Avsnitt
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This week we bring together urologists and radiologists to work towards a shared goal of innovating on kidney cancer care. Dr. Jason Abel, Professor of Urology and Radiology at the University of Wisconsin, and Dr. Louis Hinshaw, Section Chief of Abdominal Imaging Intervention at the University of Wisconsin, join our host Dr. Ruchika Talwar for a multidisciplinary conversation regarding the treatment of renal tumors.
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SYNPOSIS
Their discussion covers the history and benefits of collaboration between urology and interventional radiology (IR), advances in image-guided procedural technologies, and the importance of teamwork in improving patient outcomes. The episode also considers the encouraging, but limited data in IR treatments such as microwave ablation and discusses the lasting role for surgery. Finally, Dr. Abel and Dr. Hinshaw share their experiences in establishing a successful interdisciplinary kidney cancer program. Ultimately, they conclude that the future of renal tumor treatment lies not in silos, but in collaboration.
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TIMESTAMPS
00:00 - Introduction
04:04 - Collaboration Between Urologists and Interventional Radiologists
05:58 - Advancements in Ablation
10:05 - Patient Selection
15:19 - Technical Considerations
26:57 - Post-Ablation Surveillance and Recurrence Management
33:19 - Conclusion -
Who is the ultimate candidate for GAE, which technical approach is best, and how do you set your patients up for success? Tune into this week’s episode of BackTable to hear from interventional radiologists Dr. Osman Ahmed (University of Chicago Medicine) and Dr. Siddharth Padia (UCLA Health) as they discuss everything from patient selection to follow-up care, covering pre-procedure imaging, access, embolics, technical challenges, clinical data, and the future of genicular artery embolization.
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SYNPOSIS
Dr. Ahmed and Dr. Padia debate their approaches to patient selection criteria, the use of MRI and cone beam CT, permanent vs. resorbable embolic materials, how many arteries to embolize, and the relevance of pain metrics post GAE. They also delve into follow-up considerations and the potential for GAE as a long term treatment.
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TIMESTAMPS
00:00 Introduction
01:08 MRI for Patient Selection in GAE
08:53 Access Techniques: Femoral vs. Pedal
17:07 Cone Beam CT in GAE Procedures
27:20 Embolization Strategies
39:30 Challenges and Complications in Embolization
44:50 Follow-Up and Pain Metrics in Clinical Practice and Research
01:06:30 Repeat GAE Procedures: When and Why?
01:11:13 Post-Total Knee Replacement and GAE
01:21:01 Advice for IRs Looking to do GAE
01:24:32 Conclusion and Final Thoughts
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RESOURCES
GENESIS Trial: https://pubmed.ncbi.nlm.nih.gov/33474601/
Landers et al Trial: https://pubmed.ncbi.nlm.nih.gov/37051829/ -
Saknas det avsnitt?
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Are you thinking about pursuing a new diagnostic radiology gig? Get the download on the current job market, how to evaluate different compensation models, and what to look out for when considering your next job offer in this week’s episode of BackTable, featuring guests Dr. Ned Holman (Neuroradiologist at Alaska Imaging) and Dr. Mike Romeo (Radiologist and President of West Reading Radiology).
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SYNPOSIS
The doctors begin by exploring various employment models, including private practice, academic positions, and hybrid arrangements that combine elements of both. They share valuable insights on job transparency and the significance of leveraging professional connections to gain honest, firsthand perspectives on potential employers. They also provide advice on key questions to ask during job interviews and strategies for negotiating contracts. The doctors conclude by sharing tips to help make informed decisions to ensure job satisfaction and professional growth.
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TIMESTAMPS
00:00 - Introduction
04:30 - Employment Models
06:32 - Compensation Structures
08:43 - Evaluating Job Offers
19:05 - Red Flags in Employment
27:13 - Private Equity Jobs: Pros and Cons
31:36 - Navigating Job Boards and Resources
42:03 - Final Advice for Job Seekers -
The road towards financial literacy and financial freedom does not need to be a solo, do-it-yourself, figure it out as it goes type of journey. Guest Dr. Jim Dahle (practicing emergency medicine physician and Founder of the White Coat Investor) joins host Dr. Chris Beck to help better illuminate the process of becoming financially literate and securing financial freedom for physicians and others in similar professional arenas.
