Liver cancers are the second most frequent cause of global cancer-related mortality of which 90%are attributable to hepatocellular carcinoma(HCC).Despite the advent of screening programmes for patients with known risk...Liver cancers are the second most frequent cause of global cancer-related mortality of which 90%are attributable to hepatocellular carcinoma(HCC).Despite the advent of screening programmes for patients with known risk factors,a substantial number of patients are ineligible for curative surgery at presentation with limited outcomes achievable with systemic chemotherapy/external radiotherapy.This has led to the advent of numerous minimally invasive options including but not limited to trans-arterial chemoembolization,radiofrequency/microwave ablation and more recently selective internal radiation therapy many of which are often the first-line treatment for select stages of HCC or serve as a conduit to liver transplant.The authors aim to provide a comprehensive overview of these various image guided minimally invasive therapies with a brief focus on the technical aspects accompanied by a critical analysis of the literature to assess the most up-to-date evidence from comparative systematic reviews and meta-analyses finishing with an assessment of novel combination regimens and future directions of travel.展开更多
Hemorrhagic complications related to bone marrow aspiration and trephine biopsy are uncommon. Risk factors include thrombocytopenia, myeloproliferative disorders, concurrent use of anticoagulants, and obesity. Here we...Hemorrhagic complications related to bone marrow aspiration and trephine biopsy are uncommon. Risk factors include thrombocytopenia, myeloproliferative disorders, concurrent use of anticoagulants, and obesity. Here we describe our technique for bone marrow aspiration and biopsy of the posterior iliac crest using CT guidance. Our technique ensures needle passage only through subcutaneous fat and bone, avoiding muscle and neurovascular structures, as well as controlled and precise needle advancement within bone. This technique should be considered for use in patients that are at increased risk for procedure related complications, particularly obese patients, where surface anatomical landmarks may prove unreliable.展开更多
文摘Liver cancers are the second most frequent cause of global cancer-related mortality of which 90%are attributable to hepatocellular carcinoma(HCC).Despite the advent of screening programmes for patients with known risk factors,a substantial number of patients are ineligible for curative surgery at presentation with limited outcomes achievable with systemic chemotherapy/external radiotherapy.This has led to the advent of numerous minimally invasive options including but not limited to trans-arterial chemoembolization,radiofrequency/microwave ablation and more recently selective internal radiation therapy many of which are often the first-line treatment for select stages of HCC or serve as a conduit to liver transplant.The authors aim to provide a comprehensive overview of these various image guided minimally invasive therapies with a brief focus on the technical aspects accompanied by a critical analysis of the literature to assess the most up-to-date evidence from comparative systematic reviews and meta-analyses finishing with an assessment of novel combination regimens and future directions of travel.
文摘Hemorrhagic complications related to bone marrow aspiration and trephine biopsy are uncommon. Risk factors include thrombocytopenia, myeloproliferative disorders, concurrent use of anticoagulants, and obesity. Here we describe our technique for bone marrow aspiration and biopsy of the posterior iliac crest using CT guidance. Our technique ensures needle passage only through subcutaneous fat and bone, avoiding muscle and neurovascular structures, as well as controlled and precise needle advancement within bone. This technique should be considered for use in patients that are at increased risk for procedure related complications, particularly obese patients, where surface anatomical landmarks may prove unreliable.
