Members of the International PSC Study Group and radiologists from North America and Europe have compiled the following position statement to provide guidance regarding the application of MRI in the care of PSC patients, minimum imaging standards, and future areas of research. (Hepatology 2017;66:1675-1688).

Background. Obesity increases the risk for renal cell carcinoma (RCC). However, it has only recently been identified as an independent positive prognostic factor for localized RCC.Objective. To determine whether obesity influences longterm prognosis in metastatic RCC patients receiving vascular endothelial growth factor-targeted therapy.Design, Setting, and Participants. In 116 patients with metastatic RCC who received antiangiogenic agents (sunitinib, sorafenib, axitinib, bevacizumab) in 2005-2010, we evaluated whether body mass index (BMI), a body surface area (BSA) above the European average, the visceral fat area (VFA), or s.c. fat area (SFA) were of predictive relevance.Measurements. BMI was categorized based on current World Health Organization definitions. BSA was stratified

PurposeTo demonstrate and quantify the heat sink effect in hepatic microwave ablation (MWA) in a standardized ex vivo model, and to analyze the influence of vessel distance and blood flow on lesion volume and shape.Materials and Methods108 ex vivo MWA procedures were performed in freshly harvested pig livers. Antennas were inserted parallel to non-perfused and perfused (700,1400 ml/min) glass tubes (diameter 5mm) at different distances (10, 15, 20mm). Ablation zones (radius, area) were analyzed and compared (Kruskal-Wallis Test, Dunn’s multiple comparison Test). Temperature changes adjacent to the tubes were measured throughout the ablation cycle.ResultsMaximum temperature decreased significantly with increasing flow and distance (p<0.05). Compared to non-perfused tubes, ablation zones were significantly deformed by perfused tubes within 15mm distance to the antenna (p<0.05). At a flow rate of 700ml/min ablation zone radius was reduced to 37.2% and 80.1% at 10 and 15mm tube distance, respectively; ablation zone area was reduced to 50.5% and 89.7%, respectively.ConclusionSignificant changes of ablation zones were demonstrated in a pig liver model. Considerable heat sink effect was observed within a diameter of 15mm around simulated vessels, dependent on flow rate. This has to be taken into account when ablating liver lesions close to vessels.

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The aim of this article is to review the significance of percutaneous thermal ablation in the treatment of bone tumors. We describe available ablation techniques as well as advantages and disadvantages in specific settings. In detail, radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation, high intensity focused ultrasound (HIFU) and cryoablation are presented. In the second part of this review curative and palliative indications for the treatment of benign and malignant bone tumors are discussed. This includes especially RFA, laser or cryoablation for the treatment of osteoid osteoma, as well as the palliative treatment of painful bone metastases, for example, by means of MWA or MR-guided HIFU. Key Points: ??The various thermoablative techniques demonstrate specific advantages and disadvantages. ??Radiofrequency ablation is the evidence-based method of choice for treating osteoid osteoma. ??Laser ablation is primarily suited for the treatment of small lesions of the hands and feet. ??The intrinsically analgesic effect of cryoablation is advantageous when treating painful lesions. ??Palliative treatment of painful bone metastases can for example be performed using MWA or MR-guided HIFU, by itself or combined with cementoplasty. Citation Format: ??Ringe KI, Panzica M, von Falck C. Thermoablation of Bone Tumors. Fortschr R?ntgenstr 2016; 188: 539???550

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ObjectivesTo evaluate frequency and severity of complications after CT-guided lung biopsy using the Society of Interventional Radiology (SIR) classification, and to assess risk factors for overall and major complications.Materials and methods311 consecutive biopsies with a non-coaxial semi-automated 18 gauge biopsy system were retrospectively evaluated. Complications after biopsy were classified into minor SIR1-2 and major SIR3-6. Studied risk factors for complications were patient-related (age, sex and underlying emphysema), lesion-related (size, location, morphologic characteristic, depth from the pleura and histopathology), and technique-related (patient position during procedure, thoracic wall thickness at needle path, procedure time length and number of procedural CT images, number of pleural passes, fissure penetration and needle-to-blood vessel angle). Data were analyzed using logistic and ordinal regression.ResultsComplications were pneumothorax and pulmonary hemorrhage. The complications were minor SIR1-2 in 142 patients (45.6%), and major SIR3-4 in 25 patients (8%). SIR5-6 complications were not present. Emphysema, smaller deeply located lesion, increased puncture time length and number of procedural CT images, multiple pleural passes and fissure puncture were significant risk factors for complication severity in univariate analysis. Emphysema (OR = 8.8, p<0.001), lesion depth from the pleura (OR = 1.9 per cm, p<0.001), and fissure puncture (OR = 9.4, p = 0.01) were the independent factors for major complications in a multiple logistic regression model. No statistical difference of complication rates between the radiologists performing biopsies was observed.ConclusionsKnowledge about risk factors influencing complication severity is important for planning and performing CT-guided lung biopsies.

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