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This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
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SYNPOSIS
Dr. Dahle begins the episode by driving home how sound and solid financial education coupled with early, prudent financial behaviors can be worth millions over a career. The doctors discuss writing investment plans, goal setting, and understanding of asset allocation to ensure long-term financial success. Dr. Dahle also delves into the Mega Backdoor Roth IRA, practical tips for handling savings and expenses, as well as how to integrate real estate into your investment portfolio. The episode concludes with helpful resources, programs, and conferences available through the White Coat Investor.
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TIMESTAMPS
00:00 - Introduction
04:30 - Savings Tips and Strategies
13:22 - Retirement Goals and Savings Targets
28:20 - Real Estate as an Investment
32:30 - Mega Backdoor Roth IRA
42:59 - Advice for New High-Income Earners
46:09 - Teaching Financial Literacy to Kids
48:15 - Addressing Physician Burnout
53:53 - Common Financial Mistakes by Doctors
58:11 - White Coat Investor Book Giveaway Program
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RESOURCES
White Coat Investor:
https://www.whitecoatinvestor.com
BackTable VI Episode #194 - Financial Basics from the White Coat Investor with Dr. James Dahle:
https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor
White Coat Investor Champions Program (For Students):
https://www.whitecoatinvestor.com/wci-champions/ -
Navigating the intricate world of medical billing can be challenging, and knowing the steps needed to ensure fair reimbursement can be even more challenging. Guests Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki (private practice interventional radiologists) join host Dr. Ally Baheti to discuss how IRs in the OBL setting can legislatively rally behind the office-based facility concept and improve physician reimbursement in the light of developments addressed at the recent OEIS meeting.
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SYNPOSIS
Dr. Wiechmann and Dr. Niedzwiecki begin the episode by defining several key-terms and processes in physician reimbursement in the outpatient setting to help orient us to the issue at hand. After explaining why and how reimbursement for more advanced procedures in the OBL setting has been lagging behind, the doctors introduce the concept of creating an office-based facility concept. This would help stabilize payments for complex procedures done in the OBL space. The episode concludes with emphasis on more physician involvement and advocacy in pushing reform forward, underscoring how a unified effort is essential for long-lasting, meaningful change.
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TIMESTAMPS
00:00 - Introduction
01:42 - Medicare Physician Fee Schedule
05:46 - Challenges with Current Reimbursement Models
11:28 - Proposing the Office-Based Facility Concept
17:58 - Legislative Efforts and Congressional Involvement
26:53 - Call to Action: How You Can Help
36:40 - Conclusion
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RESOURCES
Outpatient Endovascular and Interventional Society:
https://oeisweb.com -
What are the 10 Commandments of Being a Female Interventional Radiologist? Guest Dr. Maureen Kohi (Chair of Radiology at University of North Carolina Chapel Hill) sits down with host Dr. Ally Baheti to discuss the details of her popular lecture topic and how these 10 rules are actually applicable to all current and future interventional radiologists.
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SYNPOSIS
Dr. Kohi begins by going through each of the 10 points - offering detailed advice throughout, while also acknowledging nuances and challenges women and men can encounter in medicine and best approaches. Dr. Kohi also speaks on how to build and navigate strong relationships with industry. The episode concludes with several more pearls of wisdom as Dr. Kohi shares the last of the 10 commandments.
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TIMESTAMPS
00:00 - Introduction
01:08 - 10 Commandments of Being a Female IR
23:06 - Importance of Involvement in Professional Societies
24:46 - Childcare Concerns in Professional Settings
28:58 - Making the Leadership Leap
35:24 - Navigating Gender Bias in Professional Environments
41:51 - Prioritizing Health, Family, and Personal Fulfillment
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RESOURCES
From Good to Great (Book):
https://a.co/d/gXWW1Qp
Start With Why (Book):
https://a.co/d/hgaadIt -
In honor of the 50th annual meeting of the Society of Interventional Radiology (SIR) in Nashville, let’s take it back to the beginning of IR and review how the field became what it is today. Guest host Dr. Andrew Niekamp (interventional radiologist at Miami Vascular) sits down with esteemed guest Dr. Barry Katzen, who began his training at the advent of IR, to discuss the origins and development of the field since its inception.
