ABSTRACT
PURPOSE: To state the Society of Interventional Radiology's position on the use of image-guided thermal ablation for the treatment of early stage non-small cell lung cancer, recurrent lung cancer, and metastatic disease to the lung. MATERIALS AND METHODS: A multidisciplinary writing group, with expertise in treating lung cancer, conducted a comprehensive literature search to identify studies on the topic of interest. Recommendations were drafted and graded according to the updated SIR evidence grading system. A modified Delphi technique was used to achieve consensus agreement on the recommendation statements. RESULTS: A total of 63 studies, including existing systematic reviews and meta-analysis, retrospective cohort studies, and single-arm trials were identified. The expert writing group developed and agreed on 7 recommendations on the use of image-guided thermal ablation in the lung. CONCLUSION: SIR considers image-guided thermal ablation to be an acceptable treatment option for patients with inoperable Stage I NSCLC, those with recurrent NSCLC, as well as patients with metastatic lung disease.
Subject(s)
Carcinoma, Non-Small-Cell Lung , Catheter Ablation , Lung Neoplasms , Canada , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/surgery , Humans , Lung , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Neoplasm Recurrence, Local , Radiology, Interventional , Retrospective StudiesABSTRACT
PURPOSE: To provide guidance on quality improvement thresholds for outcomes and complications of image-guided thermal ablation for the treatment of early stage non-small cell lung cancer, recurrent lung cancer, and metastatic disease. MATERIALS AND METHODS: A multidisciplinary writing group conducted a comprehensive literature search to identify studies on the topic of interest. Data were extracted from relevant studies and thresholds were derived from a calculation of 2 standard deviations from the weighted mean of each outcome. A modified Delphi technique was used to achieve consensus agreement on the thresholds. RESULTS: Data from 29 studies, including systematic reviews and meta-analyses, retrospective cohort studies, and single-arm trials were extracted for calculation of the thresholds. The expert writing group agreed on thresholds for local control, overall survival and adverse events associated with image-guided thermal ablation. CONCLUSION: SIR recommends utilizing the indicator thresholds to review and assess the efficacy of ongoing quality improvement programs. When performance falls above or below specific thresholds, consideration of a review of policies and procedures to assess for potential causes, and to implement changes in practices, may be warranted.
Subject(s)
Carcinoma, Non-Small-Cell Lung , Catheter Ablation , Lung Neoplasms , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/surgery , Humans , Lung , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Neoplasm Recurrence, Local , Quality Improvement , Radiology, Interventional , Retrospective StudiesSubject(s)
Biopsy, Needle/standards , Image-Guided Biopsy/standards , Quality Improvement/standards , Quality Indicators, Health Care/standards , Radiology, Interventional/standards , Age Factors , Biopsy, Needle/adverse effects , Consensus , Humans , Image-Guided Biopsy/adverse effects , Patient Safety/standards , Predictive Value of Tests , Risk FactorsSubject(s)
Infectious Disease Transmission, Patient-to-Professional/prevention & control , Inhalation Exposure/prevention & control , Masks/supply & distribution , Occupational Exposure/prevention & control , Occupational Health , Respiratory Protective Devices/supply & distribution , Respiratory Tract Infections/therapy , Aerosols , Humans , Inhalation Exposure/adverse effects , Occupational Exposure/adverse effects , Particle Size , Respiratory Tract Infections/transmission , Respiratory Tract Infections/virology , Risk Assessment , Risk FactorsSubject(s)
Arteries , Clinical Trials as Topic/standards , Embolization, Therapeutic/standards , Lower Urinary Tract Symptoms/therapy , Prostate/blood supply , Prostatic Hyperplasia/therapy , Radiography, Interventional/standards , Research Design/standards , Terminology as Topic , Arteries/diagnostic imaging , Consensus , Embolization, Therapeutic/adverse effects , Humans , Lower Urinary Tract Symptoms/diagnostic imaging , Lower Urinary Tract Symptoms/physiopathology , Male , Practice Patterns, Physicians'/standards , Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/physiopathology , Radiography, Interventional/adverse effects , Treatment OutcomeSubject(s)
Carcinoma, Renal Cell/surgery , Cryosurgery/standards , Kidney Neoplasms/surgery , Microwaves/therapeutic use , Radiofrequency Ablation/standards , Radiography, Interventional/standards , Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/secondary , Clinical Decision-Making , Consensus , Cryosurgery/adverse effects , Humans , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/pathology , Microwaves/adverse effects , Patient Selection , Radiofrequency Ablation/adverse effects , Radiography, Interventional/adverse effects , Risk Assessment , Risk Factors , Treatment Outcome , Tumor BurdenSubject(s)
Brain Ischemia/therapy , Education, Medical, Graduate , Radiography, Interventional/standards , Radiologists/education , Radiologists/standards , Radiology, Interventional/education , Radiology, Interventional/standards , Stroke/therapy , Brain Ischemia/diagnostic imaging , Brain Ischemia/physiopathology , Certification/standards , Clinical Competence/standards , Consensus , Curriculum , Delphi Technique , Education, Medical, Graduate/standards , Humans , Societies, Medical , Stroke/diagnostic imaging , Stroke/physiopathology , Treatment OutcomeABSTRACT
PURPOSE: To perform a systematic review and meta-analysis assessing patency outcomes following drug-coated balloon angioplasty (DCBA) in hemodialysis circuits. MATERIALS AND METHODS: MEDLINE and EMBASE systematic searches were performed from inception to November 2018 to identify comparative studies assessing DCBA vs plain old balloon angioplasty (POBA) in hemodialysis circuits. Abstract selection, data extraction, and quality assessment were performed by 2 independent reviewers. Primary outcome was loss of target lesion patency at 3, 6, 12, and 24 months for autogenous arteriovenous fistula (AVF), prosthetic arteriovenous graft (AVG), and hemodialysis-related central venous stenosis. RESULTS: Twelve studies comprising 908 patients were included. There was a significant improvement in patency among AVF after DCBA vs POBA at 3, 6, 12, and 24 months (odds ratio 0.58 [95% confidence interval, 0.36-0.94]; odds ratio 0.40 [95% confidence interval 0.23-0.70]; odds ratio 0.39 [95% confidence interval, 0.25-0.61]; and odds ratio 0.20 [95% confidence interval, 0.07-0.62]). This benefit persisted on subgroup analysis of randomized controlled trials (RCTs) only. Meta-analysis of results specific to AVG could not be performed, as only 1 RCT was identified that favored DCBA. Hemodialysis-associated central vein stenosis did not demonstrate a significant difference in patency rates between DCBA and POBA on meta-analysis. Twelve-month mortality and same-day complication rates did not differ between arms. CONCLUSIONS: Significant improvement in patency was identified with DCBA in AVF at 3, 6, 12, and 24 months. A single comparative study identified benefit of DCBA use in the AVG group. No significant benefit was identified with DCBA for central stenosis.
