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Interventional oncology

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447:(or as metastases): bone metastases located in the spine, pelvis and long bones can be treated with image guided ablative techniques (RFA, MWA, cryoablation, electroportation) with or without injection of cement (cementoplasty) to stabilize the bone. These treatments may be palliatively for bone metastases pain or for some cases such as osteoid osteoma can curatively treat tumors. 330:(also known as SIRT or Y-90 radioembolization or TARE): Injection of small beads loaded with a radioactive isotope, Yittrium-90 (Y-90), into blood vessels feeding a tumor in order to deliver a lethal dose of radiation causing cell death. Can be performed in a segmental (radiation segmentectomy) or a lobar ( 1572:
Rivero, J. Ricardo; De La Cerda, Jose; Wang, Hanzhang; Liss, Michael A.; Farrell, Ann M.; Rodriguez, Ronald; Suri, Rajeev; Kaushik, Dharam (January 2018). "Partial Nephrectomy versus Thermal Ablation for Clinical Stage T1 Renal Masses: Systematic Review and Meta-Analysis of More than 3,900 Patients".
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Interventional oncology has long been used to provide palliative care for patients. IO procedures can help reduce cancer-related pain and improve patients’ quality of life. Tumours can intrude into various ducts and blood vessels of the body, obstructing the vital passage of food, blood or waste. The
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cancer. IO treatments may be also offered in combination with any of the above oncological therapies in order to augment the therapeutic outcome in more complex or widespread (metastatic) cancer cases. There is a variety of applications of interventional oncological treatments for tumors that arise
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Hickey, Ryan; Vouche, Michael; Sze, Daniel Y.; Hohlastos, Elias; Collins, Jeremy; Schirmang, Todd; Memon, Khairuddin; Ryu, Robert K.; Sato, Kent; Chen, Richard; Gupta, Ramona; Resnick, Scott; Carr, James; Chrisman, Howard B.; Nemcek, Albert A.; Vogelzang, Robert L.; Lewandowski, Robert J.; Salem,
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Hickey, Ryan; Vouche, Michael; Sze, Daniel Y.; Hohlastos, Elias; Collins, Jeremy; Schirmang, Todd; Memon, Khairuddin; Ryu, Robert K.; Sato, Kent; Chen, Richard; Gupta, Ramona; Resnick, Scott; Carr, James; Chrisman, Howard B.; Nemcek, Albert A.; Vogelzang, Robert L.; Lewandowski, Robert J.; Salem,
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of tumours is generally accepted to offer the best long-term solution, it is often not possible due to the size, number or location of the tumour. IR therapies may be applied to shrink the tumour, making a surgical or interventional treatment possible. Some patient groups may also be too weak to
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Cancer is a multifaceted disease group that requires a multidisciplinary approach to treatment. Numerous studies have shown that cancer patients treated in multidisciplinary environments benefit greatly from the combined expertise. Interventional Radiologists are seen as playing a major role in
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can be treated with image guided ablation (RFA, MWA, cryotherapy) with similar results to partial nephrectomy. Benign kidney tumors such as angiomyolipomas can be treated with transarterial embolization to shrink the tumor size and reduce the risk of rupture/bleeding. Other
158:) solid tumors resulting in tumor cell death. Ablation techniques can be performed throughout the body such as in the lung, liver, kidney, prostate, breast, bone, and other organs using image guidance to place a needle/probe through the skin into the target tissue. 1131:
Napoli, Alessandro; Anzidei, Michele; Marincola, Beatrice Cavallo; Brachetti, Giulia; Noce, Vincenzo; Boni, Fabrizio; Bertaccini, Luca; Passariello, Roberto; Catalano, Carlo (2013). "MR Imaging–guided Focused Ultrasound for Treatment of Bone Metastasis".
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interventional radiological treatment known as stenting can be used to re-open blockages, for example of the esophagus or bile ducts in cases of esophageal cancer or cholangiocarcinoma, respectively, considerably relieving the patient's adverse symptoms.