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This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
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SYNPOSIS
The doctors discuss challenges and innovations that shaped IR’s growth, and the importance of clinical practice and patient-centered care. Dr. Katzen shares insights from his extensive career, including his early involvement in advancing image-guided therapies, his role in founding Miami Cardiac & Vascular Institute, and strategies to overcome turf-wars and complacency in medicine. Dr. Katzen emphasizes the need for continuous innovation and dedication towards improving patient outcomes in the evolving landscape of IR. The episode concludes with Dr. Katzen’s advice for future and early-career IRs.
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TIMESTAMPS
00:00 - Introduction
03:39 - Early Innovations and Training in Europe
09:08 - Founding the Miami Cardiac and Vascular Institute
17:13 - Challenges and Innovations
25:24 - Importance of Clinical Responsibility
34:07 - Birth of a Specialty
40:35 - Advice for Future Interventional Radiologists
43:29 - Conclusion -
Is social media an effective patient acquisition tool for interventional radiologists? In a word: absolutely. Learn how to reach more patients in this week’s BackTable Podcast, where Dr. Gustavo Elias joins Dr. Ally Baheti to discuss the benefits he has seen with social media, and the content strategies that he uses in his medical practice.
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SYNPOSIS
The episode begins with Dr. Elias sharing his journey of overcoming initial reservations around posting content. The doctors emphasize the importance of individuality and passion in showing what IR can offer to the public in easily-digestible ways. Dr. Elias then discusses the impact of social media on patient engagement, and shares practical tips for physicians who are looking to enhance their online presence. Dr. Elias also touches on optimal posting schedules, collaboration tips, and balancing professionalism with approachability.
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TIMESTAMPS
00:00 - Introduction
04:02 - Social Media for Interventional Radiologists
08:56 - Building a Social Media Presence
19:24 - Optimal Posting Strategies
21:58 - Collaborations and Platforms
25:27 - Conclusion -
Let’s talk liver ablations. This week’s episode of the BackTable Podcast provides a thorough review of modern microwave ablation methods, tools, and tech, featuring Dr. Asad Baig (interventional radiologist at Columbia University) and host Dr. Michael Barraza.
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This podcast is supported by an educational grant from Medtronic .
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SYNPOSIS
Dr. Baig shares practical advice on how to become a key contributor at your tumor board and how to position your skillset as an interventional radiologist. He talks through his microwave ablation procedure technique, highlighting the role of ablation zone visualization software. The doctors go on to discuss a variety of ablation approaches, needle placement, intra- and post-operative imaging, and tips for dealing with challenging tumor locations. The episode concludes with Dr. Baig summarizing best practices for ensuring safe and effective ablations, and underscoring the importance of solid patient-physician communication throughout care.
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TIMESTAMPS
00:00 - Introduction
08:28 - Microwave Ablation Techniques
12:54 - Collaborative Approach in Tumor Boards
23:30 - Combined Ablation Cases and Techniques
36:12 - Challenging Liver Ablations
45:56 - Tips for Safe and Effective Ablations
50:07 - Balancing Biopsy and Ablation
01:00:34 - Conclusion
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RESOURCES
The Emprint™ Ablation System with Thermosphere™ Technology: One of the Newer Next-Generation Microwave Ablation Technologies:
https://pmc.ncbi.nlm.nih.gov/articles/PMC4640908/
Comparison of microwave ablation and surgical resection for treatment of hepatocellular carcinomas conforming to Milan criteria:
https://pubmed.ncbi.nlm.nih.gov/24628534/
Percutaneous microwave ablation of hepatic lesions near the heart:
https://pubmed.ncbi.nlm.nih.gov/34805581/
Microwave Ablation of Hepatic Tumors Abutting the Diaphragm Is Safe and Effective:
https://ajronline.org/doi/10.2214/AJR.14.12879 -
Targeted, image-guided interventions can make a big difference for patients with hereditary hemorrhagic telangiectasia (HHT). Learn how in this week’s BackTable episode featuring Dr. Clifford R. Weiss (Director of the Johns Hopkins Vascular Anomalies Center and HHT Center of Excellence) and host Dr. Michael Barraza.
