Minimally invasive treatments for benign prostatic hyperplasia : a Cochrane network meta-analysis

Acknowledgements This project was funded by the National Institute for Health Research (NIHR) [Cochrane Incentive Award (NIHR130819)]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. We are very grateful to Cochrane Urology, especially Managing Editor Robert Lane, as well as Cochrane Urology Korea, for supporting this review. We are also grateful for the constructive feedback from the Cancer Network and the Methods Support Unit. We also thank Gretchen Kuntz for revising and providing feedback on the search strategies; Marco Blanker, Sevann Helo, and Murad Mohammad for their peer review input of the protocol; Dominik Abt, Bilal Chughtai, and Ahmed Higazy for providing details on the outcomes of their trials, for them to be incorporated accurately in our review; Marc Sapoval, Deepak Agarwal, Cameron Alexander, Harris Foster, and Mitchell Humphreys for their peer review input of the review. Juan Víctor Ariel Franco is a PhD candidate in the Programme of Methodology of Biomedical Research and Public Health, Universitat Autònoma de Barcelona (Spain)Peer reviewedPostprin

Minimally invasive treatments for lower urinary tract symptoms in men with benign prostatic hyperplasia : a network metaanalysis (Protocol)

A C K N O W L E D G E M E N T S We are very grateful to Cochrane Urology, especially the Managing Editor Robert Lane, as well as Cochrane Urology Korea for supporting this review. Furthermore, we are grateful to Gretchen Kuntz for revising and providing feedback on the search strategies. We also thank Marco Blanker, Sevann Helo, and Murad Mohammad for their peer-review input of the protocol. S O U R C E S O F S U P P O R T Internal sources • Instituto Universitario Hospital Italiano, Argentina Salary support for Juan Franco, Luis Garegnani, Camila Micalea Escobar Liquitay • Department of Urology, Yonsei University Wonju College of Medicine, Korea, South Salary support for Jae Hung Jung • Minneapolis VA Health Care System, USA Salary support for Philipp Dahm • Department of Urology, University of Minnesota, USA Support in kind for Philipp DahmPeer reviewedPublisher PD

Prostate embolization: patient selection, clinical management and results

Abstract Background Prostate artery embolization is an emerging technique, that with the continued publication of promising data, is slowly moving from the research to the everyday clinical setting. Main body This paper reviews the patient selection, clinical management and expected results of prostate artery embolization. Patient selection is paramount in delivering the desired results for any procedure. Likewise, the ability to clinically manage patients in the pre-operative and post-operative setting is an important skill to acquire when implementing new techniques. This paper introduces important urologic measurements/tests, patient selection paradigms, and clinical management concepts for interventional radiologists. It also reviews the outcomes patients can expect following prostate artery embolization as well as the complication profile. Conclusion Prostate artery embolization is a promising technique for the treatment of benign prostatic hyperplasia induced lower urinary tract symptoms

Biomarkers in the setting of benign prostatic hyperplasia-induced lower urinary tract symptoms: what an interventional radiologist needs to know

With increasing evidence to support prostate artery embolization (PAE) in the treatment of benign prostatic hyperplasia (BPH)-induced lower urinary tract symptoms (LUTS), Interventional Radiologists have begun to play an important role in the management of these patients. One area of knowledge needed when developing a PAE practice is knowledge of prostate-specific antigen (PSA) and other biomarkers utilized to detect prostate cancer in this population and what role they should play in the work up and follow-up of patients presenting with presumed BPH-induced LUTS. Furthermore, understanding how to evaluate presumed BPH-induced LUTS and stratify the risk of prostate cancer is an important skill to develop. The goal of this review is to provide Interventional Radiologists who have begun or aim to begin a PAE practice with the information they need to know regarding PSA levels and prostate cancer risk stratification for this patient population

An Objective Study of Anatomic Shifts in Intracranial Hypotension Using Four Anatomic Planes

Purpose. Intracranial hypotension (IH) often remains undetected using current MR diagnostic criteria. This project aims to demonstrate that central incisural herniation is highly effective in helping to make this diagnosis. Materials and Methods. Magnetic resonance imaging (MRI) was analyzed in 200 normal and 81 clinically known IH patients. MRI reference lines approximating the plane of the incisura, the plane of the diaphragma sella, the plane of the foramen magnum, and the plane of the visual pathway were utilized to measure the position of selected brain structures relative to these reference lines. Results. All IH patients had highly statistically significant (p<0.0001) measurable evidence of downward central incisural herniation when compared to normal controls. The first of the important observations was a downward shift of the mammillary bodies, which shortened the midsagittal width of the interpeduncular fossa cistern. A concurrent downward shift and deformity of the tuber cinereum accompanied the mammillary body shift. The second essential observation was an abnormal clockwise rotation of the long axis of the visual pathway. A severity grading system is proposed based on the extent of these shifts as well as secondary shifts of the brain stem, splenium, and cerebellar tonsils. Conclusion. This study objectively delineates the anatomic shifts of brain structures adjacent to the incisura and foramen magnum. This methodology is sufficient to recognize the features of IH and to stratify the spectrum of IH findings into a functional grading system for quantifying the results of interventional therapy

An Objective Study of Anatomic Shifts in Intracranial Hypotension Using Four Anatomic Planes

Purpose. Intracranial hypotension (IH) often remains undetected using current MR diagnostic criteria. This project aims to demonstrate that central incisural herniation is highly effective in helping to make this diagnosis. Materials and Methods. Magnetic resonance imaging (MRI) was analyzed in 200 normal and 81 clinically known IH patients. MRI reference lines approximating the plane of the incisura, the plane of the diaphragma sella, the plane of the foramen magnum, and the plane of the visual pathway were utilized to measure the position of selected brain structures relative to these reference lines. Results. All IH patients had highly statistically significant (p<0.0001) measurable evidence of downward central incisural herniation when compared to normal controls. The first of the important observations was a downward shift of the mammillary bodies, which shortened the midsagittal width of the interpeduncular fossa cistern. A concurrent downward shift and deformity of the tuber cinereum accompanied the mammillary body shift. The second essential observation was an abnormal clockwise rotation of the long axis of the visual pathway. A severity grading system is proposed based on the extent of these shifts as well as secondary shifts of the brain stem, splenium, and cerebellar tonsils. Conclusion. This study objectively delineates the anatomic shifts of brain structures adjacent to the incisura and foramen magnum. This methodology is sufficient to recognize the features of IH and to stratify the spectrum of IH findings into a functional grading system for quantifying the results of interventional therapy

Interventional Radiology Locoregional Therapies for Intrahepatic Cholangiocarcinoma

Surgical resection remains the cornerstone of curative treatment for intrahepatic cholangiocarcinoma (iCCA), but this option is only available to a small percentage of patients. For patients with unresectable iCCA, systemic therapy with gemcitabine and platinum-based agents represents the mainstay of treatment; however, the armamentarium has grown to include targeted molecular therapies (e.g., FGFR2 inhibitors), use of adjuvant therapy, liver transplantation in select cases, immunotherapy, and locoregional liver-directed therapies. Despite advances, iCCA remains a challenge due to the advanced stage of many patients at diagnosis. Furthermore, given the improving options for systemic therapy and the fact that the majority of iCCA patients succumb to disease progression in the liver, the role of locoregional therapies has increased. This review will focus on the expanding role of interventional radiology and liver-directed therapies in the treatment of iCCA