601:. For example, IO techniques can be used to shrink large tumours making them easier to excise. Chemotherapeutic drugs can also be administered intra-arterially, increasing their potency and removing the harsh effects of system-wide application. 597:
undergo open surgery. IR treatments can be applied in these complex cases to provide effective and milder forms of treatment. Interventional oncological techniques can also be used in combination with other treatments to help increase their
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Proper patient selection is the key element for the success of any medical procedure and improper conduct can have fatal consequences. Patient selection protocols must be strictly followed before treating patients with IO procedures.
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techniques that destroy neoplastic tissues by delivery of some form of heat, cryo or electromagnetic energy and embolization techniques that aim to occlude the blood vessels feeding the tumour and thereby destroy it by means of
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Patients can greatly benefit from IO treatments. The minimally invasive nature of the treatments means they cause less pain, fewer side effects and shorter recovery times. Many IO procedures can be performed on an
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procedures that help obtain tissue diagnosis of suspicious neoplasms and therapeutic ones that aim to cure or palliate the tumour. Therapeutic interventional oncology procedures may be classified further into
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feeding the lobe of liver containing the tumor(s) of interest to induce growth of the non-diseased lobe in order to have adequate liver function necessary to undergo surgical resection of lobe containing the
414:: lung metastases or inoperable primary lung cancer can be treated by interventional radiology procedures such as image guided ablation (cryoablation, microwave ablation and radiofrequency ablation). 31:
and cancer-related problems using targeted minimally invasive procedures performed under image guidance. Interventional oncology has developed to a separate pillar of modern oncology and it employs
334:) fashion. Radiation lobectomy is commonly performed with the goal of inducing growth of the non-diseased lobe in order to have adequate liver function necessary to undergo surgical resection. 281:
into the arteries feeding a tumor in order to completely occlude the tumor's blood supply and cause cell death. The most common indication is for treatment of unresectable liver cancer (
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to help guide miniaturized instruments (e.g. biopsy needles, ablation electrodes, intravascular catheters) to allow targeted and precise treatment of solid tumours (also known as
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Deneve, Jeremiah L.; Choi, Junsung; et al. (December 2012). "Chemosaturation with Percutaneous Hepatic Perfusion for Unresectable Isolated Hepatic Metastases from Sarcoma".
133:: similar to core needle aspiration but using vacuum assistance to gather the sample. Vacuum assisted breast biopsy may provide a high diagnostic yield in case of breast tumours. 459:: for small, solitary breast cancer image guided ablative techniques are used to treat tumors, however their efficacy versus surgical resection has not yet been studied. 1074:
Santiago, Fernando Ruiz; del Mar Castellano García, María; Montes, Jose Luis Martínez; García, Manuel Ruiz; Fernández, Juan Miguel Tristán (2009-01-07).
871: 926:"Phase 3 Study of ThermoDox With Radiofrequency Ablation (RFA) in Treatment of Hepatocellular Carcinoma (HCC) - Full Text View - ClinicalTrials.gov" 399: 290: 406:(SIRT/Y-90 radioembolization), portal vein embolization, transarterial/bland embolization, or image guided ablation (RFA, MWA, IRE, Cryoablation). 310:
Drug-eluting bead chemoembolization (DEB-TACE): delivery of microparticles that are themselves loaded with the chemotherapy agent – typically
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Shah, Rajesh P.; Brown, Karen T.; Sofocleous, Constantinos T. (October 2011). "Arterially directed therapies for hepatocellular carcinoma".
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Uses a machine that emits high frequency sound waves to kill cancer cells and provide relief for tumor-related pain, such as in the bone.
1334:"Treatment of unresectable intrahepatic cholangiocarcinoma with yttrium-90 radioembolization: a systematic review and pooled analysis" 71:. Interventional oncology treatments are routinely carried out by interventional radiologists in appropriate settings and facilities. 2042: 245: 1167:
Gangi, A.; Basile, A.; Buy, X.; Alizadeh, H.; Sauer, B.; Bierry, G. (2005). "Radiofrequency and laser ablation of spinal lesions".
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multidisciplinary cancer teams where they provide innovative solutions to improve combined therapies and to treat complications.
93:. Both ablation and embolization techniques are minimally invasive treatment, i.e. they may be delivered through the skin (in a 1951:
Adam, Andreas; Kenny, Lizbeth M. (2015). "Interventional oncology in multidisciplinary cancer treatment in the 21st century".