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SYNPOSIS
Dr. Weiss delves into the complexities and multisystem nature of HHT, emphasizing the significance of early diagnosis and multidisciplinary care. He goes on to explain the clinical criteria for diagnosing HHT, the role of genetic and imaging screenings, and the evolving approaches to treating pulmonary arteriovenous malformations (AVMs) in adults and children. The doctors discuss the potential impact of anti-angiogenic medications on the future management of HHT. The episode closes with a nod to the pivotal role that HHT Centers of Excellence play, and the ongoing dedication to improving patient outcomes through collaborative care and innovative research.
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TIMESTAMPS
00:00 - Introduction
03:57 - Diagnosing and Screening for Hereditary Hemorrhagic Telangiectasia (HHT)
07:37 - Treatment Approaches for HHT
12:12 - Embolization Techniques and Safety Measures
19:02 - Future of HHT Treatment and Research
22:30 - Conclusion and Final Thoughts
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RESOURCES
The Johns Hopkins Hereditary Hemorrhagic Telangiectasia (HHT) Center of Excellence:
https://www.hopkinsmedicine.org/interventional-radiology/hht -
Teleradiology, artificial intelligence, and private equity takeovers—how do we navigate these rapid changes in the radiology landscape? In this episode, our co-hosts Dr. Ally Baheti and Dr. Mike Barraza bring Dr. Ben White back to the show to provide an update on the current radiology job market and share his insights on reclaiming value for the profession. Dr. White begins by reflecting on the changes since his last appearance with us in 2022, focusing primarily on the ongoing shortage of radiologists, which has lasted longer than anticipated during the pandemic, and the explosion of teleradiology.
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SYNPOSIS
Today’s radiologists are more mobile than ever, with remote work options and the appeal of sensationalized job postings. Dr. White also discusses the instability of more established practices, particularly when legacy partners depart after fulfilling their contractual obligations. In response, many practices are refinancing their debt, which has led to a decrease in practice acquisitions.
Dr. White believes that large-scale healthcare operations often result in increased inefficiency and reduced agility. The downstream effects include the commoditization of teleradiologists, concerns about decreased quality of reads, a limited scope of practice for procedures, reduced access to imaging for smaller hospitals, longer wait times, and more unstable locum staffing. The doctors also speculate about the future division of radiology into different service tiers, depending on the level of access each hospital has to radiologists.
Finally, Dr. White highlights his Independent Radiology job board, which lists open positions from physician-owned practices. His goal in creating the website is to address the pain points of other job advertisement sites, where misleading postings are common. He wants radiologists to consider joining a team of physicians, rather than simply accepting a job. His advice to all radiologists is to expect uncertainty in the job market and to remain flexible.
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TIMESTAMPS
00:00 - Current Radiology Job Market
07:43 - Updates on Private Equity in Radiology
16:26 - Role of Artificial Intelligence
22:46 - Growing Imaging Volume and Efficiency
26:51 - Challenges in Radiology Staffing
36:49 - Independent Radiology Job Board
50:07 - Future of Radiology and Final Thoughts
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RESOURCES
BackTable VI Ep. 277- Private Equity and the Radiology Job Environment with Dr. Ben White:
https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment
Independent Radiology Job Board:
https://www.independentradiology.com/ -
Do you ever wish you could be a fly on the wall at a tumor board meeting? In this episode of BackTable, we’re excited to give you an insider’s view of the real case discussions that take place during hepatocellular carcinoma (HCC) tumor boards. Host Dr. Zach Berman sits down with a multidisciplinary team, including Drs. Adam Burgoyne (medical oncologist), Heather Patton (hepatologist), Siddharth Padia (interventional radiologist), and Gabriel Schnickel (transplant and hepatobiliary surgeon).
Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:
https://www.cmeuniversity.com/course/take/125743
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This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.
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SYNPOSIS
The team walks through a range of diverse HCC cases, reviewing patient histories, imaging, and treatment options. They cover eight cases in total, each featuring patients with varying treatment histories, comorbidities, liver function, and lesion characteristics. For the full educational experience, we recommend watching the video format on our YouTube channel.
