Renal Upper Pole IGTA

 Image-Guided Thermal Ablation of Upper Pole Renal Lesions ≤4 cm: Safety and Effectiveness

🔍 **Clinical Question:**  

To compare the safety and effectiveness of image-guided thermal ablation (IGTA) for upper pole versus nonupper pole renal lesions ≤4 cm given the technical challenges of the former.

💡 **Key Insight:**  

Upper pole renal lesions ≤4 cm treated with image-guided thermal ablation showed comparable adverse event rates to nonupper pole lesions (Grade 3 [severe], 2.4% vs 1.3%, P > .99).

Primary effectiveness was 100% for upper pole lesions versus 97.3% for nonupper pole lesions (P = .54), with no difference in 3-year overall survival (92.9% vs 87.0%, P = .22) and local progression-free survival (90.0% vs 100.0%, P = .17).

Polar location (upper vs nonupper) and R.E.N.A.L./m.R.E.N.A.L. nephrometry scores had no association with adverse events or local progression.

👉 **Why it matters:**  

Image-guided thermal ablation for upper pole renal lesions ≤ 4 cm demonstrated safety and oncologic outcomes comparable to non-upper pole lesions despite its increased technical complexity. Polar location alone should not exclude patients from consideration for image-guided thermal ablation.

➡️ **Full Article:** 

https://doi.org/10.1016/j.jvir.2025.10.026

#InterventionalRadiology #IO #RCC #IGTA #RenalTumor #TumorBoard #MedEd  

TARE Breast Cancer Liver Mets

Transarterial Microembolization Therapy for Chronic First Metatarsophalangeal Joint Pain

🔍 **Clinical Question:**  

To evaluate the association between tumor-absorbed dose (TAD) relative to response and survival among patients with breast cancer liver metastasis (BCLM) treated with yttrium-90 (90Y) transarterial radioembolization (TARE).

💡 **Key Insight:**  

Overall survival was found to be significantly improved in responders compared with nonresponders among patients with breast cancer liver metastasis treated with yttrium-90 glass microspheres.

Tumor-absorbed dose showed a significant survival advantage above 145 Gy.

No significant difference was found in tumor-absorbed dose between responders and nonresponders.

👉 **Why it matters:**  

Metabolic response predicts survival, dose thresholds matter, and higher dose alone does not guarantee response. These results highlight the need for personalized dosimetry in 90Y therapy for breast cancer liver metastases. 

➡️ **Full Article:** 

https://doi.org/10.1016/j.jvir.2025.08.045

#InterventionalRadiology #IO #TARE #SIRT #Y90 #BreastCancer #TumorBoard #MedEd  

TAME for Chronic Toe Pain

 Transarterial Microembolization Therapy for Chronic First Metatarsophalangeal Joint Pain

🔍 **Clinical Question:**  

To evaluate the feasibility, safety, and preliminary effectiveness of transarterial microembolization (TAME) for refractory first metatarsophalangeal joint (MTPJ) pain in patients with inflammatory arthritis, gout, or osteoarthritis.

💡 **Key Insight:**  

Transarterial microembolization (TAME) targets hypervascularity and pathological nerve ingrowth, key contributors to chronic pain, by selectively embolizing feeder arteries, thereby disrupting pain pathways and reducing inflammatory mediators.

TAME demonstrated significant reduction in pain and weekly analgesic use, establishing it as a safe and effective minimally invasive alternative for managing chronic metatarsophalangeal joint pain refractory to conventional treatments.

👉 **Why it matters:**  

The favorable safety profile and effectiveness of TAME suggest potential applications in other small joint pathologies.

➡️ **Full Article:** 

https://doi.org/10.1016/j.jvir.2025.08.047

#InterventionalRadiology #MSKIR #Pain #OA #MedEd