1498: 471: 952:"Cryoablation vs radiofrequency ablation for the treatment of renal cell carcinoma: a meta-analysis of case series studies" 297:
into arteries feeding a tumor that both delivers chemotherapy and blocks the blood supply to the tumor to cause cell death
773: 467:: inoperable tumors can be treated with image guided ablative techniques and more recently irreversible electroporation. 191: 151: 640:
IO treatments are carried out under image guidance. For this reason practitioners must have attained solid training in
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Pereira, Philippe L.; Salvatore, Masala; Cardiovascular Interventional Radiological Society of Europe (CIRSE) (2012).
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appointments and patients may enjoy rapid recovery and minimal pain and discomfort with low rates of complications.
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Barney Brooks, The Treatment of Traumatic Arteriovenous Fistula, Southern Medical Journal. 01/1930; 23(2):100-106.
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Sabel, Michael S. (July 2014). "Nonsurgical ablation of breast cancer: future options for small breast tumors".
1675:"Ablation of Musculoskeletal Metastases: Pain Palliation, Fracture Risk Reduction, and Oligometastatic Disease" 653: 391: 352: 282: 24: 1929: 347:
Intra-arterial chemotherapy: high dose chemotherapy is administered directly into the tumor-feeding arteries.
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Chemical ablation: one of the earliest ablative techniques involving the injection of substances such as
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with high dose chemotherapy with or without microparticles directly into the tumor-feeding arteries.
331: 127:: similar to fine-needle aspiration, only involving the use of larger needles to excise the tissue. 1976: 1911: 1868: 1674: 989: 829: 593: 395: 274: 223: 147: 124: 1332:
Al-Adra, D. P.; Gill, R. S.; Axford, S. J.; Shi, X.; Kneteman, N.; Liau, S.-S. (January 2015).
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1997 – Intra-arterial delivery of tumor-killing viruses and gene therapy vectors to the liver.
484: 480: 1525:"Standards of Practice: Guidelines for Thermal Ablation of Primary and Secondary Lung Tumors" 800:"Standards of Practice: Guidelines for Thermal Ablation of Primary and Secondary Lung Tumors" 1960: 1895: 1852: 1806: 1790: 1749: 1733: 1686: 1645: 1629: 1582: 1536: 1470: 1429: 1413: 1361: 1345: 1279: 1261: 1211: 1176: 1141: 1103: 1087: 1040: 963: 847:
The Royal College of Radiologists UK. Interventional Oncology: Guidance for Service delivery
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https://www.mskcc.org/videos/irreversible-electroporation-nanoknife-treat-prostate-tumors
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Radiology (ACR), Radiological Society of North America (RSNA) and American College of.
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1990s – RFA for soft tissue tumors, i.e., bone, breast, kidney, lung and liver cancer.
194:: delivery of electrical fields to disrupt cellular membranes and cause cell death or 2031: 968: 951: 505: 456: 427: 1915: 993: 833: 1980: 1872: 536: 498: 448: 436: 387: 209: 180:: tissue destruction through delivery of electricity that produces ionic friction. 155: 121:
with a fine needle trying to obtain tissue diagnosis by examining the tumour cells.
98: 94: 1936:. Cardiovascular and Interventional Radiological Society of Europe. Archived from 925: 676:"Cancer Concepts and Principles: Primer for the Interventional Oncologist—Part II" 726:"Cancer Concepts and Principles: Primer for the Interventional Oncologist—Part I" 378:
Interventional oncology (IO) procedures are commonly applied to treat primary or
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Laser ablation (Interstitial laser therapy): tissue coagulation by a laser beam.
231: 227: 167: 1964: 1690: 1586: 1349: 1180: 777: 741: 691: 212:: instant cell death by tissue freezing to temperatures as low as -20 Celsius. 1899: 1541: 1524: 1266: 1091: 1044: 816: 799: 606: 542:
1983 – Laser interstitial thermal therapy first performed on a tumour by Bown.