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TIMESTAMPS
00:00 - Introduction
00:47 - Case 1: Small Lesion in a Young Patient
05:01 - Case 2: Moderate Sized Lesion in an Older Patient
11:10 - Case 3: Multifocal HCC with Dominant Lesion
21:09 - Case 4: Dominant Lesion with Portal Hypertension
32:08 - Case 5: Ruptured Solitary Lesion
34:34 - Case 6: Rupture with Multifocal Lesions
44:08 - Case 7: Portal Vein Invasion
52:12 - Case 8: Metastatic HCC After Transplant
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RESOURCES
CME Accreditation Information:
https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf -
Medical, surgical, radiation, and interventional oncology all play vital roles in delivering care to patients battling liver cancer. How do we optimize outcomes when so many specialties have something to offer the same patient? The answer is collaborative oncology. Dr. Robert Martin (Director of Surgical Oncology, University of Louisville) and pioneer in liver-directed therapies, joins host Dr. Sabeen Dhand to discuss a collaborative approach to oncology and recent advances in locoregional therapy.
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This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
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SYNPOSIS
Dr. Martin discusses the importance of a growth mindset in advancing medical techniques and fostering collaborations between specialists. He then shares insights into minimally invasive procedures, such as microwave ablation and irreversible electroporation (IRE). The doctors also touch on the evolution of liver cancer treatments, emphasizing the significance of clinical trials on the horizon. To conclude, Dr. Martin encourages young professionals in surgery and interventional radiology to stay open-minded, be life-long learners, and find synergistic ways to integrate new technologies into patient care.
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TIMESTAMPS
00:00 - Introduction
02:31 - Dr. Martin’s Background and Career Path
06:18 - Evolution of Liver Directed Therapies
10:12 - Collaboration Between Specialties
18:34 - Clinical Trials and Emerging Therapies
36:08 - Advice for Young Professionals
39:15 - Conclusion
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RESOURCES
Radioembolization Oncology Trial Utilizing Transarterial Eye90 (ROUTE 90) for the Treatment of HCC:
https://clinicaltrials.gov/study/NCT05953337?term=NCT05953337&rank=1
Intratumoral Injection of IP-001 Following Thermal Ablation in Patients With CRC, NSCLC, and STS (INJECTABL-1):
https://clinicaltrials.gov/study/NCT05688280
Immunophotonics, CIRSE, and Next Research Announce Innovative Phase 2/3 Clinical Trial: INJECTABL-3:
https://immunophotonics.com/news/immunophotonics-cirse-and-next-research-announce-innovative-phase-2-3-clinical-trial-injectabl-3/ -
Are you seeking to build your reputation and patient base within interventional oncology? In this episode, host Dr. Zachary Berman interviews Dr. Siddarth Padia, Dr. Tyler Sandow, Dr. Kavi Krishnasamy, and Dr. Kevin Burns about their journeys into interventional oncology (IO) and their experiences providing care in different practice settings.
Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:
https://www.cmeuniversity.com/course/take/125742
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This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.
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SYNPOSIS
The doctors begin by discussing how they became interested in interventional oncology, with most of them recognizing opportunities to address unmet needs in the field. Each guest shares insights on the timelines and challenges involved in starting their IO practices, which vary significantly today. For instance, telehealth clinics are particularly viable in private practice IO, thanks to conferencing software and virtual translators. Hybrid care models, which combine in-person and remote consultations, can help overcome patient-level barriers such as time and transportation. The panel also emphasizes how increased clinic availability can significantly drive growth in procedural volume. Finally, they offer advice for starting an IO practice, including the importance of having clinic support staff, building strong relationships with referring physicians, and staying up to date with new technologies.
