Rhode Island Hospital news tips from Radiological Society of North America 2007 annual meeting

Embargo dates and times are noted with each news tip. All times listed below are in Central Standard Time.

Most incidentally found adrenal masses not malignant

Embargoed for release: Monday, November 26, 3:10 p.m. CST

A study by researchers at Rhode Island Hospital has determined that the vast majority of incidentally found adrenal masses identified in CT scans in patients without known malignancy are benign.

The study, led by radiologist Julie Song, M.D., examined 973 patients with 1,049 adrenal masses in order to describe the prevalence of pathology in adrenal masses incidentally identified on CT. According to the study, 1,045 of the 1,049 adrenal masses were confirmed to be benign and clinically insignificant. The study showed no metastasis even among the 14 patients who later developed malignancy elsewhere.

“Adrenal masses are common and are frequently found incidentally on CT. Our study has shown that the overwhelming majority of these masses are benign when found in patients with no known cancer. The implications of this study may save many patients from further exams,” said Song, who’s also an assistant professor of diagnostic imaging (clinical) at The Warren Alpert Medical School of Brown University.

Co-authors were Fakhra Chaudhry, M.D. and William Mayo-Smith, M.D. of Rhode Island Hospital and Alpert Medical School. (Abstract SSE06-02)

Patients respond well to new minimally invasive treatment for kidney tumors

Embargoed for release: Tuesday, November 27, 2007, 1:47 p.m. CST

A new study by researchers at Rhode Island Hospital confirms the success of a newer minimally invasive technique that uses heat to destroy kidney tumors.

After reviewing the outcomes of 143 solid kidney masses treated with radiofrequency ablation (RFA) over a nine-year period at Rhode Island Hospital, William Mayo-Smith, M.D., director of computed tomography at Rhode Island Hospital, and colleagues report that 137 of 143 tumors (96%) were successfully treated. A single treatment session was effective for 123 tumors, two sessions were required for 12 tumors and three sessions were required for two tumors. Most patients in the study were in their mid-seventies, which is not uncommon, according to Mayo-Smith, since kidney tumors tend to strike the elderly. Twenty patients in the study had only one kidney due to prior surgery.

“This new minimally invasive technique appears to be an acceptable alternative to surgery in high risk patients,” said Mayo-Smith, who’s also a professor of diagnostic imaging at The Warren Alpert Medical School of Brown University. “The technique is exciting because patients are able to go home the same day of the procedure and do not require general anesthesia.”

During RFA, a very thin needle electrode is inserted into the tumor under the guidance of computed tomography (CT). The electrode is equipped to deliver high frequency radio waves that create intense heat, killing cancerous cells. The heat also closes up small blood vessels, minimizing the risk of bleeding.

More than 700 patients have undergone radiofrequency ablation at Rhode Island Hospital. To date, this is the largest known study reporting the results of RFA in treating kidney tumors.

Co-authors were Todd Schirmang, M.D., Damian Dupuy, M.D, and John Cronan, M.D., all of Rhode Island Hospital and Alpert Medical School. (Abstract VI31-03)

New microwave technology can be safely applied to cancerous lung tumors

Embargoed for release: Thursday, November 29, 2007, 3:22 p.m. CST

A cancer treatment that uses microwave energy to shrink or eliminate tumors can be safely used to treat malignant lung tumors, according to a new study by researchers at Rhode Island Hospital.

Similar to radiofrequency ablation, microwave ablation is a minimally invasive, image-guided technique that uses heat generated by microwave energy to destroy tumors. Rhode Island Hospital physicians became the first in the United States to use microwave ablation to treat cancer and are one of only ten facilities in the country that offer the treatment.

In the study, Damian Dupuy, M.D., director of tumor ablation at Rhode Island Hospital, and radiologists treated 50 patients with microwave ablation 66 times for 82 lung tissue masses. Each tumor was ablated under computed tomography (CT)-guidance for seven to ten minutes and patients were followed up at one, three and six months with CT and positron emission tomography (PET) imaging.

All 50 patients had technical completion of their ablation. Patients with the largest tumors – or 26 percent of the overall study population – were found to have residual disease at the ablation site. An additional 22 percent of patients had recurrent disease. Yet an analysis of cancer-specific mortality yielded a one-year survival of about 83 percent, two-year-survival of approximately 73 percent, and a three year survival of about 61 percent – regardless of tumor size or the presence of residual disease.

“Microwave ablation offers patients with inoperable lung cancer or those who cannot benefit from more traditional therapies with a much-needed minimally invasive treatment option,” said Dupuy, who’s also a professor of diagnostic imaging at The Warren Alpert Medical School of Brown University and a national expert on microwave ablation. “Our findings are very promising, but because this technology is still relatively new, it’s important that we continue to examine its safety and efficacy in providing patient care.”

During microwave ablation, radiologists use imaging guidance to place a thin microwave antenna directly into the tumor. A microwave generator emits an electromagnetic wave that agitates water molecules in the surrounding tumor tissue, producing friction and heat that eventually destroy the tumor.

Co-authors included David J. Grand, M.D., Thomas DiPetrillo. M.D., and William Mayo-Smith, M.D, all of Rhode Island Hospital and Alpert Medical School; Jason Machan, Ph.D., research statistician at Rhode Island Hospital; and Farrah J. Wolf, a medical student at Alpert Medical School. (Abstract VI51-10)

Source: Lifespan

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