509: 418: 379: 338: 315: 293:(TACE): Injection of a chemotherapy agent often with microparticles through a 249: 238: 216: 202: 184: 171: 102: 80: 52: 36: 1802: 1745: 1698: 1641: 1594: 1550: 1425: 1357: 1275: 1223: 1099: 1052: 977: 439:
are also performed for symptom relief or prior to surgery to reduce bleeding.
195: 48: 1972: 1907: 1820: 1763: 1706: 1659: 1633: 1602: 1558: 1484: 1443: 1417: 1375: 1293: 1231: 1188: 1153: 1117: 1060: 985: 825: 759: 709: 1864: 277:: Injection of embolic material (microparticles, alcohol, glue) through a 1402:"Portal vein embolization: rationale, technique, and current application" 1145: 902:"Radiofrequency Ablation (RFA) | Microwave Ablation (MWA) - Liver Tumors" 598: 304: 294: 278: 90: 85: 1215: 1856: 1779:"Use of irreversible electroporation in unresectable pancreatic cancer" 580: 163: 60: 2008:
IASIOS- International Accreditation System for Interventional Oncology
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Katsanos, K.; Ahmad, F.; Dourado, R.; Sabharwal, T.; Adam, A. (2009).
1250:"Chemoembolization and radioembolization for hepatocellular carcinoma" 546: 525:
1969 – The catheter-delivered stenting technique and prototype stent.
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Cardiovascular and Interventional Radiological Society of Europe, "
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Conventional transarterial chemoembolization (cTACE): Injection of
1937: 512:(Y90) started to be investigated for the use in cancer treatments. 64: 56: 32: 79:
Interventional oncology procedures are generally divided between
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Cardiovascular and Interventional Radiological Society of Europe
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Nguyen, Tiffany; Hattery, Eleanor; Khatri, Vijay P. (May 2014).
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procedure (of a carotid-cavernous fistula); described by Brooks.
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Cancer Treatment Center of America, Intra-Arterial chemotherapy
1308:"Chemotherapy Delivery Options: Benefits of Regional Therapies" 2018:
ECIO - European Conference on Interventional Oncology Services
1076:"Treatment of bone tumours by radiofrequency thermal ablation" 97:
way) without the need for any skin incisions or other form of
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and liver metastases are often treated by procedures such as
101:. Hence, most treatments are nowadays offered as day case or 950:
El Dib, Regina; Touma, Naji J.; Kapoor, Anil (August 2012).
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1990s – Treatment of bone and kidney tumors by embolization.
1499:"Liver Cancer Interventional Radiology: Minimally Invasive" 451:
are also performed for prior to surgery to reduce bleeding.
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CIO - Annual Symposium on Clinical Interventional Oncology
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Kurup, Anil Nicholas; Callstrom, Matthew R. (2013-12-01).
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2012 – Pioneering liver chemoperfusion study reported by
483:: inoperable, or borderline resectable, locally advanced 2007: 1997: 549:
are developed for vascular and oncological applications.
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waves that accumulates high energy and burns the tissue.
2002: 2017: 2012: 1523:
Pereira, Philippe L.; Salvatore, Masala (April 2012).
774:"Interventional Radiology Treatments for Liver Cancer" 1722:"Radiofrequency ablation and breast cancer: a review" 1679:
Techniques in Vascular & Interventional Radiology
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basis, freeing up hospital beds and reducing costs.