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TIMESTAMPS
00:00 - Introduction
05:38 - Balancing Career Interests and Expectations
07:10 - Building an Interventional Oncology Practice
13:42 - Gaining Trust from Referring Physicians
17:33 - Importance of Open Communication
19:19 - Comparing Clinic Settings
26:01 - Essential Components of a Clinic
33:28 - Narrowing Your Interventional Practice
40:09 - Introducing New Technology
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RESOURCES
CME Accreditation Information:
https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf -
Is there a way to treat liver metastasis secondary to uveal melanoma without introducing systemic, treatment-related toxicity? Dr. Altan Ahmed (interventional radiologist at Moffitt Cancer Center) and Dr. Sid Padia (interventional radiologist at UCLA) join guest-host Dr. Kavi Krishnasamy to discuss HEPZATO, a novel device-based treatment for liver metastases from uveal melanoma.
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This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
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SYNPOSIS
Dr. Ahmed and Dr. Padia begin by exploring the design and setup of the HEPZATO clinical trials, while also speaking on patient selection criteria. The doctors then talk through the technical aspects of the intervention. After covering workflow and considerations related to procedure timing and coordination, the doctors go on to discuss drug dosing and optimizing treatment cycles. The episode concludes with current gaps in literature, current and future research aims, and potential future applications of the HEPZATO modality in treating other malignancies such as colorectal cancer.
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TIMESTAMPS
00:00 - Introduction
05:40 - Patient Selection Criteria
09:49 - Workflow
19:17 - Procedure Timing and Coordination
29:39 - Challenges and Considerations in Drug Dosing
32:39 - Optimizing Treatment Cycles and Patient Response
37:56 - Managing Post-Treatment and Adverse Effects
43:43 - Future Research and Gaps in Current Interventions
50:45 - Exploring New Applications for PHP Therapy
55:02 - Conclusion
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RESOURCES
Hepzato:
https://hepzatokit.com/
FOCUS Trial - Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study:
https://pubmed.ncbi.nlm.nih.gov/38704501/
FOCUS phase 3 trial results: Percutaneous hepatic perfusion (PHP) with melphalan for patients with ocular melanoma liver metastases (PHP-OCM-301/301A):
https://ascopubs.org/doi/pdf/10.1200/JCO.2022.40.16_suppl.9510
Combining Melphalan Percutaneous Hepatic Perfusion with Ipilimumab Plus Nivolumab in Advanced Uveal Melanoma: First Safety and Efficacy Data from the Phase Ib Part of the Chopin Trial:
https://pubmed.ncbi.nlm.nih.gov/36624292/
Troponin Elevation in Patients Undergoing Percutaneous Hepatic Perfusion for Metastatic Uveal Melanoma:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11010739/
Percutaneous Hepatic Perfusion with Melphalan in Patients with Unresectable Ocular Melanoma Metastases Confined to the Liver: A Prospective Phase II Study:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7801354/
Southampton group - Quality of life after melphalan percutaneous hepatic perfusion for patients with metastatic uveal melanoma:
https://pmc.ncbi.nlm.nih.gov/articles/PMC10906212/
Leiden group - Quality of Life Analysis of Patients Treated with Percutaneous Hepatic Perfusion for Uveal Melanoma Liver Metastases:
https://pubmed.ncbi.nlm.nih.gov/38587534/ -
Is surgery truly the "cure" for hepatocellular carcinoma (HCC), and when is it a viable option? In this episode, Dr. Sabeen Dhand leads a roundtable discussion with interventional radiologist Dr. Siddharth Padia and transplant/hepatobiliary surgeons Dr. John Seal and Dr. Gabriel Schnickel, delving into the complexities of surgical treatments for HCC and the evolving landscape of liver resection and transplantation.
Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:
https://www.cmeuniversity.com/course/take/125741
---
This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.
---
SYNPOSIS
The doctors begin by discussing how they manage patient expectations regarding both palliative and curative treatments, highlighting the risk of recurrent HCC as a new lesion. They then outline key factors that influence their recommendations for liver transplant versus resection, such as the extent of underlying liver disease, the function of the future liver remnant, body habitus, overall health, and organ availability. The surgeons also review various surgical approaches to liver resection and recent advancements in liver transplantation, including living donor transplants and the ability to refer patients for downstaging procedures.
Dr. Padia explains the original role of Y90 as a bridging treatment to downstage tumors and promote hypertrophy in the non-diseased liver segments, preparing the organ for surgical resection. However, Y90 treatment can also lead to the formation of adhesions, which may complicate future surgeries. Finally, the doctors discuss strategies to improve care coordination between community physicians and transplant centers to optimize patient outcomes.