Subject(s)
Angioplasty, Balloon/instrumentation , Arteriovenous Shunt, Surgical/adverse effects , Blood Vessel Prosthesis Implantation/adverse effects , Cardiovascular Agents/administration & dosage , Coated Materials, Biocompatible , Graft Occlusion, Vascular/therapy , Renal Dialysis , Vascular Access Devices , Aged , Aged, 80 and over , Angioplasty, Balloon/adverse effects , Arteriovenous Shunt, Surgical/mortality , Blood Vessel Prosthesis Implantation/mortality , Cardiovascular Agents/adverse effects , Female , Graft Occlusion, Vascular/etiology , Graft Occlusion, Vascular/mortality , Graft Occlusion, Vascular/physiopathology , Humans , Male , Middle Aged , Recurrence , Risk Factors , Time Factors , Treatment Outcome , Vascular PatencySubject(s)
Radiography, Interventional/standards , Research Design/standards , Terminology as Topic , Thorax/blood supply , Vascular Diseases/therapy , Veins , Consensus , Constriction, Pathologic , Electronic Health Records/standards , Humans , Phlebography/standards , Predictive Value of Tests , Radiography, Interventional/methods , Risk Factors , Treatment Outcome , Vascular Diseases/diagnostic imaging , Vascular Diseases/etiology , Vascular Diseases/physiopathology , Vascular Patency , Veins/diagnostic imaging , Veins/physiopathologySubject(s)
Angioplasty/methods , Mesenteric Ischemia/surgery , Quality Improvement , Stents , Chronic Disease , Humans , Treatment OutcomeABSTRACT
PURPOSE: We aimed to determine the publication rate and factors predictive of publication of oral presentations at the annual meetings of the Cardiovascular and Interventional Radiology Society of Europe (CIRSE) and the Society of Interventional Radiology (SIR). METHODS: Keywords and authors from oral presentation abstracts at the 2012 CIRSE and SIR annual meetings were used to search PubMed and GoogleScholar for subsequent publication. Logistic regression was performed to identify whether number of authors, country of origin, subject category, methodology, study type, and/or study results were predictive of publication. RESULTS: A total of 421 abstracts (CIRSE-126, SIR-295) met the inclusion criteria. The overall publication rate across both conferences was 44.9%. Time from conference presentation to publication was 15±8.9 months for CIRSE and 16.3±8.8 months for SIR (P > 0.05), with a combined time interval of 15.9±8.8 months for both. The median impact factor of published abstracts was 2.075 (interquartile range, 2.075-2.775) for CIRSE and 2.093 (2.075-2.856) for SIR (P > 0.05). The most common country of origin for published abstracts was Germany (27.1%) at CIRSE and the United States (69%) at SIR. Logistic regression did not identify factors that were predictive of future publication. CONCLUSION: Publication rates were similar for CIRSE and SIR. Factors such as country of origin, topic of study and study results were not predictive of future publication. Authors should not be discouraged from submitting their work to journals based on these factors.
ABSTRACT
PURPOSE: To develop a new adverse event (AE) classification for the interventional radiology (IR) procedures and evaluate its clinical, research, and educational value compared with the existing Society of Interventional Radiology (SIR) classification via an SIR member survey. MATERIALS AND METHODS: A new AE classification was developed by members of the Standards of Practice Committee of the SIR. Subsequently, a survey was created by a group of 18 members from the SIR Standards of Practice Committee and Service Lines. Twelve clinical AE case scenarios were generated that encompassed a broad spectrum of IR procedures and potential AEs. Survey questions were designed to evaluate the following domains: educational and research values, accountability for intraprocedural challenges, consistency of AE reporting, unambiguity, and potential for incorporation into existing quality-assurance framework. For each AE scenario, the survey participants were instructed to answer questions about the proposed and existing SIR classifications. SIR members were invited via online survey links, and 68 members participated among 140 surveyed. Answers on new and existing classifications were evaluated and compared statistically. Overall comparison between the two surveys was performed by generalized linear modeling. RESULTS: The proposed AE classification received superior evaluations in terms of consistency of reporting (P < .05) and potential for incorporation into existing quality-assurance framework (P < .05). Respondents gave a higher overall rating to the educational and research value of the new compared with the existing classification (P < .05). CONCLUSIONS: This study proposed an AE classification system that outperformed the existing SIR classification in the studied domains.