patients with incidental findings on imaging actually had a statistically significant faster time to treatment than patients without incidental findings, by 4 days.

Settembre 9, 2023

Incidental detection on imaging performed during the work-up via MDTs of patients with kidney cancer – lucky find or poisoned chalice?

Common incidental findings from imaging done for kidney cancer patients include renal cysts, lung nodules, liver cysts and gallstones. 2 out of 555 patients had an isolated malignancy of lung cancer and chronic lymphocytic leukaemia found. Through this research, patients with incidental findings and no incidental findings were found to have no difference in their median number of MDT discussions (1) and median time to treatment (35 days).

Settembre 9, 2023

Incidental findings we don’t want to miss on prostate multiparametric-MRI: a pictorial review

mp-MRI is currently the gold standard imaging method for prostate cancer diagnosis, for detecting focal areas suspicious for clinically significant malignancy that could be considered potential sites for biopsy, while assuming an equally crucial role in prostate cancer regional staging and surveillance. Its widespread usage, combined with a field-of-view that must extend at least in one of the sequences to the level of the aortic bifurcation, allows the detection of both clinically significant and indolent incidental findings, not only in the prostate, but also in the peri-prostatic region, including the remaining pelvic and abdominal organs covered, muscles, bones and vessels. Although many of these findings are benign, some may have clinical implications and represent malignant or potentially life-threatening entities, reinforcing the importance of its recognition. Taken that, and in a context where this exam is often performed for known or strongly suspected prostate cancer, it is particularly crucial for the radiologist to systematically look for and beyond the prostate as our goal is to avoid miss or misdiagnosing in a setting where prompt detection and appropriate follow-up have inevitable implications on clinical management and patient anxiety.