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TIMESTAMPS
00:00 - Curative vs. Palliative Treatment
04:03 - Choosing Between Transplantation and Resection
05:47 - Liver Resection Types
07:27 - Bridging Role of Y90
12:14 - Evolving Landscape of Liver Transplantation
20:59 - Patient Counseling in Minimally Invasive Procedures
28:40 - Considerations for Surgery After Y90
33:32 - Coordination Between Specialists
40:08 - Immunotherapy as a Bridge to Transplant
---
RESOURCES
CME Accreditation Information:
https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf -
Musculoskeletal embolization is generating significant excitement in the field of chronic pain management. In this episode, Dr. Jacob Fleming hosts a discussion with Dr. Yuji Okuno from Japan, a pioneer in both basic science and clinical practice within the field of musculoskeletal embolization.
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This podcast is supported by:
Medtronic MVP
https://www.medtronic.com/mvp
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SYNPOSIS
The conversation delves into Dr. Okuno's groundbreaking work using embolization to treat chronic pain from conditions such as frozen shoulder, knee osteoarthritis, plantar fasciitis, and various sports injuries. Dr. Okuno discusses the development of new temporary embolic agents and compares different approaches to embolization treatments, including the innovative use of antibiotics as embolic material. The doctors also cover the intriguing concept of differential recanalization, where abnormal inflammatory vessels are less likely to recanalize than normal vessels after embolic treatment. Identifying hypervascularity through MRI, ultrasound, or angiogram is a crucial step before attempting embolization.
Overall, Dr. Okuno offers valuable insights into his clinical practice and the potential for groundbreaking advancements in musculoskeletal care worldwide.
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TIMESTAMPS
00:00 - Introduction
01:54 - Origins of Embolization for Pain
04:15 - Basic Science Research Discoveries and Clinical Trials
09:02 - Temporary Embolic Materials
15:28 - Techniques for Embolization
17:33 - Plantar Fasciitis Treatment
24:04 - Future of Embolization in Sports Injuries
28:11 - Diagnostic Imaging in Embolization
36:10 - Global Expansion and Collaborations -
The process of liver transplantation involves many complexities, and each patient's path to transplant is unique. To offer insider perspectives on this process, Dr. Zachary Berman sits down with transplant and hepatobiliary surgeon Dr. John Seal, as well as transplant hepatologists Dr. Heather Patton and Dr. Steve Young.
Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:
https://www.cmeuniversity.com/course/take/125740
---
This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.
---
SYNPOSIS
The panel begins by discussing the multidisciplinary pre-transplant evaluation process, which assesses factors such as liver function, comorbidities, surgical risk, and the availability of psychosocial support. Once a patient is listed for transplant, they enter a system that prioritizes those with the highest Model for End-Stage Liver Disease (MELD) score. During the waiting period, several comorbidities should be carefully monitored. Dr. Seal explores the impact of portal vein hypertension and portal vein thrombosis, explaining how these conditions may necessitate intraoperative thrombectomy or bypass. Dr. Patton and Dr. Young focus on considerations for using anticoagulation in patients with a high baseline bleeding risk and selecting the appropriate anticoagulant for patients listed for transplant.
For patients with hepatocellular carcinoma (HCC), eligibility for MELD exception points may depend on factors such as time spent on the waiting list, adherence to the Milan criteria, and the presence of extrahepatic complications of liver disease. The panel also discusses bridging therapies to transplant, including Y90 and TACE. In the peri-transplant phase, they highlight innovations such as living donor transplants, liver perfusion pumps, and the use of hepatitis C- and HIV-positive organs. Finally, the discussion turns to post-transplant considerations, including surgical complications, organ rejection, immunosuppression, predictors of HCC recurrence, and long-term surveillance.