1616:Foster, Ryan C.B.; Stavas, Joseph M. (June 2014). 528:1970s – Embolisation agents started to be used in 470:Irreversible electroporation video demonstration: 201:Irreversible electroporation video demonstration: 1248:Salem, Riad; Lewandowski, Robert J. (June 2013). 417:Cryoablation of lung cancer video demonstration: 226:: electromagnetic energy produces high frequency 1575:Journal of Vascular and Interventional Radiology 1400:May, Benjamin J.; Madoff, David C. (June 2012). 730:Journal of Vascular and Interventional Radiology 680:Journal of Vascular and Interventional Radiology 515:1966 – Embolization therapy to treat tumors and 487:can be treated with irreversible electroporation 170:into a tumour to cause protein denaturation and 27:that deals with the diagnosis and treatment of 1934:European Conference of Interventional Oncology 355:(PVE): delivery of embolic material into the 183:Radiofrequency ablation video demonstration: 8: 1243: 1241: 150:), deliver electrical fields/electroporate ( 1888:CardioVascular and Interventional Radiology 1529:CardioVascular and Interventional Radiology 1080:Current Reviews in Musculoskeletal Medicine 804:CardioVascular and Interventional Radiology 419:https://www.youtube.com/watch?v=RH4po_14mDY 339:https://www.youtube.com/watch?v=YndyQkSZl5I 239:https://www.youtube.com/watch?v=uPcU7HFumIk 217:https://www.youtube.com/watch?v=goLRh3UX0vM 203:https://www.youtube.com/watch?v=NL-IIq-c3Ic 185:https://www.youtube.com/watch?v=8Xu0mxkLSzE 1843:Bown SG (1983). "Phototherapy in tumors". 1033:Surgical Oncology Clinics of North America 291:Trans(catheter) arterial chemoembolization 1810: 1753: 1649: 1540: 1474: 1459:"Interventional radiology in the elderly" 1433: 1365: 1283: 1265: 1107: 967: 872:"Radiofrequency ablation for lung cancer" 815: 749: 699: 1254:Clinical Gastroenterology and Hepatology 260:High-intensity focused ultrasound (HIFU) 237:Microwave ablation video demonstration: 142:Uses different types of energy to burn ( 665: 1338:European Journal of Surgical Oncology 230:of water molecules leading to tissue 7: 1622:Seminars in Interventional Radiology 1406:Seminars in Interventional Radiology 404:Selective internal radiation therapy 328:Selective internal radiation therapy 300:Can be performed in different ways: 1998:Society of Interventional Radiology 1795:10.3978/j.issn.2304-3881.2015.01.10 1783:Hepatobiliary Surgery and Nutrition 1738:10.3978/j.issn.2227-684X.2014.03.05 1503:Cancer Treatment Centers of America 1312:Cancer Treatment Centers of America 198:or enhance targeted drug delivery. 55:, including but not limited to the 51:) located in various organs of the 1777:Martin, Robert C. G. (June 2015). 1169:Seminars in Ultrasound, CT and MRI 583:for disseminated liver metastases. 215:Cryoablation video demonstration: 14: 1204:American Journal of Roentgenology 1008:"Cryotherapy for Prostate Cancer" 273:Transarterial embolization (TAE)/ 248:(HIFU): targeted beam of focused 246:High-intensity focused ultrasound 152:irreversible electroporation(IRE) 1953:Nature Reviews Clinical Oncology 969:10.1111/j.1464-410X.2011.10885.x 45:magnetic resonance imaging (MRI) 1618:"Bone and Soft Tissue Ablation" 1463:Clinical Interventions in Aging 400:transarterial chemoembolization 390:: primary liver tumors such as 1: 554:Radiofrequency ablation (RFA) 144:radiofrequency ablation (RFA) 23:) is a subspecialty field of 878:. 2017-08-21. Archived from 192:Irreversible electroporation 556:technique for liver tumors. 