Radiology Flashcards
What is the most common type of renal carcinoma?
Clear cell variant
What is the MOA of cryoablation?
Freezing and thawing of tumor cells
True or false: you can monitor the ablation zone during a cryoablation procedure
True
What are the disadvantages of cryoablation?
cryoshock–systemic inflammatory response leading to hypotension, respiratory compromise, DIC, and multiorgan failure
What percent of all adult cancers are renal cell carcinomas?
2%
How is RCC usually found?
Incidentally in imaging
What is a stage 1A renal cell carcinoma?
Tumor
What are the advantages of cryoablation?
- Outpatient
- done without general anesthesia
- Preserves renal function
- Fewer complications
True or false: you can diagnose hepatocellular carcinoma with imaging only
True
What is the primary risk factor for the development of hepatocellular carcinoma in the world? US?
world = hep b US = hep C
What alpha-1-antitrypsin disease?
protease malfunction causing liver and COPD
True or false: you need a cirrhotic liver to develop HCC
False
HCC mortality is (_)x greater in men with BMI
5x
What are the three main risk factors for the development of hepatocellular carcinoma?
HBV/HCV
Alcohol use
Obesity
Who has better 5 year survival rates: those who ablate the hepatocellular tumor, or those who get a liver transplant?
Liver transplant
What is transarterial chemoembolization?
Delivery of highly concentrated chemo in a lipid medium, combined with arterial embolization
What are the two blood supplies to the liver?
Hepatic artery
Hepatic portal vein
Why is the dual supply of blood to the liver important in chemoembolization?
allows to concentrate the chemo in the liver, and avoid high systemic doses (tumors usually get blood supply from the hepatic artery)
What is postembolization syndrome? What is the treatment?
N/v and abdominal pain following transarterial chemoembolization
Supportive
What is drug-eluting bead embolization?
300-700 micron beads loaded with chemotherapeutic drug, loaded into a specific tumor site
What is the most common drug used with drug-eluting bead embolization?
Doxorubicin
What is radiofrequency ablation?
Delivery of directed alternating current to create an ionic agitation, frictional heat, and cell death
What is microwave ablation?
Delivery of electromagnetic radiation causing agitation of the water molecules in the surrounding tissue, producing friction and heat
What is radioembolization?
Use of intra-arterially delivered microsphere emitting high dose radiation (Yttrium 90) for the treatment of unresectable liver tumors
What is radioembolization used for?
HCC and metastatic colorectal CA unresponsive to chemo
What is post-radioembolization syndrome?
mild pain and fatigue following radioembolization
What are the three most common cancers that cause malignant pleural effusions?
Lung
Breast
Ovarian
What is the prognosis fro pts with malignant pleural effusions?
4 months
What is a tunneled pleural catheter?
Tunneled, semi-permanent catheter placed in the pleural or peritoneal cavity, allowing the pt to perform home, or self drainage
What is the most common problem with a tunneled pleural catheter?
clogging/obstruction
About how many new cases of hepatocellular carcinomas are there per year? Deaths?
630,000 cases
600,000 deaths
What is the general trend of hepatocellular incidence?
Increasing
HCC incidence is increased how much in diabetics?
x2
What is the prevalence of NAFLD in western countries?
20-30% of adults
What is the survival rate of hepatocellular carcinoma?
Is transplant for HCC curative or non-curative?
Curative
Is transarterial therapy for HCC curative or non-curative?
Non Curative
Is surgical resection for HCC curative or non-curative?
Curative
Is percutaneous ablation for HCC curative or non-curative?
curative
Is systemic chemo for HCC curative or non-curative?
Non-curative
What is the best procedure for HCC? What percent of pts are eligible for this?
surgical resection
10-15%
Why are we able to target hepatomas so well?
Draw blood supply almost exclusively off of the hepatic artery
What percent of the liver’s blood supply comes from the hepatic artery?
25%
What percent of the liver’s blood supply comes from the portal vein?
75%