---
TIMESTAMPS
00:00 - Introduction
01:16 - Current Landscape of Liver Transplantation
03:22 - Transplant Evaluation Process
09:48 - Timeline from Listing to Transplantion
11:16 - Treating Portal Vein Thrombosis and Hypertension
18:44 - MELD Exception Points
22:05 - Bridging Therapies
25:34 - Peri-Transplant Considerations
30:53 - Post-Transplant Period
37:39 - Repeat Transplantation
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RESOURCES
Model for end-stage liver disease (MELD) and allocation of donor livers (Wiesner et al, 2003):
https://www.gastrojournal.org/article/S0016-5085%2803%2950022-1/fulltext
Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis- Milan Criteria (Mazzaferro et al, 1996):
https://pubmed.ncbi.nlm.nih.gov/8594428/
Validation of the prognostic power of the RETREAT score for hepatocellular carcinoma recurrence using the UNOS database (Mehta et al, 2019):
https://pmc.ncbi.nlm.nih.gov/articles/PMC6445634/
CME Accreditation Information:
https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf -
Do we finally have definitive data on the efficacy of prostate artery embolization (PAE)? Dr. Shivank Bhatia (interventional radiologist at University of Miami) joins host Dr. Michael Barraza to discuss the findings from his prospective 1,075 patient study on the long-term outcomes of PAE, the largest longitudinal, single-center, single-operator, prospective study in the United States.
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This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
Medtronic MVP
https://www.medtronic.com/mvp
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SYNPOSIS
Dr. Bhatia begins by sharing his early years of training, and the steps he took to become an expert in all things PAE. He also covers how he helped build the PAE program at University of Miami, sharing several pearls for young IRs and trainees that are interested in bringing new service lines to their institutions. Dr. Bhatia then talks through the details of the study that he spearheaded, and encourages everyone to tune in - physicians and patients alike.
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TIMESTAMPS
00:00 - Introduction
05:12 - Building a PAE Program
18:55 - PAE Procedure Technicalities
22:30 - Post-Procedure Meds and Care
25:13 - Study Details and Patient Demographics
27:36 - Procedure Time and Technical Success
28:32 - Safety and Efficacy of PAE
38:06 - PSA Levels and Prostate Cancer
40:42 - Urinary Retention and Treatment Prioritization
45:17 - Re-Intervention Rates and Medication Independence
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RESOURCES
Pisco et al (2011) - Prostatic arterial embolization to treat benign prostatic hyperplasia:
https://pubmed.ncbi.nlm.nih.gov/21195898/
Bhatia et al (2024) - Prostatic Artery Embolization: Mid- to Long-Term Outcomes in 1,075 Patients:
https://pubmed.ncbi.nlm.nih.gov/39532156/ -
Treatment of hepatocellular carcinoma (HCC), like that of many other cancers, spans a spectrum from curative to palliative intent. To explore the "grey zone" of treatment goals for intermediate-stage HCC patients, Dr. Sabeen Dhand interviews a panel of experts in the field: medical oncologists Dr. Adam Burgoyne and Dr. Lingling Du, along with interventional radiologists Dr. Kirema Garcia-Reyes and Dr. Zachary Berman.
Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:
https://www.cmeuniversity.com/course/take/125739
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This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.
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SYNPOSIS
The discussion begins with an explanation of the Barcelona-Clinic Liver Cancer (BCLC) staging system. While this system takes into account helpful factors such as liver function, performance status, and tumor burden, it fails to fully capture the true heterogeneity of the HCC patient population. Additional considerations include tumor biology, response to previous treatments, and the location of metastases. The specialists then share their experiences in treating patients with comorbid gastrointestinal cancers and mixed tumors, discuss the benefits of an interventional oncology clinic setting, and highlight virtual opportunities for connecting with tumor boards. They also offer advice on patient education regarding treatment options.
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TIMESTAMPS
00:00 - Introduction to BCLC Staging
03:02 - Impact of Performance Status
06:29 - Predictors of Survival in HCC
09:51 - Palliative versus Curative Treatment Intent
13:55 - Comorbid and Mixed Gastrointestinal Cancers
16:51 - Adverse Effects of Treatment
20:37 - Interventional Oncology in the Clinic Setting
23:06 - Navigating Multiple Provider Viewpoints
28:01 - Complex Case Examples
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RESOURCES
BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update (Reig et al, 2022):
https://www.journal-of-hepatology.eu/article/S0168-8278(21)02223-6/fulltext
CME Accreditation Information:
https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf - Visa fler