522:by blocking the blood flow. 138:Image-guided tumor ablation 2064: 1965:10.1038/nrclinonc.2014.211 1691:10.1053/j.tvir.2013.08.007 1587:10.1016/j.jvir.2017.08.013 1350:10.1016/j.ejso.2014.09.007 1181:10.1053/j.sult.2005.02.005 742:10.1016/j.jvir.2013.04.024 692:10.1016/j.jvir.2013.04.023 618:Multidisciplinary approach 337:Y-90 video demonstration: 1900:10.1007/s00270-012-0425-x 1542:10.1007/s00270-012-0340-1 1267:10.1016/j.cgh.2012.12.039 1092:10.1007/s12178-008-9042-3 1045:10.1016/j.soc.2014.03.009 817:10.1007/s00270-012-0340-1 497:1930 – First therapeutic 485:pancreatic adenocarcinoma 2043:Interventional radiology 1845:World Journal of Surgery 654:Interventional radiology 430:: kidney tumors such as 392:hepatocellular carcinoma 353:Portal vein embolization 283:hepatocellular carcinoma 148:microwave ablation (MWA) 41:computed tomography (CT) 25:interventional radiology 539:to freeze liver tumors. 178:Radiofrequency ablation 17:Interventional oncology 1634:10.1055/s-0034-1373791 1418:10.1055/s-0032-1312568 613:Further considerations 545:1985 – Self-expanding 532:to treat liver tumors. 520:vascular malformations 268:Embolisation therapies 131:Vacuum-assisted biopsy 115:Fine-needle aspiration 906:www.radiologyinfo.org 365:Palliative treatments 109:Diagnostic techniques 1146:10.1148/rg.336125162 642:radiation protection 636:Radiation protection 572:first used to treat 432:renal cell carcinoma 75:Procedures performed 1216:10.2214/AJR.11.7554 332:Radiation Lobectomy 1857:10.1007/BF01655209 930:clinicaltrials.gov 594:surgical resection 396:cholangiocarcinoma 275:bland embolization 224:Microwave ablation 125:Core needle biopsy 956:BJU International 627:Patient selection 2055: 1985: 1984: 1948: 1942: 1941: 1926: 1920: 1919: 1894:(6): 1480–1487. 1883: 1877: 1876: 1840: 1834: 1831: 1825: 1824: 1814: 1774: 1768: 1767: 1757: 1717: 1711: 1710: 1670: 1664: 1663: 1653: 1613: 1607: 1606: 1569: 1563: 1562: 1544: 1520: 1514: 1513: 1511: 1510: 1495: 1489: 1488: 1478: 1454: 1448: 1447: 1437: 1397: 1391: 1386: 1380: 1379: 1369: 1329: 1323: 1322: 1320: 1319: 1304: 1298: 1297: 1287: 1269: 1245: 1236: 1235: 1199: 1193: 1192: 1164: 1158: 1157: 1140:(6): 1555–1568. 1128: 1122: 1121: 1111: 1071: 1065: 1064: 1028: 1022: 1021: 1019: 1018: 1004: 998: 997: 971: 947: 941: 940: 938: 937: 922: 916: 915: 913: 912: 897: 891: 890: 888: 887: 868: 862: 855: 849: 844: 838: 837: 819: 795: 789: 788: 786: 785: 776:. Archived from 770: 764: 763: 753: 736:(8): 1157–1164. 720: 714: 713: 703: 686:(8): 1167–1188. 670: 374:Diseases treated 2063: 2062: 2058: 2057: 2056: 2054: 2053: 2052: 2028: 2027: 1994: 1989: 1988: 1950: 1949: 1945: 1928: 1927: 1923: 1885: 1884: 1880: 1842: 1841: 1837: 1832: 1828: 1776: 1775: 1771: 1719: 1718: 1714: 1672: 1671: 1667: 1615: 1614: 1610: 1571: 1570: 1566: 1522: 1521: 1517: 1508: 1506: 1497: 1496: 1492: 1456: 1455: 1451: 1399: 1398: 1394: 1387: 1383: 1331: 1330: 1326: 1317: 1315: 1306: 1305: 1301: 1247: 1246: 1239: 1210:(4): W590–602. 1201: 1200: 1196: 1166: 1165: 1161: 1130: 1129: 1125: 1073: 1072: 1068: 1030: 1029: 1025: 1016: 1014: 1006: 1005: 1001: 949: 948: 944: 935: 933: 932:. 24 March 2017 924: 923: 919: 910: 908: 899: 898: 894: 885: 883: 870: 869: 865: 856: 852: 845: 841: 797: 796: 792: 783: 781: 772: 771: 767: 722: 721: 717: 672: 671: 667: 662: 650: 638: 629: 620: 615: 590: 574:prostate cancer 530:palliative care 494: 376: 367: 270: 262: 140: 111: 77: 12: 11: 5: 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Index

interventional radiology
cancer
X-ray
ultrasound
computed tomography (CT)
magnetic resonance imaging (MRI)
neoplasms
human body
liver
kidneys
lungs
bones
diagnostic
ablation
ischemia
percutaneous
open surgery
outpatient
Fine-needle aspiration
biopsy
Core needle biopsy
Vacuum-assisted biopsy
radiofrequency ablation (RFA)
microwave ablation (MWA)
irreversible electroporation(IRE)
cryoablation
ethanol
acetic acid
cell death
Radiofrequency ablation

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